The care of a newborn immediately after delivery is crucial for ensuring the baby’s smooth transition from intrauterine to extrauterine life. Proper newborn care helps prevent complications such as hypothermia, infections, respiratory difficulties, and feeding problems. In the Indian context, adherence to these practices is vital to reduce neonatal morbidity and mortality.
Objectives of Care After Delivery
- Establish and maintain airway and breathing
- Maintain body temperature
- Promote early breastfeeding
- Prevent infection
- Assess overall health and detect abnormalities
- Support parent-child bonding
Steps in Care of Baby After Delivery
1. Immediate Assessment and Clearing Airway
- Once the baby is delivered, clear the mouth and nose gently using a bulb syringe or suction device if secretions are present.
- Position the baby’s head slightly extended (sniffing position) to open the airway.
- Stimulate the baby gently by drying and rubbing to initiate breathing.
2. Drying and Thermal Protection
- Immediately dry the newborn with a warm, clean towel to prevent heat loss.
- Remove wet towels and replace with dry cloth or blanket.
- Place the baby skin-to-skin on the mother’s chest (Kangaroo Mother Care) and cover both with a warm blanket to maintain body temperature.
- Keep the baby’s head covered with a soft cap to prevent heat loss.
3. Apgar Scoring
- Assess the newborn at 1 and 5 minutes after birth using the Apgar score, which evaluates:
- Heart rate
- Respiratory effort
- Muscle tone
- Reflex irritability
- Color
- Each parameter is scored 0 to 2; total score helps determine if resuscitation or special care is needed.
4. Cutting and Care of Umbilical Cord
- Clamp the umbilical cord at about 2–3 cm from the umbilicus.
- Cut the cord using sterile scissors.
- Keep the stump clean and dry.
- Educate the mother on cord care to prevent infection.
5. Identification
- Apply identification bands to the baby and mother to prevent mix-ups.
- Record birth details (time, weight, sex, condition).
6. Initiation of Breastfeeding
- Encourage initiation of breastfeeding within the first hour of birth.
- Help mother with proper positioning and attachment.
- Promote exclusive breastfeeding to provide colostrum, which contains vital antibodies.
7. Vitamin K Administration
- Administer vitamin K (usually 1 mg intramuscularly) soon after birth to prevent hemorrhagic disease of the newborn.
8. Eye Prophylaxis
- Apply antibiotic eye ointment (e.g., erythromycin) to prevent neonatal conjunctivitis caused by gonococcal or chlamydial infections.
9. Weighing and Measuring
- Weigh the baby using a calibrated scale and measure length and head circumference for baseline data.
10. Physical Examination
- Perform a thorough head-to-toe examination to detect congenital anomalies or birth injuries.
- Check vital signs: respiratory rate, heart rate, temperature.
11. Immunization
- Administer BCG vaccine and oral polio vaccine (OPV) as per Indian immunization schedule.
12. Maintaining Hygiene
- Keep the baby’s environment clean and dry.
- Teach mother and family about hygiene practices to prevent infection.
Summary Table
| Care Aspect | Key Actions |
|---|---|
| Airway and Breathing | Clear secretions, stimulate breathing |
| Thermal Protection | Dry immediately, skin-to-skin contact, cap on head |
| Apgar Scoring | Evaluate at 1 and 5 minutes |
| Umbilical Cord Care | Clamp, cut sterile, keep dry |
| Identification | Apply ID bands, record birth details |
| Breastfeeding | Initiate within 1 hour, promote exclusive breastfeeding |
| Vitamin K | IM injection to prevent bleeding |
| Eye Prophylaxis | Apply antibiotic ointment |
| Physical Examination | Check for anomalies, vital signs |
| Immunization | BCG and OPV as per schedule |
| Hygiene | Maintain clean environment, educate family |
Conclusion
Care of the baby immediately after delivery is a vital responsibility that affects neonatal survival and health. Timely and appropriate measures to ensure airway patency, thermal regulation, early feeding, infection prevention, and monitoring are essential in Indian healthcare settings. Educating mothers and families also strengthens newborn care at home.