"Routine Newborn Care: Expert Tips & Best Practices for a Healthy Baby" 

Care at Birth: Ensure proper newborn care at birth, which is crucial for a baby’s health and well-being. Here’s what needs to be in place:

1.Personnel & Equipment

• Every delivery room must have one healthcare provider (doctor or nurse) trained in neonatal resuscitation, regardless of the baby's risk level. Having someone “on call” isn’t enough1,4.

•  If a high-risk birth is expected, two healthcare professionals should be present to manage the newborn. For multiple births, each baby requires a separate resuscitation team2,5

• The resuscitation station should be set up inside the delivery room. A designated healthcare provider should check its readiness before birth3

2.Standard Hygiene & Aseptic Measures: To prevent infections, medical staff should follow universal precautions:

• Wear gloves, masks, gowns, and eye protection during resuscitation3,4

• Treat all fluids from the baby and mother as potentially infectious.

• Follow the Five Cleans to prevent newborn sepsis1,5:

  1. Clean hands – Practice proper hand hygiene and wear sterile gloves.

  2. Clean surface – Use a sterile towel to dry and wrap the baby.

  3. Clean blade – Cut the umbilical cord using a sterile blade or scissors.

  4. Clean tie – Clamp the cord with a sterile clamp or tie.

  5. No application on the cord – Keep it dry and avoid applying substances.

3.Preventing Hypothermia

Newborns are highly vulnerable to hypothermia, which can impact their health6. Key steps to prevent this include:

• Maintaining a delivery room temperature of 25°C, free from air drafts.

• Receiving the baby in a pre-warmed, sterile linen sheet.

• Thoroughly dry the baby, including the head and face, and remove any wet linens3.

• Encouraging skin-to-skin contact (STS) with the mother immediately after birth to maintain body temperature, support early breastfeeding, and reduce maternal bleeding1,7.

• Ensuring the baby wears caps and socks for extra warmth.

4.Delayed Umbilical Cord Clamping:

• The umbilical cord should be clamped 1-2 minutes after birth to allow additional blood transfer from the placenta3,6.

• Benefits of delayed clamping:

  • In full-term babies: Improves iron levels and reduces anemia at 2-6 months1,5.

  • In preterm infants: Lowers the risk of intraventricular hemorrhage (IVH) and other complications2,8.

5.Cleaning & Cord Care:

• Dry and clean the baby with a soft, sterile cloth, wiping away blood and meconium without removing the protective vernix caseosa (natural skin barrier) 3,4.

• Clamp the umbilical cord 2-3 cm away from the abdomen with a sterile clamp, thread, or rubber band. The stump should be monitored every 15-30 minutes for signs of oozing or infection1,5.

6.Newborn Identification & First Assessment

• Identity band: Every baby should have a band with the mother’s name, hospital ID, gender, and birth weight2.

• Weighing the baby: After stabilization, weigh the baby using an electronic scale with 10 g sensitivity to ensure accuracy.

• First examination: Conduct a thorough head-to-toe assessment, checking for birth abnormalities and ensuring the anal opening is patent6.

7.Early Breastfeeding

• Breastfeeding should begin within one hour of birth. Healthcare providers should actively assist mothers, especially first-time moms1,9.

• Proactive support is key to successful breastfeeding. Lactation consultants or nurses can help increase breastfeeding success rates2,5.

8.Vitamin K Administration:

• All newborns should receive Vitamin K to prevent bleeding disorders3:

  • 0.5 mg for babies <1000 g

  • 1 mg for babies >1000 g

• If Vitamin K1 is unavailable, Vitamin K3 can be used, but it may cause hemolysis in G6PD-deficient infants1,6.

9.Family Communication & Rooming-In:

• Before leaving the delivery room, healthcare providers should inform the family about4:

  1. Baby’s gender

  2. Birth weight

  3. Overall well-being

• Mothers and families should witness the baby’s gender and ID for verification.

• Newborns should never be separated from their mothers unless medically necessary. Rooming-in encourages early bonding and successful breastfeeding7.

10.Care in the First Few Hours After Birth

Umbilical Cord Care

• Keep the cord stump dry and air-exposed—avoid applying substances.

• Fold the diaper below the stump to prevent contamination.

Massage & Skin Care

• Gentle oil massage is beneficial, particularly for low birth weight babies. Avoid mustard oil, as it can irritate. Coconut oil is a safe and effective choice.

• Minimize cosmetic use—opt for mild, fragrance-free soaps and avoid talcum powder to prevent inhalation risks.

Breastfeeding & Sleep Position

• Support and encourage exclusive breastfeeding, ensuring mothers understand its benefits.

• Newborns should always sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS).

Discouraged Traditional Practices

• Avoid applying kajal/surma in the eyes, oil in the ears, or cow dung on the umbilical stump.

Discharge Readiness & Follow-Up

A healthy newborn should stay at the hospital for at least 24 hours before discharge1. The following criteria must be met:
✔ Routine newborn examination completed
✔ Proper breastfeeding established (baby urinates 6-8 times a day, sleeps well)
✔ Initial immunizations administered
✔ Mother trained in newborn care
✔ No significant jaundice or health concerns
✔ Follow-up scheduled, especially for first-time mothers and at-risk babies5

Danger Signs Requiring Immediate Medical Attention

Parents should seek medical care immediately if the baby experiences6:
🚨 Difficulty feeding
🚨 Seizures
🚨 Lethargy (weak or minimal movement)
🚨 Fast breathing (>60 breaths per minute)
🚨 Severe chest in-drawing
🚨 High fever (>37.5°C) or low temperature (<35.5°C)

11.Common Parental Concerns & Their Solutions:

Weight Loss in the First Week

• Babies normally lose 8-10% of their birth weight in the first week but regain it by day 7-10. After that, they gain 20-40 g per day1,3,4.

Crying During Urination

• Babies may cry before urination due to bladder discomfort—this is normal. However, if a baby cries during urination, it may indicate a urinary tract infection (UTI) 3,5.

Bathing & Hygiene

• Sponge baths are recommended until the umbilical cord falls off (usually within a week) 2,6.

• Bathing every 2-3 days is enough, ensuring a warm, draft-free environment4,6.

Regurgitation & Frequent Stools

• Mild milk regurgitation is normal unless the baby fails to gain weight1,3.

• Frequent loose stools in breastfed babies are also common and do not indicate diarrhea4,6.

Skin Issues & Rashes

• Erythema toxicum (newborn rash) is common and resolves on its own3,4.

• Diaper rash is caused by moisture and can be prevented by keeping the area dry and using soft cotton diapers2,5,8.

12.References:

1. Ghai OP. Essential Pediatrics. 2023.

2. Hockenberry MJ, Wilson D. Wong’s Essentials of Pediatric Nursing. 2022.

3. Kliegman RM, St Geme JW. Nelson Textbook of Pediatrics. 2023.

4. World Health Organization (WHO). Newborn Care Guidelines. 2022.

5. Centers for Disease Control and Prevention (CDC). Neonatal Health Recommendations. 2021.

6. World Health Organization (WHO). Essential Care for Every Baby. 2023.

7. Journal of Perinatology. Best Practices in Neonatal Care. 2022.

8. Journal of Neonatology. Advances in Preterm Infant Care. 2022.

9. Journal of Human Lactation. Breastfeeding Initiation and Support Strategies. 2022.

13. Interactive Quiz Session: