Ce diaporama a bien été signalé.
MITTAL COLLEGE OF NURSING
IMMEDIATE AND ESSENTIAL CARE OF
NEW BORN BABY
SUBJECT :- OBSTETRIC $ GYNECOLOGY
SUBMITTED TO, SUBMITTED BY
MRS SNEHLATA PARASHAR Miss KHUSHBU RAWAT
M.SC LECTURER B.Sc Nursing
(OBG $ GYN) IVth Year
DATE :- 27/03/2019
At end at the class presentation, students will able
1 To explain the introduction and definition of new born.
2 To discuss the characteristic and reflexes of new born.
3 To discuss the immediate care of new born.
4 To discussion the immunization.
5 Assessment of gestational age.
6 To discuss the essential and daily routine care.
7 Explain about the follow up care and general observation
of new born.
8 To explain the grade of neonatal care.
NEW BORN BABY
The healthy new born infant born at
term , between 38-42 weeks ,cries
immediately after birth , establishes
independent rhythmic respiration ,
quickly adapts with extra uterine
New born refers to an infant
in the birth 28 days after
birth , a new born is an infant
with in hours , days or up to a
few weeks from birth.
Characteristics of new born -
1.General measurement –
2. Head measurement-
Shape – round symmetrical , may
have moulding and over riding suture.
Fontanel in size ,shape-
Colour - blue white sclera
Movement - random
Reaction to light - pupils equal in
size ,round and reaction to light.
Tears - absent or occasionally
Eyelids - Oedema present
Reaction to noise – startle reflex
to loud noise
Position – symmetrical
Patency – evidence of hearing
2.patency-Infant are obligatory nose
Sucking and swallowing reflex
1.breast tissue – Nipple
2.shape – almost circular and
3. size – 30-35cm[12-13inches].
1. Rate – 30-60 min
2. Rhythm – shallow ,irregular
3. muscular activity - diaphragmatic
1. Rate - 120-160 min
2.Rhythm – irregular after crying
Rounded ,protruded , bowel sound
audible after 1-2 hours after birth.
1.Apperance – clear ,gelatin,odorless
2.Number vessels at birth-
2.Muscle tone –Flexed
3.fist – often clenched
13.GENITO –URINARY -
Female genitals – usually oedematous
Male genitals – testes palpable each side
Voiding – start by 24 hrs. after delivery ,3-
Number of stool – meconium by 24
Symmetrical , glateal folds even .
16 . SKIN –
Colour – generally pink
Birth mark – may be present
Lenguo – present over shoulder , pinnas
Vernix caseosa – white , cheesy odorless ,
present in creases and folds .
Hair – amount varies
17. TEMPRATURE –
Heat loss – by conduction ,radiation
DOLL ‘S EYE – present
Rooting - present
Sucking /swallowing – present
Gag reflex – present
Grasp - present
Babinski – present
Moro – present
Tonic neck reflex – present
1.Frequancy – variable
2.pitch – moderate , pitch may be
20. BEHAVIOUR –
Responding to handling
.Reacts to environment .
Eating ,sleeping pattern varies in
Check abnormal spinal curvature
Spina bifida occulta ,meningocele
Observed for any mass .
Perianal area examined – anal opening
,anal fissures or any other
The neonate passes urine and
meconium within 24 hrs.
Afterwards for first few days baby
voids 10-15 times and average six
stool per day .
1. Reflexes' of EYE –
1.blinking – infant blink at
sudden appearance of bright
light or any object towards eye .
At birth .
2.Pupillary reaction -
Pupil constrict when bright light falls
3.DOLL’S EYE -
At head is
moved to right
or left ,slowly .
– 3-4 month.
REFLEXES OF NOSE -
nasal passage to
any irritant .
tapping on the
forehead , cause
eye to close
REFLEXE’S OF MOUTH -
1. Rooting –
REFLEX OF EXTERMITIES -
Disappearance – 3
2. BABINSKI –
- 1 yr.
MASS REFLEX’S -
1. MORO’S -
Disappearance – 3-4
2. TONIC NECK
Disappearance - 3-4
Disappearance – 4
Disappearance – 3-4
5.GALANT [ TRUNK
IMMEDIATE CARE OF
Essential care of the normal healthy
neonates can be provided by the mothers
under supervision of nursing personnel or
basic /primary health care providers . About
80percent of the newborn babies should be
kept with their mothers rather than in
separate nursery .
IMMEDIATE BASIC CARE
Maintenance of temperature .
Establishment of open airway and
Identification of new born .
Vitamin k injection .
Initiation of breast feeding .
Immediately dry the infant under a radiant warmer .
Skin to skin contact with mother .
Keep neonate head and extremities covered .
Rooming in [the baby should not be separated from
Bathing is avoided to prevent hypothermia and infection .
Temperature should be recorded and observation .
Avoided to unnecessary exposure and undressing baby.
[majority of babies cry at birth and take
spontaneous respiration ]
When the head is delivered birth attendant
immediately suction the secretions ,wipe
mucus from face and mouth and nose .
Suction the mouth and nose by using
bulb syringe .
Keep head slightly lower than the body
Position the baby on their backs or
tilted to the side ,but not on their
Importance of suctioning ;
As the foetal chest passes through the birth
canal it is compressed ,squeezing excess
fluid out of the baby taking its first breath.
After several seconds in this ‘’partly
delivered ‘’ position ,fluid can be seen
streaming out of the baby’s nose and mouth
Series of action ,used to assist newborn
babies who have difficulty with making
the physiological ‘transition ‘ from the
intrauterine to extra uterine life .
Neonatal resuscitation is a set of
intervention used to assist the airway,
breathing ,and circulation of a
It means a to support a maintain
breathing ,circulation ,for an neonate
.who has stop breathing or whose heart
Initial steps of resuscitation -
Receiving the newborn baby in a prewarmed
towel and placing the baby on the preheated
radiant warmer .
Positioning the baby on the back with the
neck slightly extended .[sniffing position]
Providing tactile stimulation – [rubbing the infant
back , slapping the sole of the foot , flicking the
1.Bag mask ventilation
2.Mouth to mouth
3.Mouth to mask
CHEST COMPRESSION -
1.two finger method.
2. two thumb encircling hand .
15;2 =2 RESCUE
30;2 = 1 RESCUE
APGAR SCORING -
A –Activity /muscle tone
P-Pulse / heart rate
G-Grimace /reflex response
A-Appearance /skin colour
0 points – flaccid /floppy limp
1 points – some flexion of extremities
2 point – active body movement
P - Pulse rate
0 points –absent
1 points – below [100 beats /min.]
2 points –more than [100 beats /min.]
0 points –no response
1 points –facial movement /grimace with
2 points – cry
0 points –blue ,pale ,bluish -gray
1 points –body pink ,but extremities blue
2 points – complete pink
0 points –absent
1 points –irregular ,slow cry
2 points –good , strong cry
TOTAL SCORE = 10
no depression – 7-10
Mild depression – 4-6
Severe depression – 0-3
Apgar score quick test performed on a baby at 1 -5
min. After birth .
The 1 min. Score determine how well the baby
tolerate the birthing process .
The 5 min. Score tells the health care provider
how well the baby is doing outside’s the mother
In rare case ,the test will be done 10 min. After
New born identification before a baby
leaves the delivery area , identification
bracelets with identical numbers are
placed on the baby and mother . Babies
often have two ,on the wrist and ankle.
VITAMIN – K
Vit.k prevent neonatal haemorrhage
during first few days of life before
infant is able to produce vit.k
Term infant [ 1mg ] –IM
Preterm infant [ 0.5 mg ] – IM
ALTERNATIVE ROUTE -
ORAL DOSE - 2 mg orally at birth
REPEAT DOSE – [ 2 mg ] at 3-5 days
and at 4-6 weeks of age .
INITIATION OF BREAST
Babies can be breast – feed as soon as the
airway is cleared and they are breathing
Breast feeding is the most effective way to
provide baby with a caring environment and
complete nutrition .
The first breast feeding should be with in 30
min. Of normal delivery and 4 hrs.in lscs .
Breast milk and colostrums prevent neonate
from anaemia and many nutritional
deficiency disease .
Breast milk contains high lactose , low
protein , enhance growth of lactobacillus
which inhibit growth of E.Coli .
Breast milk reducing the risk of breast and
uterine cancer in mother .
ASSESSMENT OF GESTATIONAL AGE AT
Assessment of gestational age is mandatory
for all neonates for further management . Last
menstrual period is important clue for
calculation of gestational age .
Using a new Ballard scale ,can be use with
neonate born between 20-44 week
The Ballard scale is a commonly used
technique of gestational age assessment .
These criteria are divided into two type
physical and neuromuscular maturity .
The new Ballard score is a set of procedures
developed by Dr. JEANNE L
Score ranged from
5 – 50 26 -44
Score starts with
-10 to 50 20 -
Starts with - 1
Optimal age for
between 30 and
42 hrs. Of age .
Eyes ; not included
Birth to 96 hrs.
As maturation progresses –
increasing passive flexor tone.
Increasing passive flexor tone –
centripetal direction .
Lower extremities slightly ahead of
upper extremities .