MANAGEMENT PROTOCOL FOR CARE OF THE NEWBORN IMMEDIATELY AFTER BIRTH (Flowchart No. 31) PLAN A: 1. 0 Within the iirst 30 seconds, while waiting for the placenta to be expelled, dry the baby, cleal· l1is air . ray and stimulate h1m to cry if he does not do so spontaneously. 1. 1 Gently wipe th~ baby's face, neck and hody but do not wipe off veroix. 1. 2 Do not suction unless the baby·s mouth aud/or nose is blocked with secretio ns or other materials. 2. 0 Do a quick physical examination and observe the following: 2. 1 His color : blue all over, completely pink or blue extremities with pink body. 2. 2 Heart or pulse rate : absent, below 100 beats per minute or 1. 00 beats and ahove. 2. 3 His grimace or response to an irritation (like the suction bulb being placed in his nose) : no response, gives a grimace or gives a good, vigorous and sustained cry. 2. 4 His activity or muscle tone: flaccid/soft, some bendingofth. e extremities or has active motion. 2. 5 His respiration: absent, slow/frregula{" or he is crying vigorously. 2. 6 His physical,ippeara nce: any obvious congenital defect, like abse:ace of an extremity, concave breast hone or flat abdomen. 3. 0 Within the first 60 seconds: 4. 0 5. 0 270 3. 1 If the newborn is hreatbing or crying and Lhei:e are no abnorm : abdomen or chest, place him in a prone position on the mother's cbr head turned to either breast. Ensure that there is skin-to-skin conta, the mother and the ne,vbom '-' in his ·. vith his hetween 3. 2 Covei: his back with a clean dry blanket and his bead with a clean dry bonnet. Within 90 minutes of life, initiate breastfeeding. 4. 1 Make sure that the newborn is properly position, and 1us whole hody well supported 4. 2 Observe for feeding cues such as tonguing, licking or rooting. 4. 3 Encourage the mother to nudge the newborn towards her breast. 4. 4 Do not give sugared water, formula, milk or any prelactea ls. 4. 5 Do not throw away the colostrums. After the first full breastfeed is completed, separate the newborn from his mother, do the following: 5. 1 Administer eye care and give immunization (BCG and Hepatitis 8) if available. 5. 2 Postpone giving the baby a bath till at least six hours after birth. 5. 2. 1 Clean yo\Jr hands with soap, water and alcohol. 5. 2. 2 Wet some sterile cotton balls with warm water and use them to clean the baby's eyes. Start from the corner of the eye near the nose bridge and then move gent Jy towards the outer corner of the eye. 5. 2. 3 Clean the baby's skin with the wet cotton balls. 