Care of the Newborn at Birth
Newborn Identification and Registration • It is important to avoid the babies being handed to the wrong parents • Also to avoid kidnapping of babies
Identification Band • It is a plastic bracelet with permanent locks that require cutting to be removed • It has the same number as the mother’s hospital number, the mother’s full name, date & time of infant’s birth • 2 bands should always be used
Birth Registration • The physician or nurse-midwife who delivered the infant must be certain that a birth registration is filed to the corresponding agency where the infant was born • It contains the correct infant’s name, mother’s name, father’s name, birthdate and place of birth.
Footprinting • It should be taken with care because it will be part of the child’s permanent record
Birth Record Documentation • Be certain that the birth record lists the ff: – Time of birth – Time the infant breathed – Whether respiration is spontaneous or aided – Apgar score at 1 and 5 minutes of life – Whether eye prophylaxis was given – Whether vitamin K was administered
Birth Record Documentation – General condition of the infant – Number of vessels in the umbilical cord – Whether cultures were taken – Whether the infant voided and passed a stool
Apgar Scale Sign
0
1
2
Heart rate
Absent
Slow (<100)
>100
Respiratory effort
Absent
Slow, irregular, weak cry
Good, strong cry
Muscle tone
Flaccid
Some flexion of extremities
Well flexed
Grimace
Cough or sneeze
Grimace
Cry and withdrawal of foot
Body normal pigment, extremities blue
Normal skin coloring
Reflex Irritability: Response to No response catheter in nostril lap to sole of foot No response Color
Blue, pale
Initial Feeding • May give breastfeeding immediately after birth • If formula feeding will be done, it would be after 2-4 hours after birth • Fed as often as every 2 hours
Metabolic Screening Test • Every infant must be screened for phenylketonuria (a disease of defective protein metabolism) and hyperthyroidism • This is a simple blood test in which 3 drops of blood from the heel are dropped onto a special filter paper • The baby should have received milk before the test for it to be accurate
Hepatitis B Vaccination • All newborns received a 1st vaccination against hepatitis B within 12 hours after birth • Second dose: 1 month • Third dose: 6 months
Vitamin K Administration • Newborns are at risk for bleeding disorders during the 1st week of life because their gastrointestinal tract is sterile at birth and unable to produce Vitamin K, necessary for blood coagulation • Vitamin K stimulates the liver to produce factors II, VII, IX and X
• A single dose of 0.5 to 1.0 mg of Vitamin K is administered intramuscularly within the first hour of life