Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
• Measure the axillary temperature:
o If the temperature remains above or equal to 36.5 ºC, keep the baby on the mother’s
chest.
o If the temperature is less than 36.5 ºC, warm the baby by skin-to-skin contact or by
placing under a warmer as is most appropriate, based on available equipment and
the status of the baby and mother. If the infant remains hypothermic, this represents
a danger sign; refer the baby to the appropriate referral center.
• After resuscitation, reassess the baby periodically every 15 minutes for 2 hours and
every 30 minutes for 6 hours for breathing, color, and activity. Continue assessment,
including evaluation of feeding, every 3 hours for the next 48-72 hours.
• If the baby develops respiratory difficulty or any one of the danger signs noted in
chapter 13 on major infections, refer him/her to the appropriate referral center following
the guidelines for appropriate referral in the same chapter.
• If the baby improves, commence routine essential newborn care:
o Keep him/her warm and dry, if feasible in skin-to-skin contact with the mother.
o Administer vitamin K (1mg intramuscular for a normal weight baby) to the baby.
o As soon as the baby is stable, help the mother to start breastfeeding. A newborn
that required resuscitation is at risk for hypoglycemia.
o If the baby does not suck well, transfer him/her to a hospital that cares for sick
newborns. If the baby has a good suck, it is sign that he is improving.
o Defer the first bath preferably for at least 24 hours, until the baby is much more
stable, warm, and continues to breathe and feed normally.
o Provide all the routine care and counseling noted in the chapter on care of the
normal baby at birth.
o Record all the findings and treatment provided for birth asphyxia in the mother/baby
records and in the delivery register.
o Make sure that all equipment is decontaminated, cleaned, and sterilized as
appropriate and all disposable supplies are replenished and kept ready for the next
delivery.
• Counsel the mother and the family regarding:
o What was done for the baby and why, in simple terms.
o Continuing breastfeeding on demand, and ask them to inform you if the baby does
not demand to be fed or does not suck well.
o Keeping the baby warm, in skin-to-skin contact where required, and to verify that the
baby remains warm.
o Identification of danger signs noted in chapter 9 on systematic examination of the
baby. Even the presence of a single danger sign is important and requires referral to
a higher center/hospital.
• Where the baby has to be referred, follow all the steps for referral outlined in chapter 13
on major infections.
Care Following an Unsuccessful Resuscitation
When resuscitation attempts are not successful, it is extremely important to inform the parents
and provide an explanation.
Integrated maternal and newborn care
Basic skills course
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