Integrated Maternal and Newborn Care Basic Skills Course ...

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