- Ensure an airway and maintain respiration.
- Care of Baby to prevent cold stress (hypothermia).
- Provide a time for complete observation.
- Stimulate circulation as adequate to maintain health.
- Keep the skin of the baby clean and in good condition.
New born babies.
Definition-Care of Baby
Provide a baby soon after birth. A detailed and systematic whole body examination of a stabilized newborn during the early hours of life.
Gyneac & Obstetric Department and NICU.
Consultant, Medical Officer, Staff Nurse, Auxillary Nurse Midwife and Head Nurse.
- Vacuum suction and sterile catheter and oxygen.
- Cord ligature or clamp.
- Warm sterile towel.
- Sterile scissor and artery.
- Rectal thermometer.
- Cotton balls.
- Birth record.
- Eye drop if require.
- Wash hands and wear gloves.
- Receive newborn in warmed blanket or towel and place under radiant warmer.
- Place newborn in trend Len burg position (extend head).
- Do suction of oro-pharyngeal canal.
- Oxygen may be given in care of baby.
- Continue reinserting tube and provide suction as fluid is aspirated.
- Avoid deep suction during early minute following delivery.
- Do minimum naso-pharyngeal suctioning in care of baby.
General Physical Examination
- Complete 1–minute Apgar score and complete the 5-minute Apgar score.
|(Apgar Score Chart)|
|Mother’s Name :||Date of Admission :|
|Time of delivery :|
|Procedure Steps||Zero||1||2||1 min||5 min.|
|Respiratory Effort||Absent||Slow irregular||Good-cry|
|Heart Rate||Absent||Below 100 B/M||Over 100 B/M|
|Muscle tone||Flaccid||Some Flexion of limbs||Well flexed|
|Reflex||No response||Grimace||Cough or sneeze|
|Colour||Blue or pale||Body pink, limbs blue||All pink|
|Apgar Score Risk :|
|1 – 4||H.R.||High Risk|
|5 – 7||M.R.||Moderate Risk|
|7 – 8||S.R.||Small Risk|
- Apical pulse (Auscultate chest for heart beats with stethoscope for 1 min.) (put stethoscope under its nipple)
N.B. Temporal area is the most popular for new born.
- Respiration – Observe respiratory movement rate, depth, pattern and sound and count the rate for one minute for care of baby.
- Expiration – Count chest and abdominal movement with each inspiration.
- Clinical / Rectal temperature
- Shake down thermometer below 35O
- Remove the new born towel.
- Grasp the new born ankle firmly, placing your index finger between the ankle bones.
- Place the bulb of the thermometer in the anus and hold it securely in place for a minute.
- Remove thermometer, wipe it with a tissue/gauze and record the temperature.
Growth Measurement – include
- Head circumference
- Chest circumference
- Remove the towel of the newborn.
- Place the newborn in the supine position.
- Grasp the knee together gently.
- Push down on the knee until the legs are fully extended and hold the legs firmly.
- Measure the length with a tape measure and record it.
- Average length in cm.
- Check to see that the scale is balanced by setting it at zero.
- Place new born on the scale without cloth.
- Keep hand over new born without touching in.
- Average weight in Kg / gms.
Head circumference (at its great circumference)
- Place the tape across the nipple line.
- Assess for any gross abnormalities, congenital defects in head, eyes, ears, chest, spine, face, nose, abdomen, anus, etc.
- Wash hands before manipulating cord.
- Use sterile plastic clamp about 2.5 cm from the abdomen.
- Cut the cord by blunt sterile scissor after the clamp.
- Examine umbilical cord structure.
- Paint the end of the stump with alcohol.
- Cover the cord with sterile gauze.
- Wash hands.
- Eye lids should be cleaned with sterile cotton ball moistened with sterile
- Wipe from the nose outward.
- Identification of the new born is made by labeling on wrist or ankle the mother’s name, hospital number, sex and weight of new born).
- Wrap the baby and give to the mother.
- Assist mother to breast feed, if she desires.
- Complete charting, reporting and recording.
- Replace equipment after use and care for it
|g)||NEUROLOGICAL REFLEXES :|
|Reflex Name||Evoking Stimulus||Response|
|Grasping reflex||Finger placed in palm of hand.||Infant’s fingers close around and grasp object.|
|Tonic neck reflex||Head turned to one side while infant lies on back.||Arm and leg are extended on the side, the infant faces. Opposite arm and leg are flexed.|
|Abdominal reflex||Tactile stimulation or tickling.||Abdominal muscles contract.|
|Withdrawal reflex||Slight pinprick to the sole of the infant’s foot.||Leg flexes.|
|Walking reflex||Infant supported in an upright position with feet lightly touching a flat surface.||Rhythmic stepping movement. Disappears at about 4 months of age.|
|Babinski reflex||Gentle stroking on the sole of each foot.||Fanning and extension of the toes (adults respond to this stimulation with the flexion of toes)|
|Plantar or toe-grasping reflex.||Pressure applied with the finger against the balls of the infant’s feet.||A plantar flexion of all toes. Disappears by the end of the first year of life.|
|Blinking reflex||Light flash||Eyelids close.|
|Pupillary reflex||Light flash||Pupil constricts.|
|Sucking reflex||Finger (or nipple) inserted into mouth.||Rhythmic sucking occurs.|
|NEUROLOGICAL REFLEXES :|
|Reflex Name||Evoking Stimulus||Response|
|Rooting reflex||Light touch of finger on check close to mouth.||Head rotates towards stimulation; mouth opens and attempts to suck finger. Disappears by about 4 months of age.|
|Moro reflex||Infant lying on back: slightly raised head suddenly released, infant held horizontally, lowered quickly about 6 inch and stopped abruptly.||Arms are extended, head is thrown back, fingers are spread wide, arms are then brought back to centre, convulsively with hands, clenched; spine and lower extremities are extended. Disappears by about 6 months of age.|
|Sterile reflex||Loud noise||Similar to Moro reflex, flexion in arms, fists are clenched.|
Nurse’s Observation Sheet