Care of Normal Newborn

Normal newborn is of gestational age of 37 to 42 weeks having birth weight of 2500 gram to 4000 gram, cried immediately after birth and is shifted to mother as soon as possible after birth for breastfeed. Mother is the best newborn care provider. Early involvement of the mother in care helps in establishment of breastfeeding.

1. BREASTFEEDING:- Breast Crawl i.e. when a newborn is placed on her mother’s abdomen, soon after birth , has the instinct ability to find her mother’s breast all on its own and to decide when to take the first breastfeed. The breastfeeding should be initiated immediately after birth preferably within 1 hour. There is inadequacy of breast milk during first three days. And this period is the vulnerable period in which family lands up buying a powder milk to supplement breastfeed. A term baby has enough extracellular fluid and enough glycogen storage in liver to counter the risk of dehydration or hypoglycaemiapossible due to inadequacy of lactation at this stage. Supplementing powder milk delays the establishment and continuation of breastfeeding. And that is harmful to newborns. Unconfident mother and the anxious family members needs here proper counselling that small amount of colostrum produced during first 2-3 days is enough to meet the nutritional needs of a healthy term newborn.
2. TEMPERATURE:- There is danger of hypothermia especially during winter season when it is needed to keep the baby warm by proper clothing, blanket with cap, gloves and socks. When the baby trunk and all the extremities are warm and pink , baby is having normal body temperature.
3. OIL BODY MASSAGE:- Body massage is widely prevalent in India. Oil massage of the newborn should be done when the baby is more than 3kg and after 2 weeks when the umbilical cord has already fallen. Massage promotes mother-infant bonding . Most baby enjoy it. It improves circulation, tone up the muscles, helps in growth and development.It helps enhances skin barrier function, acts as a source of nutrition and helps in weight gain. One can use coconut oil and sunflower oil. Avoid using mustard oil, olive oil, mineral oil and synthetic oil for massaging newborn. Oil massage should be done done before bath during summer and after bath during winter. It should be given when the baby is alert and active, preferably 1-2 hour after feed, in a warm room. The care provider should have trimmed their nail, removed their ring and watches. The pressure should be gentle, smooth and firm and not jerky given from head to foot. It usually takes 15 minutes for 1 session.
4. CARE OF SKIN/SCALP:- After breast crawl, baby must be cleaned off blood, mucus and meconium before giving to mother. The baby should be bathed or sponged next day with luke warm water using unmediated soap. Avoid dipping bath till the umbilical cord has fallen. Daily baths are more preferable. During winter and in cold regions , babies may be given bath twice or thrice a week. Crusts and scaling of scalp (peeling of scalp) is common in newborns. Baby shampoos could be used in removal of crusts and scales. Wash the baby’s scalp and hair only after the cord falls off. After that you can wash your baby’s scalp and hair twice every week.
5. CARE OF SKIN OF PRETERM:- Strict hand hygiene should be practiced while handling the preterm that also minimal gently. Sponge bath the baby till 2.5 kg after which regular bath can be given using a mild cleanser.
6. CARE OF UMBILICAL CORD:- The umbilical cord should be kept dry and clean and normally falls after 5 to 10 days. Lukewarm water should be used for cleaning and cord should be kept exposed to air.
7. CARE OF DIAPER AREA:- Once the caregiver change the baby’s diaperwash hands with soap and water each time. One may require 8-12 changes per day. Ensure provision of enough number of baby’s clothes and diapers. Use dustbin with lid to store the soiled diaper before it is thrown.Mothers are advised to use cloth napkins which should be changed frequently. Diaper area is exposed to excessive hydration,occlusion,friction and maceration. Luke warm water and wet clothes should be used be used for cleaning nappy area. It is important to keep the area dry. If diaper are used , barrier creams containing Zinc Oxide and Petroleum based preparation could be used.
8. URINATION AND BOWEL MOVEMENT:- A baby should pass 6-8 times a day if adequately fed. If the baby passes urine less than this inadequacy of her milk may be the cause. A baby will usually pass semi-solid yellow coloured on breastfeed and sometimes may not pass stool at all.There is no reason to be alarmed unless the baby is not taking the feed, vomiting or showing signs of discomfort.Due to gastrocolic reflex, a newborn may pass small amount of stool each time the baby is feed on.
9. HELP BABY SLEEP:- After 2-4 weeks of birth, the baby will follow a unique sleep cycle. The baby might want to wake at night and sleep at day. Mother should rest when the baby sleeps. Provide a suitable environment by putting off the bright light and allow light when the baby is awake. Baby usually sleeps for 16-18 hours and this duration gradually decrease with time. Help baby sleep by:-
   • Well positioned and well covered
   • Keep the baby warm and well fed before making baby sleep.
   • To help baby adapt normal day night cycle, keep the baby in day light at day time when awake and at night use minimal light.
10. CLOTHING:-It depends on weather of the region.Two layers of clothing one inner vest and outer a frock are always required.Cotton clothes are the best. Soft woolen cloths 2-3 layered along with caps, socks and gloves should be worn in wintertime. Absorbent soft cloths can be used as diaper.