1. Immediate Care at Birth

The immediate care a newborn receives after birth is foundational to their survival and well-being. Several practices are essential at this stage to ensure the baby adapts well to life outside the womb:

• Delayed Cord Clamping: Traditionally, the umbilical cord was clamped immediately after birth, but evidence now supports delaying clamping for at least 1–3 minutes. This practice allows more blood to flow from the placenta to the newborn, providing important nutrients and oxygen to support the baby's organs and tissues. Delayed cord clamping has been shown to reduce the risk of anemia and iron deficiency in the first few months of life.
• Thorough Drying: After delivery, newborns are often covered in amniotic fluid, blood, and vernix (a protective coating on the skin). Thorough drying of the baby’s body helps remove this fluid and also helps in preventing hypothermia, which is a common and dangerous risk in newborns. Drying stimulates the baby’s circulation, promotes warmth, and encourages the baby to breathe on their own.
• Assessment of Breathing: At birth, it is crucial to assess the newborn’s breathing immediately. Healthy newborns typically begin to breathe on their own shortly after birth, but some may experience difficulty. Healthcare providers should assess the baby’s breathing rate and effort. If the newborn is not breathing or is struggling, resuscitation should begin immediately.
• Skin-to-Skin Contact: Placing the newborn on the mother’s chest immediately after birth (skin-to-skin contact) is one of the most beneficial practices for both the baby and the mother. This practice helps regulate the newborn’s body temperature, encourages bonding, and stimulates early breastfeeding. It also stabilizes the baby’s heart rate and breathing. Skin-to-skin contact is vital for the baby’s emotional and psychological development and strengthens the bond between mother and child.
• Early Initiation of Breastfeeding: Early breastfeeding should begin within the first hour of birth. This is important for both the baby and the mother. Colostrum, the first milk produced by the mother, is rich in nutrients and antibodies that protect the newborn from infections. Early breastfeeding also stimulates the production of breast milk and helps establish a healthy breastfeeding routine. Exclusive breastfeeding in the first six months of life is a cornerstone of infant health.

2. Thermal Care

Newborns are highly susceptible to temperature fluctuations, as they are unable to regulate their body temperature effectively. Hypothermia (low body temperature) can lead to serious complications, including respiratory distress and increased risk of infection. Thermal care is therefore a critical component of newborn care:

• Maintaining Warmth: Keeping the newborn warm is essential immediately after birth and during the first days of life. This can be achieved through skin-to-skin contact with the mother, drying the baby thoroughly, and wrapping the baby in warm clothing or blankets. Avoiding the baby’s exposure to cold environments is key.
• Using Warm Surfaces: When placing the baby on a surface, such as a scale or changing table, it is essential to ensure that the surface is warm. Many hospitals use radiant warmers to maintain the baby’s temperature during medical procedures.

3. Resuscitation When Needed

While most newborns transition smoothly after birth, some may require assistance in the form of resuscitation. Immediate recognition of breathing problems or circulatory failure is critical:

• Resuscitation Techniques: Newborn resuscitation may involve providing positive pressure ventilation (PPV) to help the baby start breathing. If the baby’s heart rate is too low or breathing is absent, chest compressions and advanced care may be necessary. Healthcare providers must be skilled in neonatal resuscitation to save the lives of babies experiencing birth asphyxia or respiratory distress.
• Prompt Action: Resuscitation is time-sensitive, and delays can have detrimental effects. Healthcare workers should be trained in neonatal resuscitation protocols and be ready to act quickly if the baby shows signs of distress after birth.

4. Support for Breast Milk Feeding

Breastfeeding is the optimal method of feeding for newborns, as it provides the ideal nutrition and helps protect against infections:

• Exclusive Breastfeeding: Newborns should be exclusively breastfed for the first six months of life, which means no other liquids or solids are given. Breast milk contains the perfect balance of nutrients, growth factors, and antibodies that support the baby’s immune system and growth. Early and frequent breastfeeding helps establish a good milk supply and prevents issues like low milk production.
• Encouraging Breastfeeding: It is important to provide mothers with support, guidance, and encouragement to initiate breastfeeding within the first hour of birth. This practice, along with continued support, is vital for establishing a successful breastfeeding routine.

5. Infection Prevention

Newborns have an immature immune system, making them vulnerable to infections. Infection prevention is essential for keeping the baby healthy:

• Hygiene and Cleanliness: Practicing good hygiene is one of the most effective ways to prevent infections. Healthcare providers must ensure that their hands and equipment are clean when handling the newborn. Ensuring the birth environment is sanitary also helps minimize the risk of infection.
• Cord Care: The umbilical cord stump should be kept clean and dry to prevent infections. In many places, antiseptics are used to clean the stump, but in low-resource settings, keeping the area dry and exposed to air is often recommended to reduce the risk of infection.

6. Nurturing Care

Nurturing care focuses on meeting the emotional, psychological, and physical needs of the newborn. This is essential not only for the baby’s development but also for the mother-child relationship:

• Emotional Bonding: Responsive care, including holding, talking to, and soothing the baby, is important for emotional development. The newborn’s primary caregivers should interact frequently with the baby, responding to their cries and cues to build a strong attachment.
• Supporting Parental Involvement: Encouraging both parents to be involved in caregiving and bonding with the newborn is essential. This helps promote the baby’s emotional well-being and fosters healthy relationships.

7. Ongoing Health Assessments

Regular health assessments are necessary to identify and address any potential health issues early:

• Newborn Screening: Early screening for metabolic, genetic, and hearing disorders can identify conditions that may require treatment and intervention. This can significantly improve the baby’s health outcomes.
• Monitoring Growth and Development: Routine checks on weight, feeding patterns, and developmental milestones are important to ensure the newborn is growing well and is not at risk of malnutrition or other health issues.