Essential Newborn Care

Reni Mareta
ENC: Definition
 Majority of babies born healthy and at term
 Care during first hours, days and weeks of life
determine whether they remain healthy
 Basic care to support survival and wellbeing is
called ENC
 It includes immediate care at birth, care during
the first day and up to 28 days
Assess breathing
 Newborn crying  yes  provide routine care
 Newborn crying  no  chest is rising symetrically,
RR: > 30 x/mnt  provide routine cae
 Newborn crying  no  not breathing, RR < 30 or
>60 x/mnt  immediately start resuscitacion
Essential care for all newborn
 Most newborn breath as soon as they are born and
only need:
 A clean and warm welcome
 Observation
 Warmth
 To be observed for breathing
 To be given to the mother for warm and breastfeeding
Immediate cord care
 Change gloves. If not possible, wash gloved hands.
 Clamp and cut cord.
 Put ties tightly around cord at 2cm and 5cm from babies
abdomen.
 Cut between ties with a sterile instrument.
 Observe for oozing blood. If blood oozes, place a second tie
between the skin and first tie.

 DO NOT apply any substance to stump.

 DO NOT bind or bandage stump.
 Leave stump uncovered

ENCC 3 5
Eye care at the time of
birth

ENCC 3 6
ENCC 3 7
Four basic needs of ALL
newborns
 To breath normally
 To be protected
 To be warm
 To be fed
 Summary
 Universal precautions
 Use soap and warm water to wash and clean hands (protection)
 Wear gloves (Protection)

 Make sure delivery area is ready for mother and new

baby:
 Keep delivery room warm, close windows (warmth, protection)
 Have resuscitation equipment near delivery bed (breathing)
 Have clean warm towels/covers/cloths ready for newborn baby at delivery
(warmth)
 Dry baby with a clean cloth immediately after delivery (warmth,
protection)
 Have sterile kit to tie and cut cord (protection)
 Help mother to wear clothes which make immediate skin contact easy
(warmth)
 Keeping mother and baby in skin-to-skin contact from birth encourages
early breastfeeding (feeding)

ENCC 3 9
RENI MARETA
PENGERTIAN
 Merupakan bayi neonatus yang lahir dengan memiliki
berat badan kurang dari 2500 gr atau sd 2449 gram
 Bayi BBLR dengan prematuritas murni: yaitu bayi yg
lahir pd usia kehamilan kurang dr 37 mg
Ciri bayi prematuritas murni
 Bbl < 2500gr
 Pb< 45cm, LK < 33 cm, LD < 33 cm, masa kehamilan
kurang dr 37 mg, kepala lebih besar drpd badan,
lanugo banyak, ubun-ubun dan sutura lebar, labia
minora blm tertutp ol labia mayora, testis blm turun,
posisi spt fetal, tangisan lemah, reflek menghisap,
menelan dan batuk masih lemah
Risk factor
 Mother
 Newborn
 placenta
Associated problems with LBW
 Immaturity of thermoregulation system
 Immaturity of immunology system
 Immaturity of respiration system
 Immaturity of nervous system
 Immaturity of digestive system
 Decreased nutrition
Care of the preterm/LBW newborn
 Assosiated problems with prenaturity/LBW
1. Feeding
2. Respiratory
3. Jaundice
4. Intracranial bleed
5. Infection
6. Kongenital anomali
Principles of management for LBW
 Warmth: for all newborn
 Lay newborn on mother’s abdomen or other warm
surface
 Dry nerborn with clean (warm) cloth or towel
 Remove wet towel and cover with a second dry towel
 Bath after temperature stable
lanjutan
 Penatalaksanaannya: inkubator

 Potensial sumber infeksi

 Kontrol temperatur kadang tidak berfungsi
 Biasanya 1 inkubator u lebih dari 1 bayi baru lahir
 Metode alternatif: perawatan kanguru
Perawatan kangguru
 Adalah perawatan bayi baru lahir dengan melekatkan
bayi di dada ibu (kontak kulit bayi dan kulit ibu)
sehingga suhu tubuh bayi tetap hangat
 Syaratnya: BBLR yang stabil (sudah bernafas spontan
dan tidak memiliki masalah kesehatan serius)
Kangaroo mother care
Keuntungan PMK
 Suhu tubuh bayi tetap normal
 Mempercepat pengeluaran ASI
 Meningkatkan keberhasilan menyusui
 Perlindungan bayi dari infeksi
 BB bayi cepat naik
 Stimulasi dini
 Mengurangi biaya RS, tidak perlu inkubator
Jenis PMK
 PMK intermiten: PMK dgn jangka waktu yg pendek
(perlekatan lebih dr 1 jam sehari) dilakukan saat ibu
berkunjung , diperuntukkan bagi bayi dalam proses
penyembuhan dan masih memerlukan tindakan medis
(infus, O2)
 PMK kontinue: PMK dgn jangka waktu yang lebih
lama drpd PMK intermiten. Pada perawatan ini
dilakukan dlm 24 jam
Kontraindikasi PMK
 Bayi yang tidak sadarkan diri
 Demam
 Muntah
 Bayi kejang
 Kesulitan bernafas
 Diare
 Kulit tampak kuning dan biru
Tahap –tahap PMK
 Cuci tangan, keringkan
 Ukur suhu badan bayi
 Pakaikan baju kangguru pada ibu
 Bayi dimasukkan dlm posisi kangguru,gunakan topi,
popok, kaos kaki
 Letakkan bayi di dada ibu, dgn posisi tegak langs ke
kulit ibu, siku dan tungkai tertekuk
 Ibu memerlukan support karena metode kangguru:
1. Sangat melelahkan bagi ibu
2. Mengurangi kebebasan ibu
3. Memerlukan komitmen untuk melanjutkan
Perawatan BBLR di rumah
 Perhatikan suhu
 Beri minum dengan porsi kecil tapi sering
 Pemberian imunisasi
 Lakukan banyak sentuhan
 Beri vitamin
Harus dirawat. Bila…
 Gangguan pernafasan
 Kasus-kasu berat: perdarahan otak, kelainan jantung
 Infeksi
 Apnea periodik
 Ikterus atau kuning
 Muntah