Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
• A white discharge from the vagina, with or without blood, is normal in the first week of
life. Referral is required only if bleeding is excessive and should be done after
administration of vitamin K1 (1 mg).
Check the back
• Turn the baby over gently, ensuring that the head is turned to one side, and examine the
back for obvious defects such as a swelling or an open spina bifida along the vertebral
column. Sometimes spina bifida occulta may be present without any obvious swelling or
an opening but may manifest with a tuft of hair or a dimple. Although not urgent, such
babies need referral to a higher center for x-rays of the spine.
Assess Feeding
This can be done at any convenient time after excluding danger signs, such as the inability to
suck, that need immediate attention. If the baby can suck well, assess attachment of the baby’s
mouth. Note that:
• The baby’s chin is touching or nearly touching the breast.
• The mouth is wide open.
• The lower lip is everted.
• Most of the areola is inside the mouth, especially the part below, so that it is visible more
above the mouth than below.
• The sucking is slow and deep and swallowing is often audible.
Counsel the Mother/Family
Advise the mother on:
• frequent breastfeeding on demand day and night
• keeping the baby appropriately warm
• washing hands before handling the baby, at least after using the toilet and after
changing the napkin/diaper
• having an extra meal and additional fluids
• the danger signs to look for in herself and in the baby
• when she has to come with the baby for follow-up and for immunization (make an
appointment)
Integrated maternal and newborn care
Basic skills course
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