Most of the babies are born healthy and at term. The care they receive during the first hours, days and weeks of life can determine the health status of the children. All babies need basic care to support their survival and well-being.

This primary care is called essential newborn care (ENC), and it includes immediate care at birth, care during the first day and up to 28 days. Remember that the baby has just come from the mother's uterus, an environment that was warm and quiet and where the amniotic fluid and walls of the uterus gently touched the baby.

Therefore, you should gently hold the baby immediately after birth and keep the baby warm by putting the child skin-to-skin contact to the mothers or if the mother is not possible to hold the baby wrap the child with clean and warm cloth and put in the warm place this is important to avoid hypothermia. So you should encourage and help the mother to keep the newborn warm. The care you give to the baby and mothers immediately after birth is critical; so by giving essential newborn care to the baby, you reduce child mortality rate at the time of birth.

The eight steps of essential newborn care

  • Deliver the baby on to mother's abdomen or on to her arms And reassure and congratulate the mother and tell the sex of her baby.
  • Dry baby's body with a dry and warm towel. Wipe the eyes. Wrap with another dry one and cover all of the body. But not to remove the vernix (the creamy, white substance which is present on the skin) because it can prevent hypothermia and infection.
  • Assess breathing and colour of the skin, and the tongue or any reflex action of the baby; if not breathing or gasping or if breathing is <30 breaths per minute, immediately cut the cord and give resuscitate. The normal newborn breathing is between 30-60 b/m.
  • Tie the cord two finger above the umbilicus (4 cm) and another tie two fingers from the 1st one. Cut between the two ties if the baby has breathing problems and requires resuscitation cut the cord immediately and give resuscitation. After cutting the cord, use a small piece of cloth or gauze to cover the part of the cord.
  • Place the baby skin-to-skin contact in between the two breasts to initiate immediate breastfeeding within 1 hour or apply kangaroo mother care (KMC). KMC it is the means of providing heat to the newborn as well as it is important to initiate early breastfeeding within an hour and it helps the baby in stabilising its temperature, making the breathing stable and regular, improving immunity, reducing infection and enabling it to feed better and gain weight faster.
  • Apply 1% Tetracycline eye ointment once to the newborn's eyes.
  • Give Vitamin K 1mg IM on the anterior thigh.
  • Weight the baby.

Essential newborn care

  • Deliver the baby on to mother's abdomen.

  • Dry baby's body with a dry and warm towel. Wipe eyes. Wrap with another dry one and cover all of the body.

  • Assess breathing and colour of the skin, and the tongue or any reflex action of the baby.
  • Tie the cord two fingers above the umbilicus (4cm) and another tie two fingers from the 1st one.

  • Place the baby skin-to-skin contact in between the two breasts to initiate breastfeeding within 1 hour.

  • Apply 1% tetracycline eye ointment once to the newborns.

  • Give Vitamin K, 1mg IM on the anterior thigh BCG & OPV0 are given if it is readily available.
  • Apply chlorhexidine on the cord.
  • Weigh the baby.

Fig. 1.9 Steps of immediate newborn care.



Last modified: Tuesday, 21 February 2017, 4:42 PM