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3 Newborn Health

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COMMUNITY

IMPLEMENTATION
OF DOH PROGRAMS

A. Pre-pregnancy Health Care


B. Maternal Health in Pregnancy

C.Newborn Health
D. Neonate and Infant Health
E. Child Health
F. Adolescent Health
G. Healthcare for Adults
H. Elderly
The Newborn Phase of the
life-cycle approach cover
discussions on the
different roles and
responsibilities of BHWs
in promoting Essential
Intrapartum and Newborn
Care (EINC), Newborn
Screening and
Breastfeeding Programs of
the DOH.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)
There are 4 important interventions during the
immediate post partum phase of pregnancy:
1. Immediate and thorough
drying
2. Skin-to-skin contact
3. Delayed cord clamping
4. Non-separation of the mother
and the baby

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Role of the BHW

Under the Newborn Package Program, adequately trained


BHWs are expected to identify and record the eligible
population of their HH catchment areas who have newborn
babies.
BHWs can give health education, but comprehensive
counseling will be given by a health professional

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO


DO?
1. All pregnancies are considered
high risk and should be
delivered only by adequately
trained health personnel in a
birthing facility.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

However, in extreme cases where home or in transit delivery


is unavoidable, the BHWs may do the following while
waiting for the SBA:
a. Using a clean, dry cloth, thoroughly dry the baby and wipe
the face, eyes, head, front and back, arms and legs.
b. If a baby is crying and breathing normally, place the
newborn on the mother’s abdomen and cover the back with
a blanket and head with a bonnet. DO NOT manipulate or
clamp the umbilical cord. Neonatal infection or tetanus can
be caused by unsterile materials and environment.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Cont. WHAT BHWs NEED TO DO?


2. Using the latest family profiling and risk assessment form for newborns, gather
the following data during your 1st postpartum visit:
a. Name of the newborn
b. Place of delivery
c. Name of parents
d. Date of birth
e. Place of delivery
f. Type of delivery
g. Date registered at the Municipal Registry
h. Compliance to newborn health services (e.g. BCG and hep B vacc, NBS, BF)

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Cont. WHAT BHWs NEED TO DO?


3. Encourage mothers to have their newborn vaccinated and
screened on time.
4. To prevent neonatal sepsis, educate mothers on proper cord
care (keeping the umbilical cord dry without putting anything
– alcohol/betadine, or any dressing).

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Cont. WHAT BHWs NEED TO DO?


5. Immediately refer the newborn to your RHM or to the
nearest health facility if there are any of the following:
a. Poor suck, cry or activity
b. Foul-smelling discharge on the umbilicus
c. Yellowish discoloration in the skin and eyes
d. Difficulty of breathing

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Cont. WHAT BHWs NEED TO DO?

6. Educate mothers on the importance of breastfeeding and


proper breastfeeding techniques.

7. Assist the mothers in registering their newborn to the


local civil registry.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

NEWBORN SCREENING

Newborn Screening is a practical


procedure to determine the possibility
of having a congenital metabolic
disorder that may lead to mental
retardation and death, if not detected
early and appropriately treated.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

ROLE OF THE BHW

Under the NBS Program, BHWs are


expected to assist RHMs in
identifying within their household
catchment areas who are qualified to
undergo newborn screening, or those
who were born within 24-72 hours.
They are expected to assist in the
information campaign on newborn
screening.
Community Program Implementation: Newborn Health (0-28 days old)
Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO SAY?

What is Newborn Screening?

Newborn Screening is a practical procedure to


determine the possibility of having a congenital
metabolic disorder that may lead to mental
retardation and death, if not detected early and
appropriately treated. It uses heel prick method.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO SAY?

When should it be done?

It is done ideally after the 1st 24 hours of life and


not later than 3 days. The procedure is performed
only by a physician, nurse, trained midwife or
medical technologist.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO SAY?

Where can it be availed?

It is available in hospitals, lying-in clinics, rural


health units, health centers and some private
clinics.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO DO?

1. Assist the mother in identifying the nearest


newborn screening facility within the
community.

2. If mothers are residing in far flung areas or


geographically isolated areas, assist the mother
to follow up results (if necessary).

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

BREASTFEEDING
Exclusive breastfeeding is best for
babies during the first 6 months of life
and may be initiated within 30 minutes
after birth by initiating skin-to-skin
contact.
The first few drops of breastmilk,
called colostrum, contains high level of
antibodies which can increase the
baby’s resistance against common
infections.
Community Program Implementation: Newborn Health (0-28 days old)
Essential Intrapartum and Newborn Care (EINC)

ROLE OF THE BHW


Under the post partum and lactating
program, adequately trained BHWs are
expected to identify and record the
eligible population of their HH
catchment areas.
However, they are not expected to
be able to comprehensively discuss
breastfeeding and lactation.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO SAY?

Breastfeeding is still the best source of


nutrition for babies until 6 months of
age.

It may be continued until 2 years of age


and beyond.

It is always available, safe and


economical.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO SAY?

What do we mean by exclusive breastfeeding?

 only breast milk without water or any other


liquids for the 1st 6 months of life.

 For working mothers, they can still continue


breastfeeding by storing expressed breastmilk
in a clean, safe and cool place that is properly
labeled and covered .

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO SAY?

How do we store breast milk?


Key points:
 Expressed breast milk can be stored for 8
hours at room temperature.

 When stored in a refrigerator, it is good for


24 hours; in a freezer compartment– 2 weeks,
in a freezer section – 3 months.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO DO?

1. Teach the mother how to perform the proper


techniques for breastfeeding:

 Take a bath daily and wear clean clothes –


and you are ready to breastfeed any time of
the day.

 Breastfeed by demand (or when there are


breastfeeding cues: smacking/licking lips,
opening or closing mouth, sucking on lips,
tongue, hands, fingers, toes or clothing)
Community Program Implementation: Newborn Health (0-28 days old)
Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO DO?

 Allow the baby to suck at the areola of the


mother’s breast and not just the nipples to
prevent nipple sores.

 At each feeding, encourage the baby to


empty the breast and then offer the other
breast.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

WHAT BHWs NEED TO DO?

2. Teach the mother breastfeeding


positioning and attachment.

Key Points:
 Baby’s head and body in line
 Baby’s head held close to the
mother’s body
 Baby’s whole body supported

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Proper Breastfeeding Hold


•Look for a quiet place
•Find a most relaxed position for mother
•Provide adequate back support
•Support feet
•Do not hunch shoulders
•Do not “scissor” the breast

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Cradle Hold

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Cross Cradle Hold

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

• Football hold
• Baby is held like a
clutch bag
Underarm Hold
• Nose further away
from the breast
• Baby’s trunk is
secure beside
mother’s trunk
Community Program Implementation: Newborn Health (0-28 days old)
Essential Intrapartum and Newborn Care (EINC)

Breastfeeding after Cesarean Delivery

Community Program Implementation: Newborn Health (0-28 days old)


Side-Lying Position

Community Program Implementation: Newborn Health (0-28 days old)


Side-Lying Position

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Don’t be afraid
that the baby
cannot breathe.
The nose bridge
allows space for
breathing.
Community Program Implementation: Newborn Health (0-28 days old)
Essential Intrapartum and Newborn Care (EINC)

SIGNS OF GOOD
ATTACHMENT

i. Mouth wide open


ii. Lower lip turned upward
iii. Chin touching the breast
iv. More of the areola is seen
above the baby’s mouth
than below it

Community Program Implementation: Newborn Health (0-28 days old)


Good and Poor Attachment
What Differences do you see?

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

3. Encourage the mother to


maintain good nutrition
and avoid alcohol and
tobacco, which can
decrease milk production.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

Nutritional advice for lactating mothers:


 Eat at least 2 additional servings of staple food per day

 Eat at least 3 additional servings of calcium-rich foods (e.g. dark green leafy
vegetables, sardines, milk/dairy products) per day

 Drink at least 8 glasses of fluids (2 liters) each day

 Eat smaller, more frequent meals if unable to consume larger amounts in


fewer meals

 Take micronutrient supplements such as iodine through the use of iodized


salt as directed.

Community Program Implementation: Newborn Health (0-28 days old)


Essential Intrapartum and Newborn Care (EINC)

4. Encourage the mother to join breastfeeding


support groups within the community to help
her know more about the proper techniques
for breastfeeding, and some practical answers
to commonly asked questions about
breastfeeding.

5. Refer to the RHM if the mother experiences


difficulty in breastfeeding.

Community Program Implementation: Newborn Health (0-28 days old)


Any Questions?

CHT-48 38
THANK YOU!!!!

39

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