Tickler Neonatology

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ESSENTIAL NEWBORN CARE (ENC) / UNANG YAKAP

Pediatrics Pediatrics

IMMEDIATE NEWBORN CARE Call out time of birth. Deliver the baby prone on the mother’s abdomen. Dry the newborn thoroughly for a full 30 seconds. Remove wet cloth. Check breathing while drying. Position newborn prone on the mother’s abdomen in skin-to-skin contact. Cover the back with a dry blanket. o If this is not possible, place newborn in a warm, safe place close to the mother. Exclude second baby Remove first set of glove. Clamp and cut the cord after cord stops pulsating (1-3 minutes) for pretransfusion and lesser chance of anemia and intraventricular hemorrhage. Maintain skin-to-skin contact; do not separate baby from the mother until a full breastfeed is achieved; watch for feeding cues. Place identification band on ankle.

      •   •   CLASSIFICATION OF NEONATAL SEPSIS   LATE, LATE EARLY ONSET LATE ONSET ONSET  Time of Onset Birth to 7 days 7 – 30 days > 30 days usually 15 mg/dL (PT) • DSB > 2 mg/dL or 20% of TSB (total serum bilirubin) • Persists > 1 wk (FT) or >2 wks (PT)

Usually absent

Vertical: Vertical: Environment/ maternal genital Postnatal community tract environment Clinical Fulminant Insidious, focal Multisystem or Manifestations course, infection, focal multisystem meningitis involvement, (common) pneumonia (common) Prematurity is the most important neonatal factor predisposing to infection

NEONATAL COLD INJURY

BREASTFEEDING JAUNDICE • Occurs in the first week of life • Starvation jaundice • Can be prevented by frequent breastfeeding

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BREASTMILK JAUNDICE Occurs beyond the first week of rd life until the 3 week of life Extension of physiologic jaundice Enhanced enterohepatic absorption of UCB of unidentified factors in human milk which inhibits hepatic glucoronosyl transferase β-glucoronidase converts back conjugated bilirubin to unconjugated bilirubin

RESPIRATORY DISTRESS SYNDROME

SIGNS AND SYMPTOMS: • Apathy • Refusal to eat • Oliguria • Coldness to touch • Edema • Redness of the extremities • Temperature between 29.5-35 °C • Bradycardia, apnea, hypoglycemia, acidosis and massive pulmonary hemorrhage TREATMENT OF NEONATAL COLD INJURY • Warming o Warm, ironed blanket o For premature babies, you can put a cap on the head since the head has the highest surface area (especially important for low birth weight and SGA babies) o Thermoregulated bed sheet o Radiant warmer • Correction of metabolic disturbances

HYPOGLYCEMIA Definition: Blood sugar of