Integrated Maternal and Newborn Care Basic Skills Course ...

Drying the Baby and Keeping the Baby Warm (Initial Steps for All Babies)
• In general, the first step immediately after birth is to dry the baby well. Drying the baby well
also serves to provide safe stimulation to a baby who is not breathing. While drying, verify
if the baby is breathing/crying.
• If the baby is breathing well, follow the steps noted above in the section of care of the baby
immediately after birth.
• If the baby is not breathing, discard the wet cloth. Wrap the baby’s body and head with a
fresh dry cloth, keeping the baby on the mother’s abdomen, and verify again if he/she is
breathing. Where it is clean and feasible, placing the baby who is not breathing on the
table between the mother’s legs will allow a better flow of blood to the baby.
• If the baby is still not breathing, clamp and cut the cord. If you have an assistant who can
deal with/observe the mother and a separate place for special care, take the baby there
and place it under a warmer (if available) for commencing additional steps for
resuscitation.
Position of the Baby
Initially during the steps noted above, the baby can be turned on one side with the head slightly
extended. However, if the baby is still not breathing, it is convenient to have the baby on its back
on a warm, firm surface with the head towards you. The head should be slightly extended,
which you can do either by extending the head slightly with your hand or by placing a roll of
linen under the shoulders to raise them by 2-3 cm (see Figure 8.5).
Positioning during Resuscitation
Correct position
(Neck slightly extended)
Newborn with elevated shoulders 2 to 3 cm. with a small linen roll,
placed below, to slightly extend the neck.
The neck may be extended by positioning with the hand
without the linen roll
Incorrect positions
Neck hyperextended
Neck flexed
Figure 8.5. Correct positioning.
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Integrated maternal and newborn care
Basic skills course