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