Midwifery Nursing | Newborn Care and Neonatal Nursing |

 

Newborn Care and Neonatal Nursing

Immediate Newborn Assessment :


APGAR Score

The APGAR Score is a quick test performed at 1 and 5 minutes after birth to evaluate a newborn's physical condition. It assesses five criteria:

Criteria

0 Points

1 Point

2 Points

Appearance (Skin Color)

Blue, Pale

Body Pink, Extremities Blue

Completely Pink

Pulse (Heart Rate)

Absent

<100 bpm

≥100 bpm

Grimace (Reflex Irritability)

No Response

Grimace

Cry or Active Withdrawal

Activity (Muscle Tone)

Limp

Some Flexion

Active Movement

Respiration

Absent

Slow, Irregular

Strong Cry
  • Score Interpretation:
    • 7-10: Normal
    • 4-6: Moderate Distress
    • 0-3: Severe Distress, Requires Resuscitation

Neonatal Reflexes

Newborns exhibit several primitive reflexes, indicating neurological function:

  • Moro Reflex: Startle response when startled.
  • Rooting Reflex: Baby turns head when cheek is touched.
  • Sucking Reflex: Sucks when lips or mouth are touched.
  • Grasp Reflex: Fingers close around an object placed in the hand.
  • Babinski Reflex: Toes fan out when the sole is stroked.

Breastfeeding and Infant Nutrition

Breastfeeding is crucial for newborn health, providing essential nutrients and antibodies.

  • Early Initiation: Breastfeeding should start within the first hour of birth.
  • Exclusive Breastfeeding: Recommended for the first 6 months.
  • Breast Milk Composition:
    • Colostrum (first 2-3 days): High in proteins, immunoglobulins.
    • Transitional Milk (4-10 days): Increased fat and lactose.
    • Mature Milk (after 10 days): Balanced nutrients for growth.

Benefits of Breastfeeding

  • Provides antibodies (IgA) to protect against infections.
  • Promotes bonding between mother and infant.
  • Reduces the risk of SIDS, obesity, and diabetes in infants.
  • Helps the uterus contract and reduces postpartum bleeding in mothers.

Common Neonatal Conditions

Neonatal Jaundice

Causes:

  • Physiological Jaundice: Normal breakdown of fetal hemoglobin, appearing after 24 hours, peaking at 3-5 days.
  • Pathological Jaundice: Occurs within 24 hours, caused by hemolysis, infection, or liver dysfunction.

Management:

  • Phototherapy: Exposing the baby to special blue light.
  • Frequent Feeding: Promotes bilirubin excretion.
  • Exchange Transfusion (Severe cases).

Neonatal Respiratory Distress Syndrome (NRDS)

Causes:

Signs & Symptoms:

  • Rapid breathing (>60 breaths per minute).
  • Nasal flaring, grunting, retractions.
  • Cyanosis (bluish skin color).

Management:

  • Oxygen Therapy.
  • Surfactant Replacement Therapy.
  • Mechanical Ventilation if severe.

Nursing Care Plan: Neonatal Jaundice

Nursing Diagnosis

Hyperbilirubinemia related to immature liver function

Assessment

Yellow skin, sclera, poor feeding, lethargy

Nursing Interventions

- Monitor bilirubin levels - Initiate phototherapy - Encourage breastfeeding - Observe for dehydration

Expected Outcome

Bilirubin levels decrease, baby remains hydrated

Newborn care and neonatal nursing focus on immediate assessment, proper nutrition, and managing common neonatal conditions like jaundice and respiratory distress. Timely intervention ensures a healthy start to life for the newborn.


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