GENERAL CARE OF NEWBORN AFTER DELIVERY

Provide the following care up to the time of discharge:

TYPE OF CARE
AND MONITORING
NOTES
Keep baby with mother

  • In same bed or within
    easy reach
  • Under mosquito net
If baby is in a cot, ensure baby
is dressed or well-wrapped:
covered with blanket, head is
covered and the feet and hands
have socks

Ensure room is warm

(>25°C) and has no cold
breeze (draughts)
Do NOT put baby in direct
sun or on any cold surface or
directly in the line of a cold
breeze
Advise/teach mother
how to:

  • Keep the baby warm
  • Give cord care
  • Ensure hygiene
  • If mother is unable to
    take care of baby, provide
    required care or teach her
    next of kin
  • Wash hands before and after
    handling baby
  • Do not bath baby for up
    24 hours

Support exclusive
breastfeeding

on demand, day and
night, whenever baby
wants

If breastfeeding difficult:

  • Help mother to position and
    attach the baby

If breastfeeding not possible:

  • Advise on safe replacement
    feeding (AFASS)

Ask mother and
companion to:

  • Watch the baby
  • Report breastfeeding
    or breathing problems,
    cold feet, bleeding
    from cord or other
    bleeding


Check every baby at 4
and 8 hours then daily
for:

  • Warm feet
  • Normal pink colour
  • Feeding
  • Breathing problems

If feet cold-this is a sign of
hypothermia:

  • Teach mother how to
    rewarm the baby; apply one
    to two layers of clothes more
    than adults, and use of hats/
    caps
  • Reassess in 1 hour; if
    no improvement, take
    temperature and manage
    accordingly


If breathing problem

  • Assess and manage
    accordingly

If cord tie loose/cord bleeding:

  • Retie cord
  • If bleeding persists, refer
    urgently
Check any baby with
warning signs at 2, 4, 8,
and 12 hours:

  • Listen for grunting
  • Look for chest in
    drawing
  • Count breaths/minute
  • Measure temperature
  • Observe breastfeeding

Refer urgently if:

  • Breathing problem worsens
    or persists for >8 hours
  • Temperature <36.5°C
    persists or decreases
  • Not able to feed at 8 hours
Give prescribed
treatments according to
dosage schedule
If referring the baby, write
treatments given, when, and
why
Assess breastfeeding
in every baby before
planning discharge
Do not discharge if baby is not
feeding well
Do not discharge baby < 24 hours old
Advise mother:

  • When to seek care
  • When to return if
    danger signs appear
    (refusal to feed,
    excessive crying,
    bleeding from the cord
    stump, fever, bulging
    fontanel, abdominal
    distension, grunting
    respiration)
Do NOT plan early discharge if:

  • Baby small (LBW or
    preterm)
  • Not feeding well
Give BCG and polio 0
before discharge
Counsel mother on next
routine check in 3-7 days and
next immunization in 6 weeks