Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
APPENDIX B: Alternative Assessment/Physical
Examination of the Newborn at More
Established Peripheral Centers
TIMING OF ASSESSMENTS
• As soon as feasible after birth.
• At least once a day as long as the baby is in the facility.
• Before discharge. This is extremely important to detect any high risk factor or a danger
sign in the early stages. These may necessitate a longer stay at the facility,
commencement of treatment/referral to the hospital, or the recommendation of an earlier
follow-up visit. The early postpartum period is very important; 75 percent of deaths in
babies take place in the first week following the birth.
• At first and follow-up visits in the postnatal period.
CONDUCTING THE ASSESSMENT
Preparation
• Wash your hands with soap and water.
• Greet the mother/attendant, make her and the baby comfortable in a warm place free of
drafts, and explain what is going to be done.
Ask the Mother/Family
• about any problems noted by them in the baby
• how the baby is feeding
• about stools, and urination (number, quality, etc)
• about the presence of specific danger signs including:
o difficulty in/poor feeding
o lethargy or diminished activity
o fever or body feeling too cold
o fast breathing/difficulty in breathing
o repeated vomiting and/or abdominal fullness
o convulsions
o signs related to severe umbilical infection (surrounding redness, swelling, foul smell
with or without pus discharge)
Assess for Danger Signs
• Check for general alertness and activity. Except in deep sleep, babies move frequently,
spontaneously, and on stimulation. The arms and legs are flexed. If a limb is consistently
kept straight, evaluate for paralysis. Note also if the limbs seem very limp or flaccid.
• Assess temperature:
o Assess the body temperature by at least touching the baby’s abdomen, hands, and
feet and ensuring all are warm.
Integrated maternal and newborn care
Basic skills course
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