FIRST EVALUATION OF THE NEWBORN BABY AT THE HOSPITAL
NOTE: This examination / follow-up will be done in the Hospital and it has been put on this page for information purposes. The follow-up protocol in Family Health centers is different.
I. Moment of Birth and Immediately Postpartum • See Flowchart 1 (AŞ1) • Assess Apgar at 1 and 5 minutes (Y1)
II. After the Baby is Stabilized • Take care of the baby's belly and eye (Y2) • Apply 1 mg IM of vitamin K • Measure the baby's head circumference, weigh it, measure its height (Y3) • Check for congenital anomalies in the baby (AŞ2) • Assess breathing; Check for tachypnea, irregular breathing, apnea, groaning, nose wing breathing and withdrawal • Examine skin; assess for jaundice, pallor, bruising, swelling, edema, and rash • Assess movements and tone; see if it is normal and symmetrical • Evaluate the neonatal reflexes (Y4) • Make the risk assessment for the baby's hypoglycemia (AŞ3), sepsis (AŞ4a-c) and jaundice (AŞ5) and take appropriate precautions (Is there Rh and ABO incompatibility? PROM, chorioamnionitis history?, Is the baby small or large for the week of gestation, is it preterm, does the mother have diabetes?). • If the baby feels cold or hot, measure the body temperature (Y5). Dress the baby to prevent the baby from losing heat • Ensure that it is in contact with the mother and breastfeeding so that she gets breast milk as soon as possible
III. Before discharge: According to the type of delivery, mother and baby; 24 hours after normal vaginal delivery and 48 hours after cesarean delivery. Before the baby is discharged, be sure to evaluate it according to the checklist below and see if it meets the criteria. In the evaluation for discharge, each mother and baby couple should be evaluated individually. 1. Baby's clinical course and physical examination should not have an abnormality that would require re-hospitalization. 2. It should be noted that the baby's vital signs were within normal limits and stable for 12 hours (These limits are 30-60 / min for respiratory rate, 100-160 / min for heart rate. and for axillary body temperature 36.5-37.4 ˚C when the baby is in an open bed and clothed) 15 3. It should be observed that the baby urinates regularly and has at least one meconium output 4. The baby was able to provide sucking-swallowing and breathing coordination. 5. Must have been adequately evaluated and monitored for sepsis according to the risk factors of the mother (AŞ4) 6.Blood should be taken for the Neonatal Screening Program (NTP) (Y6, AŞ6) 7. Hepatitis B vaccine should have been administered. (Y7) 8. The baby should have been screened for jaundice and the next follow-up plan should be made according to the risk status (AŞ5) 9. Hearing screening should be done or planned (Y8) 10. The baby's vision should be evaluated (Y9a, AŞ7a) 1 1. Saturation should be evaluated (AŞ8) and 12. If any of the known risk factors for DDH is positive, an appointment should be made for hip ultrasonography, if there is no risk factor, the family doctor should be referred for screening at the age of 3-4 weeks (AŞ9) 13.Mothers, breastfeeding, The importance of breast milk, adequate amount of urine and stool, umbilical and hygiene care, jaundice, important disease symptoms and baby safety should be assessed. Provide counseling to the mother on the following issues • Breastfeeding (AŞ10a-b) • Belly care (Y2) , baby care (Y10), hand washing (Y11) • Situations that require immediate consultation (fever, poor sucking, vomiting, diarrhea, jaundice, tendency to sleep, etc.) • Protection from accidents (Y12a-b) • Family planning 14.Family, environmental and social risk factors should be evaluated, if necessary, discharge should be delayed until these risk factors disappear.
IV. Before the baby and mother leave the institution:
• Record your findings on the baby's records
• Issue and give the family the vaccination card
• Prepare and deliver the birth report to the family
• Answer the family's questions and provide brochures with recommendations given
• Instruct the baby to contact the GP for a check-up within the first week after birth.