1. Immediate and thorough drying
Time
Band: Within 1st 30 seconds: Immediate Thorough Drying
a.
Call out the time of birth
b.
Dry the newborn thoroughly for at least 30 seconds
–
Wipe the eyes, face, head, front and back, arms and legs
c.
Remove the wet cloth
d.
Do a quick check of breathing while drying
Notes: During the 1st second:
·
Do not ventilate unless the baby is floppy/limp and not breathing
·
Do not suction unless the mouth/nose are blocked with secretions or other material
Notes:
·
Do not wipe off
vernix
·
Do not bathe the
newborn
·
Do not do
footprinting
·
No slapping
·
No hanging upside
- down
·
No squeezing of chest
2. Early skin-to-skin contact
If newborn is breathing or crying:
a. Position the newborn prone on the mother’s abdomen
or chest
b. Cover the newborn’s back with a dry blanket
c. Cover the newborn’s head with a bonnet
Notes:
·
Avoid any
manipulation, e.g. routine suctioning
that may cause trauma or infection
·
Place
identification band on ankle (not wrist)
·
Skin to skin
contact is doable even for cesarean
section newborns
3. Properly timed cord clamping
a. Remove the first set of gloves
b. After the umbilical pulsations have stopped, clamp
the cord using a sterile plastic clamp or tie at 2 cm from the umbilical base
c. Clamp again at 5 cm from the base
d.
Cut the cord close to the plastic clamp
Notes:
·
Do not milk the cord towards the baby
·
After the 1st clamp, you may “strip” the cord of blood before applying the 2nd clamp
·
Cut the cord close to the plastic clamp so that
·
there is no need for a 2nd “trim”
·
Do not apply any substance onto the cord
4. Non-separation of the newborn and mother for early
initiation of breastfeeding
a. Leave the newborn in skin-to-skin contact
b. Observe for feeding cues, including tonguing, licking,
rooting
c. Point these out to the mother and encourage her to
nudge the newborn towards the breast
d. Counsel on positioning
·
Newborn’s neck is
not flexed nor twisted
·
Newborn is facing
the breast
·
Newborn’s body is
close to mother’s body
·
Newborn’s whole
body is supported
5. Counsel on attachment and suckling
·
Mouth wide open
·
Lower lip turned
outwards
·
Baby’s chin
touching breast
·
Suckling is slow,
deep with some pauses
Notes:
·
Minimize handling
by health workers
·
Do not give sugar
water, formula or other prelacteals
·
Do not give
bottles or pacifiers
·
Do not throw away
colostrum
·
Weighing,
bathing, eye care, examinations, injections (hepatitis B, BCG) should be done after
the first full breastfeed is completed
·
Weighing,
bathing, eye care, examinations, injections should be done after the first full
breastfeed is completed
·
Postpone washing
until at least 6 hours
