You’ve heard of essential newborn care course, but you probably don’t know exactly the modern essential care for small babies.

Am I right?

That’s because you probably thought that essential care was just for the professionals.

But hey! 

 It's not what you think.

But you should note that you have to be a health service provider or a midwife (accoucheuse).

The federal ministry of health in collaboration with stakeholders developed the integrated maternal newborn and child health strategies in 2007 which was revised in 2013/2014 and 2015 edition.

The strategy stipulates the developed of a training package for capacity building of Frontline health workers in provision of quality Newborn Health Services.
Also Read: Best Birth Control Pills for women.
The development of the essential newborn care (small babies) course (ENCC) is a major breakthrough in child health associates effort to reduce preventable newborn deaths across the world, most especially, in developing country like Nigeria.

Who is to participate in the Essential Care for Small Babies?

To those whose provide care for small babies (newborn babies), and anyone who is trained to assist women in childbirth or a physician.

Essential care for small babies

Notice, I didn’t say “anyone working in the health sector.”

It's strictly for trained essential care staffs and pros.

Why do I need to study the modern essential care for small babies?

1. To maintain and increase knowledge and skills: It gives you a quick avenue to refresh your knowledge and continue building skills for helping babies breathe.

2. Identify a provider in your facility who will become your partner for review and practice. Ideally this provider should have completed the essential care for small babies course.

3. To help one another identify gaps in knowledge and improve skills.

4. It helps you to identify differences between the recommended actions and the way these actions are performed in your facility.

5. It teaches you how to work with others in your facility through an improvement team to make changes that improve health of mothers and babies.

What are the steps involved in Helping Babies Breathe after birth?

You can easily learn the modern essential care for small babies here as a health service provider or midwife.

Here’re Some Steps Involved In Helping Babies Breathe

Step 1

Weigh The Baby Within 90 Minutes After Birth

Birth weight helps identify babies at higher risk, provides a baseline for monitoring growth and may also be necessary for calculating drug doses.

Babies should be weighed within 90 minutes of birth. However, weighing should be deferred if an infant is cold unless needed for calculating antibiotic doses.

Use scales designed for weighing babies.

Notice, zero the scales before each use to test that they function properly. Clean the scales with dilute bleach solution or other safe cleaning product before each use to prevent infection.

Babies with birth weight under 2500 grams may require special care to prevent low body temperature. Also babies with birth weight under 2000 grams should receive prolonged skin to skin care. These babies may need alternative feeding methods and more frequent assessment to identify problems and Dangers Signs. Babies with birth weight under 1500 grams should be referred for advanced care when possible.

Step 2

Classify A Small Baby By 90 Minutes

You should classify a small by 90 minutes to determine further care. Classification is based on the baby's weight, temperature, and exam.

The small baby with No Danger Signs 
  • Weighs between 1500 and 2500 grams and 
  • Maintains a normal temperature with thermals care and 
  • Breathe well.
The baby with Danger Signs or Very small
  • Weighs less than 1500 grams or 
  • Develop a problem or
  • Has a Danger Sign such as fast breathing, temperature <35.5°C or >37.5°C, severe chest in-drawing, no movement or convulsions.
Note that classification may be delayed up to 4 hours if a small baby has:
  • Fast breathing or chest in drawing that is improving.
  • Temperature <36.5°C that rises within 1 (one) hour of improved thermal care.
  • Poor feeding due to lack of energy or difficulty with coordination to breastfeed.
These basis require careful assessment for other signs of illness.

All small babies require ongoing routine assessment as they are at risk of developing problems.

Step 3

Maintain Thermal Care - Kangaroo Mother Care (KMC) 

Kangaroo mother care is a care of preterm infants carried skin to skin with mother.

Components of Kangaroo Mother Care include:
  • Early continuous and prolonged skin to skin contact between the mother and the baby.
  • Exclusive breastfeeding (ideally); it's initiated in the hospital and can be continue at home. It's a gentle, effective method that avoids the agitation routinely experienced in a ward with preterm infants.
Notice! Mother at home require adequate support and follow up.

Benefits of Kangaroo Care for Premature Babies
  1. It is the effective way of maintaining the correct body temperature of the newborn 
  2. It promotes exclusive breastfeeding, leads to a higher rate and longer duration of breastfeeding 
  3. It increases the quantity of EBM for cup feeding or naso/orogastric tube feeding
  4. Babies gain weight faster (grow Faster). This is due to the fact that babies receiving KMC may easily feed on demand and have lower caloric expenditures to maintain body temperature (low metabolic rate).
  5. Decrease number of preterm and LBW babies dying due to the reduction of apneic attacks, irregular breathing, and hypothermia. This is achieved through the action of the mother's heartbeat, respiration, and voice which act as stimulants to the baby's breathing control center in the brain.
  6. It requires fewer equipment 
  7. It improves bonding 
  8. Increases mothers confidence in handling her small newborn.
  9. It reduces cost (it is cheaper than incubator care), both to the hospital facility and to the mother/guardian.
Everyone can provide KMC as long as they understand the method and are motivated to practice it. All those who want to assist the mother can practice KMC, such as grandmothers, sisters, aunts, husbands, and even friends.

Step 4

Counsel The Mother / Care Giver

Counseling is the process of helping an individual or a group of individuals to their own decision by providing appropriate, accurate and unbiased information and emotional support.

Topic to counsel mother on depends on the stage KMC:

When the Mother is Admitted to KMC:
  • Meaning of KMC 
  • Basic needs of small baby 
  • Advantages/Disadvantages of kmc
  • How to practice KMC 
  • Care of the baby
What to do during the Mothers at the KMC 
  • Feeding 
  • Support to the mother
  • Potential problems
  • Discharge Criteria 
  • General personal hygiene 
  • Activities while in the KMC ward
  • Information about family planning
At the Time of Discharge from the KMC

  • Experience in KMC unit and implications of KMC at home
  • Dealing with community and opposition to KMC 
  • Support for the mother for continued KMC at home 
  • General care for the baby at home 
  • Follow up after discharge 
  • Discontinuation of KMC.
Step 5

Prepare Baby and Mother (Positioning  the Baby)

Dress the baby in socks, a nappy, and a cap, place the baby between the mother's breasts. The health worker should help the mother position the baby upright between her breasts, feet below her breasts and hands above.

Step 6

Apply KMC Wrapper

How to make the KMC wrapper (care of the very small baby 1.5kg to less than 2.5kg.

Snugly wrap the baby to your body, place the center of a long cloth or wrapper over the back of the baby on the mother's chest, cross the ends of the cloth behind the mother's back bring them back around, and tie them in the front underneath the baby.

Mother covers her baby with her own clothes and an additional blanket or shawl to cover the baby. The mother needs to appear in culturally acceptable clothing.

Step 7

Maintain Breastfeeding To Provide The Best Nutrition

Breast milk is the best food for small babies. Small babies may not have the skills or strength to feed at the breast initially. Mothers attempting to breastfeed as a small baby require extra support and encouragement since it's one of the modern essential care methods for small babies.

Support the special needs of small baby who is attempting breastfeeding with:

* Nipple stimulation prior to feeding.

* Added attention to positioning and supporting head.

* Early licking and practice at the breast.

* Manual expression of breast milk into baby's mouth.

* Awakening baby when changing to opposite breast.

Evaluating of effectiveness and adequacy of early breastfeeding requires following the baby's weight, wet diapers, and stools. If possible, providers should watch a mother breastfeed and discuss observation.

Step 8

Expressing Breast Milk

A mother will need to and should express breast milk for a baby who can't feed directly from the breast.

Mothers need early support to express milk for babies who are unable to feed on the breast, mothers may also express milk to help the baby latch on to the nipple or relieve breast engorgement.

How To Express Breast Milk
  • Wash hands with soap and water.
  • Sit comfortably.
  • Hold a clean container under the nipple.
  • Place thumb above and first finger below and behind the dark portion of the breast.
  • Support the breast with other fingers.
  • Press the breast gently towards the chest wall. 
  • Compress the breast between the thumb and finger. 
  • Avoid sliding the thumb and finger on the skin of the breast.
  • Gently rotate the position of the thumb and finger around the breast with each compression.
  • Express breast until milk drips, then express the other breast.
Express breast milk at the time when a baby would normally feed. 

Expressed milk should be:

* Stored in a clean, covered container.

* Kept in the coolest place possible for up to 6 hours.

* Discarded after 6 hours unless if refrigerated it can be used up to 24 hours.

After all the above step by step guide of essential care for small babies, a baby born at 1600 grams is now 2 weeks old, the baby received adequate feeds for ten days he now weighs 1850 grams and he is doing well with continuous skin to skin care and is breastfeeding well.

We hope that this modern essential care for small babies would get you to know the pros and cons of how to take care of a very small baby or premature baby without any mistake.

We know you’ve really spent much time reading this article, and we hope this content is really helpful?

Axact

Safe Milli

Safe Milli is a graduate of FPI, he studied office technology and management. He is a young enterpreur who loves to share his thoughts on latest technology trends, new business ideas and opportunities, how-tos related topics. You can chat with him on Facebook for enquiry.

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