- Dry the baby with a clean cloth.
- While drying observe breathing, muscle tone, and colour. If all normal remove the wet cloth, wrap baby in a dry one and give to
mother to initiate breastfeeding. - Cover baby well to prevent over-cooling.
- If not breathing, initiate resuscitation as shown in the chart below.
For babies not requiring resuscitation do the following:
- Initiate breastfeeding within an hour of birth.
- Wrap in dry linen.
- Weigh the baby.
- Keep warm next to mother (skin to skin is the best way of keeping baby warm).
- Instill tetracycline eye ointment within 1 hr in both eyes and given only once.
- Examine carefully to exclude congenital malformation.
Postnatal Care of the Normal Newborn
The infant should join the mother as soon as possible. The following are important:
- Breastfeeding should start within the first hour of life to ensure good positioning and attachment
- Encourage exclusive breastfeeding (no water).
- Babies should be fed on demand at least 8–12 times/24 hours.
- HIV positive mothers who have chosen not to breastfeed should be encouraged to cuddle their babies.
- Observe cord for bleeding and keep it clean.
- Give OPV
0
and BCG. - On discharge: Counsel the mother on cord care and breastfeeding at home and tell her to bring the baby back immediately if she notices a problem, e.g, poor feeding or jaundice.
What to Teach the Mother
- All expectant mothers should be taught about cord care.
- They need to know that babies often acquire infection through the cord.
- If they deliver in the community, cutting of the cord with clean instrument is needed.
- After delivery harmful practices need to be discouraged.
- Mothers should keep the cord dry until it drops off.