Introduction to New Born Baby Care

The most exciting affaire in the lives of a couple is having a newborn baby. Caring for a newborn, especially your first, is one of life's biggest challenges. You and your partner may feel overwhelmed at the beginning-after all, there's so much to learn. AS soon as your little darling arrives, your life will be changed forever. It's a good idea to start preparing for that change early. As you find out you are pregnant, before delivery it is time for you to prepare for facing the changes. Cord Care Many parents wonder when the umbilical cord stump will fall off. The cord stump should fall off within one to three weeks after birth. Until the umbilical stump heals, keep the area dry by exposing it to air. To prevent infection, clean the stump well with alcohol or hydrogen peroxide, using a cotton swab. If the area around the navel turns red, swollen, or oozes, call your pediatrician. Holding style for your Baby Good baby care begins with the way you hold your baby. Support the back and head with your arm and hand. Touch your baby often. Use skin-to-skin contact and hold your baby close to you. There are too many comfortable ways to carry a baby. Whatever position you choose you have to keep always in mind that a comfortable support should be provided to your newborn's head and neck, as a baby cannot hold his head up. Laying your baby on his back on your lap and scoop up with two arms -one to support his bottom while the other rests comfortably against his head. Your neck can also be a comfortable nestle for your baby. But here your one hand should support the head and neck, and the other should support the baby's bottom. Baby's Food Breast milk is the optimal form of nutrition for your baby as breastfeeding ensures the best possible health as well as developmental and psychosocial outcomes for baby. The only acceptable alternative to breast milk is infant formula. Solid foods can be introduced when the baby is 4 to 6 months old, but a baby should drink breast milk or formula, not cow's milk, for a full year. The primary benefit of breast milk is nutritional. Human milk contains just the right amount of fatty acids, lactose, water, and amino acids for human digestion, brain development, and growth. Cow's milk contains a different type of protein than breast milk. This is good for calves, but human infants can have difficulty digesting it. Bottle-fed infants tend to be fatter than breast-fed infants, but not necessarily healthier. Breast-fed babies have fewer illnesses because human milk transfers to the infant a mother's antibodies to disease. About 80 percent of the cells in breast milk are macrophages, cells that kill bacteria, fungi and viruses. Breast-fed babies are protected, in varying degrees, from a number of illnesses, including pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and measles. Furthermore, mothers produce antibodies to whatever disease is present in their environment, making their milk custom-designed to fight the diseases their babies are exposed to as well. Human milk contains at least 100 ingredients not found in formula. No babies are allergic to mother's milk,

although they may have a reaction to something the mother eats. If she eliminates it from her diet, the problem resolves itself. Newborns usually eat every three to four hours. Breastfed babies feed more frequently than bottle-fed infants because breast milk is easier to digest. As your baby grows, she will feed less frequently but her mealtimes will be lengthen. If you think your baby may be dehydrated, watch for these signs: lethargy; fewer than eight wet diapers a day; refusal to feed; and dry, sallow skin and mucous. In more serious cases, a sunken soft spot will appear on the top of the baby's head. Burping Babies tend to swallow air during feeding, causing them to spit up or become fussy if they're not burped frequently. Using one arm, hold your baby upright against your shoulder. Gently pat his back with your other hand. Sit the baby upright on your lap, support his chest and head and pat his back. Lay the baby on your lap face down, and gently pat your hand on his back. Crying Crying is a baby's means of communication. Babies cry when they have to burp or are wet, soiled, tired, bored, or just lonely. As time goes by, you'll learn what your baby's crying means. If feeding cues accompany crying, it's usually a sign of hunger. You will not spoil your baby by responding promptly to crying. Your baby only cries if he or she needs something. When you satisfy his or her needs, your baby is learning to trust people and begins to know that someone cares for him or her. After taking care of physical needs, there are many things you can do to calm a crying baby. Try holding your baby over your shoulder, or place your baby on his or her stomach across your knees or arms. You can also try to rock your baby, swaddle your baby in a blanket, use a carrier, run the vacuum cleaner, or consider using a pacifier. If breastfeeding, you should try to avoid the use of a pacifier until breastfeeding is well established (usually by three to four weeks). Sleeping Most newborn babies sleep more than they do anything else. Your baby will develop his or her own sleeping pattern. It is normal for a tiny baby to sleep 16 to 20 hours a day. Take advantage of your baby's sleep periods to get the rest that you need. During sleep, your baby may make sucking motions, whimper, smile, or move his or her eyes. Bathing A tub bath is off-limits for the first two weeks or so, until baby's umbilical-cord stump has fallen off and healed. To sponge bathe baby, choose a warm, draft-free room, since newborns get cold easily. To start, place baby on a waterproof pad, changing mat, or towel. To help him stay warm, keep his undershirt on or cover him loosely with a towel. Another strategy is to undress each part of his body as you're ready to wash it. To prevent accidents, don't take the diaper off until it's

time to wash his bottom. Gently wipe baby's face and neck folds, nose, and outer ears with a washcloth or cotton ball moistened with warm water. Never clean inside baby's ears (even if you spy some wax), because you could damage his eardrum. Wipe baby's face dry, paying special attention to his neck creases, where moisture can cause irritation. Carefully wipe baby's eyes from the inner corner outward with two clean, moistened cotton balls. Use a fresh cotton ball for each eye to prevent the spread of infection. To wash baby's arms and hands be sure to rinse his hands of soap since they're one of baby's favorite sucking toys. Gently wash his torso and clean the umbilical stump. To wash baby's hair holding his head as he's lying back on the towel or by sitting him up, supporting his back, and reclining his head slightly. With your free hand, rub lightly to lather, and then rinse with a wet washcloth, gently towel. Baby's hair just needs a drop of shampoo once or twice a week. If you have a girl, wash her genital area from front to back. Don't use soap there. it can cause irritation or infection. Wash her buttocks with soap, and also make sure to clean in the creases of her thighs. If your baby boy is circumcised, don't wash his penis with soap until the wound heals. If he's uncircumcised, use soap, but don't attempt to pull back the foreskin. It will remain attached for several more years. Dry baby well. Your infant is ready for the baby tub while the umbilical stump and circumcision have healed. For now you'll only need to bathe him every two to three days. In between, daily cleaning of the face, neck, hands, and diaper area is sufficient. As your baby starts crawling around the house, he'll need washing more often. Keep bath time short and sweet. Avoid bathing him right after his meal. Test the temperature by dipping your finger- tip in the water, it should be warm but not hot. Caring others A newborn's nails grow like wildfire. To trim baby's nails use blunt edged small scissors or file with an emery board to prevent scratching. Cut nails straight across. Wrap your finger in a bit of damp gauze or a washcloth, and then swipe it over baby's gums. You can do this as often as twice a day. No toothpaste is needed at this early stage. Once baby has sprouted a few teeth, it's time to get him used to a toothbrush. Let him chew on one as he would a teething aid. After his first birthday he can imitate you brushing your own teeth. Either way, you'll still have to wipe baby's teeth yourself, either with a soft, baby-specific brush or damp gauze. After a bath, gently clean the outside and back of baby's ears with a moist cotton swab. The important thing to be avoided pushing the swab into the ear canal as it can damage the eardrum and even cause hearing loss. Removing the wax isn't necessary; earwax protects your child's ear canal by sealing out moisture, dust, and bacteria. Cut baby's hair after a bath when it's still damp. Wet hair is more pliable. You can also sprite baby's hair to wet it, but if this upsets , cut it while it's dry. Don't give a haircut while baby is in the bathtub. Daily massage is a great way to make tight bondage with your baby. Massage actually promote better sleeping, relieve colic, and perhaps even enhance an infant's immune system, motor skills, and intellectual development.

Routine Newborn Baby Care Procedures

Choices for newborn baby care procedures begin immediately at birth. The best preparation is to have considered them and decided beforehand what procedures you want or would rather decline for your newborn. For a hospital birth, there are numerous routine procedures which can be administered, delayed or even refused. Unfortunately, first time parents are often unaware that many of these routine procedures are not grounded in evidence-based practice, but are rather the product of ease and access for staff.

Many parents don't realize the impact that these procedures can have on their newborn child. Once you have decided what procedures you prefer and whether you want them performed immediately or on a delayed schedule, the best way to communicate them to staff/caregivers is to include a Newborn Baby Care section in your birth plan. This will ensure that your preferences are on paper before the birth and remove any doubt as to your wishes for your new child after birth.

Another critical point to remember is that you can and absolutely have the right to receive information about each and every procedure that will be performed, as well as the right to either request the procedure be performed in your room or that a parent/guardian accompany the newborn for each one. This includes weighing, measuring and the pediatrician's evaluation of the baby - in most instances all can be performed right there in the mother's room. Remember, your first responsibility is to the welfare of your child, not to the comfort of the hospital staff nor arbitrary hospital policies.

The most commonly performed routine newborn baby care procedures to consider are:

Suctioning Delayed Cord Clamping Vs. Immediate Cord Clamping Newborn Vitamin K Injection PKU Test Silver Nitrate or Antibiotic Eye Ointment

Hep B Vaccine To Bathe or Not to Bathe Circumcision

SUCTIONING For most hospital births, it is routine procedure to suction the baby's mouth and nose as soon as the head emerges on the perineum, in advance of its full birth. Either a deep suction hose or a bulb syringe will be used to extract any mucus or meconium that may be present.

According to the International Guidelines for Neonatal Resuscitation (2000), only approximately 5-10% of newborns will require some degree of active resuscitation (stimulation to breathe) at birth, which can vary from simple skin rubbing to suctioning or full resuscitation. This in turn means that 90-95% of all newborns need no assistance breathing at birth.

While it may seem wise to suction as soon as possible, the reality is that the baby is not at great risk of breathing difficulties at this point since it will typically not take its first breath until it has been fully birthed. As long as the cord is pulsating and is not clamped, cut, nor compressed, the baby will continue to receive oxygen via the placenta until after it has been fully birthed. There is rarely a clear need to hurry the neonatal transition to breathing room air at this early stage when only the baby's head has emerged.

Suctioning can be delayed until after the baby has been born. Alternately, suctioning can only be performed when indicated rather than a routine procedure for those infants who do not need it, as most infants will be able to clear their own airways with no outside assistance.

CORD CLAMPING The next and perhaps most critical newborn baby care decision to be made for your baby's welfare is cord clamping - immediate or delayed. The benefits of delayed cord clamping, which is defined as waiting until the cord has stopped pulsating until clamping or cutting it, are welldocumented. Once the baby is born, its entire circulatory system undergoes an amazing transformation to allow the baby to receive oxygen via its lungs rather than through the umbilical cord - a valve in the heart closes, the lungs perfuse with blood and eventually a first breath is taken. When this delicate balance is interrupted by prematurely severing the child's lifeline, its umbilical cord, numerous undesirable side effects can occur.

NEWBORN VITAMIN K INJECTION All newborns are born with a low level of Vitamin K which is responsible for preventing hemorrhage by enhancing the blood's clotting ability. In a small percentage of newborns, cerebral hemorrhage can occur which spurred the universal practice of newborn vitamin K injections in the United States. There are, however, some points to ponder when considering this intervention, especially the alternative of an oral dose.

PKU SCREENING Certain metabolic disorders, including a PKU test, are routinely screened for at birth through a heel stick blood sample. These disorders have devastating effects that are best handled with early detection and treatment to ensure the best possible outcomes. This is the least controversial newborn baby care procedure since the benefits clearly outweigh the risks.

HEP B VACCINE The Hep B Vaccine, a disease that is transmitted via infected blood and sexual intercourse, is given at birth in the hope of catching as many people as possible. It is not required for administration at birth and may be given at any time in childhood or adulthood. In low-risk families, it may be advisable to delay the administration to the weeks after birth, rather than injecting a minutes-old baby, causing pain as one of its first experiences outside the womb.

SILVER NITRATE OR ANTIBIOTIC EYE OINTMENT To prevent the chance of blindness due to gonorrhea from an infected mother, hospital-born babies are given silver nitrate or other antibiotic drops in their eyes, even if the mother previously screened negative for this or other STDs in her pregnancy. Silver nitrate causes pain, burning, swelling and blurred vision for the first days of life and in the vast majority of cases, is not needed when the mother is known to be free from infection.

TO BATHE OR NOT TO BATHE If there is one newborn baby care procedure that many families never consider, it's bathing a newborn. However, this may indeed be something a new family decides to decline. The vernix which coats the baby's extremely sensitive skin is the best natural moisturizer available and will protect it from infection when massaged into the skin. Additionally, a bath can cause a baby's body temperature to drop, thus necessitating further interventions to regulate it.

CIRCUMCISION Male circumcision, and female circumcision, for that matter, are very controversial subjects. Some religions require circumcision. However, there are no proven medical benefits to the procedure and significant drawbacks. It is now considered a cosmetic procedure and its routine performance is being phased out in many areas. The American Academy of Pediatrics no longer supports it. In Australia, public hospitals are no longer performing routine circumsions.

Please give due diligence to your decision in this matter. There is little research supporting it as a routine procedure. If you are uncertain whether or not to circumcise your son, consider viewing a circumcison video to understand what the newborn will experience. The majority of circumcisions are done with no anesthesia as it can cause swelling which makes the surgery more difficult and can lead to further complications. Some will use topical anesthetic creams; however, these take 45 minutes to numb the area so most are not yet active when the surgery is performed, and their use has not been approved or studied in newborns.

Carefully consider your newborn baby care options, especially if birthing in a hospital. Over 1 million healthy infants each year spent up to 3 days in the NICU for "observation" in the United States, with many unneeded interventions simply because the technology exists. If at any time you have questions about a procedure for your newborn, don't hesitate to ask. You are your child's first and foremost advocate - be the voice they lack.

IN PARTIAL FULFILLMENT OF AN RLE 105 REQUIREMENT

SUBMITTED BY: SUPANGA, GLEN DAVID D.

SUBMITTED TO: MRS. MARIA TERESA CADUADA

NEWBORN CARE INSTRUMENTS