What is the plan of care for a newborn immediately after birth?

The successful transition of a fetus, which is immersed in amniotic fluid and totally dependent on the placenta for nutrition and oxygen, to a crying, air-breathing baby is a source of wonder. Healthy newborns (age birth to 1 month) and infants (age 1 month to 1 year) need good care to ensure their normal development and continued health.

Immediately after the normal delivery of a baby Overview of Labor and Delivery Although each labor and delivery is different, most follow a general pattern. Therefore, an expectant mother can have a general idea of what changes will occur in her body to enable her to deliver... read more , the doctor or nurse gently clears mucus and other material from the mouth, nose, and throat with a suction bulb. The newborn is then able to take a breath. Two clamps are placed on the newborn's umbilical cord, side by side, and the umbilical cord is then cut between the clamps. The newborn is dried and laid carefully on the mother's abdomen with skin-to-skin contact or on a sterile, warm blanket. Not all deliveries follow a standard pattern. For example, some women need to have a cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more

Keeping the newborn warm is critical. As soon as possible, the newborn is wrapped in lightweight clothing (swaddled), and the head is covered to reduce the loss of body heat. A few drops of an antibiotic, such as erythromycin, tetracycline, or silver nitrate or, in some countries, povidone iodine, are placed into the eyes to prevent infection from any harmful organisms that the newborn may have had contact with during delivery.

Immediately after a normal birth, the parents are encouraged to hold their newborn. Some experts believe that early physical contact with the newborn helps establish bonding. However, parents can bond well with their newborn even when the first hours are not spent together. The mother and newborn usually recover together in the delivery room. If the delivery is in a birth center, the mother, father or mother's partner, and newborn remain together in the same room. Mothers who are breastfeeding put their newborn to their breast within the first 30 minutes after delivery. Breastfeeding stimulates oxytocin, a hormone that helps the mother's womb to heal and promotes development of the milk supply. Once transported to the nursery, newborns are placed on their back in a small crib and kept warm. Because all babies are born with low levels of vitamin K, a doctor or nurse gives an injection of vitamin K to prevent bleeding (hemorrhagic disease of the newborn).

About 6 hours or more after birth, newborns are bathed. The nurse tries not to wash off the whitish greasy material (vernix caseosa) that covers most of the newborn's skin because this material helps protect against infection.

High-quality universal newborn health care is the right of every newborn everywhere. Babies have the right to be protected from injury and infection, to breathe normally, to be warm and to be fed. All newborns should have access to essential newborn care, which is the critical care for all babies in the first days after birth. Essential newborn care involves immediate care at the time of birth, and essential care during the entire newborn period. It is needed both in the health facility and at home.

Essential newborn care includes:

• Immediate care at birth (delayed cord clamping, thorough drying, assessment of breathing, skin-to-skin contact, early initiation of breastfeeding)
• Thermal care
• Resuscitation when needed
• Support for breast milk feeding
• Nurturing care
• Infection prevention
• Assessment of health problems
• Recognition and response to danger signs
• Timely and safe referral when needed

• Working with countries and partners to implement the Every Newborn: An action plan to end preventable deaths adopted in May 2014 in the framework of the UN Secretary-General’s Global Strategy for Women’s, Children’s and Adolescents' Health (2016-30);
• Working with countries to strengthen the availability and quality of data on routine health care for babies
• Coordinating the development of indicators at national and subnational level to assess coverage of key indicators for essential newborn care  

• Regularly updating clinical guidelines for the routine care of newborns
• Supporting countries to implement these guidelines

 Selected guidelines

This up-to-date, comprehensive and consolidated guideline on essential intrapartum care brings together new and existing WHO recommendations that, when...

This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving maternal and...

• Working with partners to develop tools to improve health workers’ skills and to assess the quality of health care provided to all babies

Much progress has been made during the past two decades in coverage of births in health facilities; however, reductions in maternal and neonatal mortality...

Deaths in the neonatal period (the first 28 days of life) now represent nearly half (47%) of all deaths of children under 5 years, with 2.5 million neonatal...