ARELLANO UNIVERSITY

Jose Abad Santos Campus

COLLEGE OF NURSING

DYNAMIC LEARNING PROGRAM (DLP)

I. STUDENT’S NAME: Michelle S. Untalan

____________________________________________
II. HOSPITAL/ HEALTH CENTER/AREA: CCMC
____________________________________________
III. CLINICAL INSTRUCTOR: Dr. Anna Liza R. Alfonso
____________________________________________
IV. ACTIVITY TITLE: Essential Newborn Care
V. LEARNING TARGETS: Explain the concepts EINC

REFERENCE/SOURCE: Pillitteri, Adele.c2010 Maternal & child health nursing : care of the childbearing &
childrearing family. 6th ed. Philadelphia : Wolters Kluwer Health/Lippincott Williams & Wilkins

VI. AREA ACTIVITY & GUIDE QUESTIONS:

As a nurse student assigned in the delivery room entails you the knowledge of the following:

1. Identify the Four (4) Core steps in Essential Newborn Care, include the time frame for each
steps.
Recommended EINC practices for newborn care are time-bound interventions at the time of
birth
1. Immediate and thorough drying of the newborn
2. Early skin-to-skin contact between mother and the newborn
3. Properly-timed cord clamping and cutting
4. Unang Yakap (First Embrace) of the mother and her newborn for early breastfeeding initiation
1. IMMEDIATE AND THOROUGH DRYING
A. Ensure quality provision of time bound interventions.
B. Within the first 30 seconds dry and provide warmth the newborn to prevent hypothermia
1. Put on gloves (double gloves)
2. Use clean and dry cloth to thoroughly dry newborn by wiping the eyes, face, head, front,
back, arms and legs
3. Remove wet cloth – cover baby with another clean and dry warm cloth
4. Do not wipe off vernix caseosa if present. The vernix is a protective barrier to bacteria
such as E. Coli and Group B Strep.
5. Do a quick check of the newborn’s breathing
6. Do not separate baby from the mother – if newborn must be separated from the mother
put baby on a warm surface in a safe close to the mother
7. Do not put newborn on a cold or wet surface
8. Use radiant warmer or heat source if resuscitation is required
 9. Do not bathe the newborn earlier than 6 hours of life. Washing expose the baby to
hypothermia. Washing also removes the crawling reflex.
 Partial and incomplete drying gives risks to hypothermia which can lead to
 Infection
 Coagulation defects
 Acidosis
 Delayed fetal to newborn circulatory adjustment
 Hyaline membrane disease
 Brain hemorrhage
2. EARLY SKIN TO SKIN CONTACT
A. Place the newborn on prone position unto the mother’s abdomen or chest, skin to skin
B. Cover the newborn’s back with a blanket and head with bonnet
C. Place the identification band on the ankle
D. Do not separate the newborn from the mother as long as the newborn does not exhibit
severe chest in drawing, gasping or apnea and the mother does not need urgent stabilization.
 Skin to skin contact is generally perceived to be an intervention for the provision of warmth
and bonding. Appreciated contributions are to the following:
o Immuno-protection of the newborn
 Colonization with maternal skin flora
 Stimulation of the mucosa- associated with the lymphoid tissue system
 Ingestion of colostrum
o Overall success of breastfeeding
 Studies show that delayed breastfeeding has a greater risk of death due to infection.
o Protection from hypoglycemia
 90 minutes after birth, blood glucose levels are significantly higher
3. PROPERLY TIMED CORD CLAMPING
1. Remove first set of gloves prior to cord clamping
2. Clamp the cord aseptically and cut the cord after the pulsations have stopped between 1 to 3
minutes after birth to allow for transfusion of blood from the placenta to the newborn.
3. Do not milk the cord towards the newborn.
a. Put the clamp tightly around the cord 2cm and 5cm from the abdomen of newborn
b. Cut between the clamp with sterile instrument
c. Observe for oozing of blood
d. After clamping, give oxytocin to the mother.
Note: Clamp and cut the cord immediately only if the baby requires help with breathing.
 Delayed Cord Clamping is found to:
a. Increase the newborn’s iron reserves
b. Reduces the incidence of Iron Deficiency Anemia (IDA) in infancy
4. NON SEPARATION OF NEWBORN AND MOTHER FOR EARLY BREASTFEEDING
 Within 90 minutes of age, facilitate the newborn’s early initiation to breastfeeding and
transfer of colostrum.
1. Leave the newborn on the mother’s chest in skin-to-skin contact.
2. Health workers should not touch the newborn unless there is medical indication.
3. Counsel mother on positioning infant and attachment to breast. If attachment is not good,
reassess. Suggest mother to assist baby towards the breast.
 4. Advice mother not to throw away colostrum.
5. Advice mother to start feeding once the newborn shows feeding cues like opening the
mouth, licking and rooting.
6. Encourage the Kangaroo Mother Care.
 Kangaroo mother care provides the newborn with low birth weight or preterm babies
with benefits of incubator care. Once baby is stable, kangaroo mother care can begin.

2. Appropriate Anthropometric Measurements for Newborn

 Measure weight
 length
 Head circumference
 Chest circumference

WEIGHT:
 The average daily wt gain for healthy term babies is about 30gm/day in the first month of life
 It is about 20gm/day in second month
 10gm per day afterwards during the first year of life.
LENGTH: (from top of head to the heel with the leg fully extended)
 Average range: 18-22 inches (46-56 cm)

Head circumference:
 Head circumference (repeat after molding and caput succedaneum are resolved). Average range:
33 to 35 cm (13-14 inches) Normally, 2 cm larger than chest circumference Place tape measure
above eyebrows and stretch around fullest part of occipital at posterior fontanel.

Chest circumference (at the nipple line):

 Average range: 30-33 cm (12-13 inches) Normally, 2 cm smaller than head circumference Stretch
tape measure around scapulae and over nipple line.

(Adele Pillitteri (2010), Maternal and Child Health Nursing, 6 th edition, Lippincott Williams and
Wilkins Publications)