CARE OF THE NEWBORN

 CARE OF THE NEWBORN

A. FACTORS AIDING IN THE ETABLISHMENT OF BREATHING [20%]

1. Compression of the head

During labor as the baby passes through the birth canal, the negotiation process leads to the Head making it to mould. This therefore leads to the stimulation of the hypothalamus to initiate breathing.

2. Compression of the chest

As the baby try to pass through the birth canal, it's chest gets compressed leading to removal of fluids in the lungs to help lungs to expand.

3. Hypoxia

Lack of enough oxygen at birth makes the baby attempt to breath

4. Hypercapnia

Increased carbon dioxide in the baby makes it attempt to breath in and out to inhale oxygen and exhale carbon dioxide.

5. Hands if the birth attended

The hands of the attended when drying the baby helps stimulate respirations.

B. DIFFERENCES BETWEEN CAPUT SUCCEDANEUM AND CEPHALOHEMATOMA [30%]

1. Onset

Caput succedeneum is present at birth while cephalo hematoma occurs after 24hours

2. Suture lines

Caput succedeneum may cross the suture lines while caphalo hematoma does not cross the suture lines.

3. Disappearance

Caput succedeneum disappears within 36 hours while cephalo hematoma may persist for weeks.

4. GROWTH

Caput succedeneum tends to grow less while cephalo hematoma tends to grow big day by day.

5. DEFINITION

Caput succedaneum is the accumulation of fluids under the skin while cephalo hematoma is the accumulation of blood under the periosteum.

C. IMMEDIATE MANAGEMENT OF THE NEWBORN [30%]

AIMS

To initiate and sustain respirations

To prevent hypothermia

To prevent infections

To prevent Hypoglycemia

1. RESPIRATORY EFFORT

Immediately when the head is born, wipe the mouth and nose to clear the airways

Place the baby on the mother's naked abdomen for bonding and note down the time of birth.

If any secretions sanction using a penguin sucker starting from the mouth 3-5 cm and then nose 2-3 cm.

2. CLAMP THE CORD

Then measure 2.5 cm from the baby and clamp with the cord and cut. Rub the the baby's feet for stimulation to help it cry and take a deep breath.

3. PREVENTION OF HYPOTHERMIA

Immediately the baby is born, wipe the baby dry with a clean towel to prevent heat loss by evaporation.

Then cover the baby with warm clothes for warm

Transfer the baby to prewarmed resuscitaire for warmful.

4. APGAR SCORE

I will use this tool to score or assess the condition of the baby.

A for Appearance or color, P for pulse rate or heart rate, G for Grimace, A for Activity and R for Respirations.

A good score should be 8 to 10 which signal good adaptability to extra uterine life

I will use APGAR SCORE at 1 minute, 5 minutes and 10 minutes.

5. PREVENTION OF INFECTIONS

Use sterile gloves when delivering to prevent infections

Use sterilized forceps and scissors for clamping and cutting the cord respectively.

Isolation of the baby from babies with URTIs to prevent cross infections.

6. PREVENTION OF HYPOGLYCEMIA

Make sure mother initiate breastfeeding within an hour

Explain the importance of breastfeeding the baby to the mother

Breastfeeding frequently and on demand

Exclusive breastfeeding

D. IEC(INFORMATION, EDUCATION AND COMMUNICATION) [20%]

1. HYGIENE

Cord care to prevent omphalitis or tetanus,

baby bath to promote good hygiene

2. EXCLUSIVE BREASTFEEDING

Emphasize on exclusive breastfeeding to promote good nutrition

Breastfeeding frequently and on demand

3. FOLLOW UP CARE

Advise the mother to take the baby to uner five clinic for immunizations

Explain the importance of vaccines

4. DANGER SIGNS

Tell mother to note danger signs in the baby e.g. fever, cord bleeding, headache,refusal to feed.

Danger signs in the mother

5. NUTRITION

Advise the mother to eat balanced diet for quick healing

Food rich in proteins for replacement of worn out tissues.