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 />
• Cutting the cord: Squeeze the cord at the site where it is to be cut to flatten it, but do not<br />
milk the cord, especially towards the baby. Cut the cord with sterile scissors or a scalpel<br />
blade, under a piece of gauze in order to avoid splashing of blood. At every delivery, a<br />
pair of scissors or a scalpel with blade should be designated for this purpose. If an<br />
episiotomy is performed, use a different pair of scissors for cutting the cord.<br />
• Tying the cord: Tie the cord firmly with sterile ligatures after the mother <strong>and</strong> baby are<br />
stable <strong>and</strong> after implementation of AMTSL. In finally tying the cord, make sure that it is<br />
tied tightly with 2-3 knots, about two fingers (about 2-3 cm) from the baby’s abdomen<br />
<strong>and</strong> cut the cord 2 cm from the ligature. Check for bleeding/oozing <strong>and</strong> retie if<br />
necessary. The cord may be tied by using sterile cotton ties, elastic b<strong>and</strong>s, or presterilized<br />
disposable cord clamps (see Figure 5.6).<br />
• Advise the mother not to cover the cord with the diaper.<br />
• Counsel the family not to apply harmful substances such as clay, herb mixtures, or<br />
butter on the cord.<br />
• If recommended by the Ministry of Health, apply an antiseptic on the umbilical stump<br />
after washing h<strong>and</strong>s with soap <strong>and</strong> water. In such cases, demonstrate to the mother<br />
before she leaves the facility how to apply the antiseptic on the cord, including the base.<br />
Eye <strong>Care</strong><br />
Figure 5.6. Use of a pre-sterilized disposable cord clamp.<br />
• Apply prophylactic eye drops as recommended by the Ministry of Health (tetracycline<br />
ophthalmic drops or ointment).<br />
• Apply prophylactic drops or ointment as follows:<br />
o Wash your h<strong>and</strong>s with soap <strong>and</strong> water if not washed earlier.<br />
o Place the infant on the back.<br />
o Clean the baby’s eyes by swabbing each eye separately with a sterilized cotton swab<br />
or cloth (boiled for 10 minutes <strong>and</strong> then cooled).<br />
o Hold one eye open or depress the lower eyelid, allow one drop of medication to fall<br />
into the eye. If using ointment, put a ribbon of ointment along the inside of the lower<br />
eyelid. Repeat the procedure on the other eye.<br />
o Make sure the tip of the dropper or the tube does not touch the baby’s eyes or other<br />
objects.<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course<br />
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