Newborn Care
Newborn Care tests immediate transition support, thermoregulation, feeding, infection prevention, screening, and recognition of danger signs in the first days of life.
Core rules
- Immediate care: dry, warm, stimulate, assess breathing; delay cord clamping 1–3 minutes for a vigorous newborn; place skin-to-skin; support breastfeeding within 1 hour.
- APGAR is scored at 1 and 5 minutes: Appearance, Pulse, Grimace, Activity, Respiration, each 0–2. A score of 7–10 is generally normal; 4–6 indicates moderate depression; 0–3 indicates severe depression.
- Prevention: vitamin K 1 mg IM for a term newborn; eye prophylaxis per protocol; cord care with clean, dry technique; BCG and hepatitis B vaccine per national schedule.
- Newborn screening under RA 9288 is done after 24 hours and ideally within 48–72 hours, before discharge, using a heel prick.
- Danger signs: poor feeding, lethargy, hypothermia, respiratory distress, jaundice in the first 24 hours, convulsions, and pus or bleeding at the cord require referral.
Worked example
At 1 minute a newborn has heart rate 90, slow irregular cry, some flexion, acrocyanosis, and grimaces to suction. Scoring: Appearance 1, Pulse 1, Grimace 1, Activity 1, Respiration 1 = 5. This is moderate depression. The midwife stimulates, keeps the newborn warm, ensures airway positioning, gives oxygen if indicated, and reassesses at 5 minutes; APGAR guides assessment but does not delay resuscitation.
Traps
Do not wait for the 5-minute APGAR to begin breathing support. Do not skip vitamin K because the birth was normal. Do not perform screening immediately at birth. Do not dismiss jaundice on day 1 as ordinary.