Labor, birth and the immediate postnatal period are the most critical for newborn and maternal survival.
Physiologic Respiratory and Circulatory changes at Birth:
When the baby is delivered, the umbilical cord is cut and clamped near the navel. This ends the baby’s dependence on the placenta for oxygen and nutrition. As the baby takes its first breath, air moves into the lungs. Before birth, the lungs are not used to exchange oxygen and carbon dioxide, and need less blood supply. The fetal circulation sends most of the blood supply away from the lungs through special connections in the heart and the large blood vessels. When a baby begins to breathe air at birth, the change in pressure in the lungs helps close the fetal connections and redirect the blood flow. Now blood is pumped to the lungs to help with the exchange of oxygen and carbon dioxide. Some babies have excess amounts of fluid in their lungs. Stimulating the baby to cry by massage and stroking the skin can help bring the fluid up where it can be suctioned from the nose and mouth.
Newborns who do not start breathing on their own by one minute after birth should receive positive pressure ventilation with room air by a self-inflating bag and mask.
Providing Appropriate Warmth to Newborn:
A newborn baby is wet from the amniotic fluid and can easily become cold. Drying the baby and using warm blankets and heat lamps can help prevent heat loss. Drying the baby with warm towels or cloths, while being placed on the mother’s abdomen or in her arms helps in mother-child skin-to-skin contact which is important to maintain the baby’s temperature, encourage bonding and expose the baby to the mother’s skin bacteria.
Checking Apgar Score:
Health assessments of the new baby begin immediately. One of the first checks is the Apgar test.
The doctor or midwife and nurses will evaluate the following signs and assign a point value:
Physical Examination: A brief, physical examination is performed to check for obvious signs that the baby is healthy. check for any birth deformities. Also check rectal temperature.
Initiation Of Breast feeding:Early initiation of breastfeeding, and exclusive breastfeeding is recommended. First time mothers may need some help to start breast feeding the baby. Also nipple stimulation by the baby may influence uterine contractions and postpartum blood loss which is an addition advantage for the mother.
Eye Care:
It is part of the routine care of the newborn to give prophylactic eye treatment against gonorrhea conjunctivitis or opthalmia neonatorum. Erythromycin or tetracycline Opthalmic Ointments are the ones commonly used now a days for eye prophylaxis because they do not cause eye irritation and are more effective against Chlamydial conjunctivitis.
Vitamin K administration:
The newborn has a sterile intestine at birth, hence, the newborn does not possess the intestinal bacteria that manufactures vitamin K which is necessary for the formation of clotting factors. This makes the newborn prone to bleeding. As a preventive measure, 0.5mg (preterm) and 1 mg (full term) Vitamin K is injected IM in the newborn’s thigh muscle.
Care of the Umbilical Cord:
The cord is clamped and cut approximately within 30 seconds after birth. The cord and the area around it are cleansed with antiseptic solution. The manner of cord care depends on hospital protocol. What is important is that the principles are followed. Cord clamp maybe removed after 48 hours when the cord has dried. The cord stump usually dries and fall within 7 to 10 days leaving a granulating area that heals on the next 7 to 10 days.
Giving a Bath:
Once a baby’s temperature has stabilized, the first bath can be given.
Physiologic Respiratory and Circulatory changes at Birth:
When the baby is delivered, the umbilical cord is cut and clamped near the navel. This ends the baby’s dependence on the placenta for oxygen and nutrition. As the baby takes its first breath, air moves into the lungs. Before birth, the lungs are not used to exchange oxygen and carbon dioxide, and need less blood supply. The fetal circulation sends most of the blood supply away from the lungs through special connections in the heart and the large blood vessels. When a baby begins to breathe air at birth, the change in pressure in the lungs helps close the fetal connections and redirect the blood flow. Now blood is pumped to the lungs to help with the exchange of oxygen and carbon dioxide. Some babies have excess amounts of fluid in their lungs. Stimulating the baby to cry by massage and stroking the skin can help bring the fluid up where it can be suctioned from the nose and mouth.
Newborns who do not start breathing on their own by one minute after birth should receive positive pressure ventilation with room air by a self-inflating bag and mask.
Providing Appropriate Warmth to Newborn:
A newborn baby is wet from the amniotic fluid and can easily become cold. Drying the baby and using warm blankets and heat lamps can help prevent heat loss. Drying the baby with warm towels or cloths, while being placed on the mother’s abdomen or in her arms helps in mother-child skin-to-skin contact which is important to maintain the baby’s temperature, encourage bonding and expose the baby to the mother’s skin bacteria.
Checking Apgar Score:
Health assessments of the new baby begin immediately. One of the first checks is the Apgar test.
The doctor or midwife and nurses will evaluate the following signs and assign a point value:
- Activity; muscle tone
- Pulse rate
- Grimace; reflex irritability
- Appearance; skin color
- Respiration
Physical Examination: A brief, physical examination is performed to check for obvious signs that the baby is healthy. check for any birth deformities. Also check rectal temperature.
Initiation Of Breast feeding:Early initiation of breastfeeding, and exclusive breastfeeding is recommended. First time mothers may need some help to start breast feeding the baby. Also nipple stimulation by the baby may influence uterine contractions and postpartum blood loss which is an addition advantage for the mother.
Eye Care:
It is part of the routine care of the newborn to give prophylactic eye treatment against gonorrhea conjunctivitis or opthalmia neonatorum. Erythromycin or tetracycline Opthalmic Ointments are the ones commonly used now a days for eye prophylaxis because they do not cause eye irritation and are more effective against Chlamydial conjunctivitis.
Vitamin K administration:
The newborn has a sterile intestine at birth, hence, the newborn does not possess the intestinal bacteria that manufactures vitamin K which is necessary for the formation of clotting factors. This makes the newborn prone to bleeding. As a preventive measure, 0.5mg (preterm) and 1 mg (full term) Vitamin K is injected IM in the newborn’s thigh muscle.
Care of the Umbilical Cord:
The cord is clamped and cut approximately within 30 seconds after birth. The cord and the area around it are cleansed with antiseptic solution. The manner of cord care depends on hospital protocol. What is important is that the principles are followed. Cord clamp maybe removed after 48 hours when the cord has dried. The cord stump usually dries and fall within 7 to 10 days leaving a granulating area that heals on the next 7 to 10 days.
Giving a Bath:
Once a baby’s temperature has stabilized, the first bath can be given.
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