Integrated Maternal and Newborn Care Basic Skills Course ...

• Where feasible and available, place the mother/family in contact with a trained
community health worker or volunteer.
Step 6: Counsel the mother and family.
Counsel the mother and family in the following topics:
• Continue exclusive breastfeeding on demand, day and night, for six months. After that,
start semisolid food but continue breastfeeding into the second year of life. Tell the
mother that if breastfeeding is exclusive, frequent, and on demand, and if the woman
has not resumed menstruation, it can also prevent pregnancy during the first six months.
• Keep the baby warm:
o The room where the baby stays should be warm and free of drafts. In cold weather
the baby should be wearing warm clothes with a hat/cloth covering the head. Wet
diapers should be changed quickly. The baby should sleep with the mother in bed.
o Check the baby’s temperature, touching feet, hands, and abdomen (if the abdomen
is cold, moderate to severe hypothermia is present).
o Skin-to-skin contact is the best way of keeping the baby warm at home if the
newborn is hypothermic, especially for a LBW baby. (See kangaroo mother care in
chapter 12.)
o Teach the mother/family how to avoid chilling during a bath (the section below also
includes a few additional points for promoting cleanliness during bathing):
Wash hands with soap and water before handling the newborn.
Delay the first bath for at least 6 hours, preferably 24 hours after delivery.
Have everything ready before the bath.
Bathe the baby in a warm room with no drafts.
Make sure the water is warm (verify this by touching the water with a clean hand
or elbow).
Take care to expose and clean all skin folds.
Wash the baby’s hair last; dry the baby fast with a cloth or towel.
Place the baby in skin-to-skin contact with the mother after the bath (if
necessary).
• Keep the cord and umbilicus clean:
o Keep the cord dry and clean.
o Fold the diaper below the cord so that it does not touch the cord.
o Don’t apply harmful substances on the cord (e.g., ash, mud, clay, or herbs).
o If recommended by the Ministry of Health/health center, apply the appropriate
antiseptic on the cord, taking care to apply it to the base.
• Additional basic hygiene/cleanliness of the baby:
o Wash hands with soap and water before handling the baby, especially after changing
the diaper/napkin, after cleaning the house, and after using the toilet. Hands should
be washed every time before handling a low birth weight baby.
o The baby should be cleaned/bathed daily, taking care to ensure that the folds of skin
are exposed and cleaned.
• Birth spacing and family planning: see chapter 7 on maternal postpartum care.
• Prevention of malaria: see chapter 7 on maternal postpartum care.
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Integrated maternal and newborn care
Basic skills course