Unang Yakap

ESSENTIAL INTRAPARTUM AND
NEWBORN CARE
(EINC)
• Developed and well tested by International and
local experts.
• EINC practices reflect current knowledge.
• EINC distinguishes the necessary practices in
the delivery & care for the newborn and the
mother from the unnecessary.
ESSENTIAL NEWBORN CARE
THE FIRST 90 MINUTES
The 4 core steps/ time -bound interventions
Early Skin-to-Skin Contact
If breathing or crying:
• Position prone on the
mother’s abdomen or chest
• Cover the newborn’s back
with Dry linen
• Bonnet for head
• Temperature Check
• Room: 25-28 °C
• Baby: 36.5 – 37.5 °C
Skin-to-Skin Contact
• General perception is purely for mother-
baby bonding
Other benefits:
• To provide warmth
• Increases the duration of breastfeeding
• Allow the “good bacteria” from the
mother’s skin to infiltrate the newborn.
Properly-Timed Cord Clamping
• Prevents anemia in both term and preterm
babies
• Prevents bleeding in the brain in
premature babies
• When preparing for delivery, don 2 pairs of
gloves after thorough hand washing
• Remove the first set of gloves
• Palpate the umbilical cord
• Wait 1-3 minutes or until cord pulsations
have stopped
Properly-Timed Cord Clamping
Clamp cord
Clamp Cut the cord
using a sterile
again at 5 close to the
plastic clamp or
cm from plastic
tie at 2 cm from
the base clamp
the umbilical
base
Care of the Cord
• Do not milk the cord towards the baby

• Observe for the oozing of blood. If blood oozes,
place a second tie between the skin and the
clamp
• DRY cord care is recommended
• Do not apply any substance onto the cord *
• Do not use a binder or “bigkis” *
Washing
• Vernix - protective barrier to E.coli and
Group B Strep
Early washing
• Hinders crawling reflex
• Can lead to hypothermia
• infection, coagulation defects, acidosis,
delayed fetal to newborn circulatory
adjustment, hyaline membrane disease,
brain hemorrhage
Early and Appropriate Breastfeeding
Initiation
• Leave the newborn between the mother’s breasts
in continuous skin-to-skin contact
• The baby may want to rest for 20-60 mins and
even up to 120 minutes
before showing signs of
readiness to feed
Non-separation of Newborn from Mother
for Early Breastfeeding
• Weighing, bathing, eye care, examinations, injections
should be done after the first full breastfeed is completed
• Postpone bathing until at least 6 hours
Non-separation of Newborn from Mother
Never leave the mother and baby

unattended
Monitor mother and baby q15
minutes in the first 1-2 hrs. Assess
breathing and warmth.
Breathing: listen for grunting,
look for chest in-drawing and fast
breathing
Warmth: check the temperature
Initiation
• Health workers should not touch the
newborn unless there is a medical
indication
• Do not give sugar water, formula
• Do not give bottles or pacifiers
• Do not throw away colostrum
• Let the baby feed for as long as he/she
wants on both breasts
Initiation
• Help the mother and baby into a comfortable position
• Observe the newborn
• Once the newborn shows feeding cues, ask the mother
to encourage her newborn to move toward the breast
Breastfeeding Cues
• eye movement under closed lids

• alertness, movements of arms and legs
• turning or wiggling
• mouthing, licking, tonguing movements
• rooting
• changes in facial expression
• squeaking noises or light fussing
• Crying is a late sign of hunger
Support Continued and Exclusive
Breastfeeding
• After delivery, mother is moved

onto a stretcher with her baby
and transported to Recovery
Room, mother-baby ward or
private room
• Breastfeeding support is continued
Breastfeeding
Counsel on positioning
1. Mother
• Comfortable with back, feet
and breast supported as needed.
2. Baby
a. Face to face, chest to chest,
tummy to tummy.
b. Newborn’s whole body is
supported.
c. Facing the breast with baby’s
nose opposite the nipple.
Breastfeeding
Counsel on attachment
Signs of Good attachment:

• Mouth wide open
• Lower lip turned outwards
• Baby’s chin touching breast
• Areola : More visible above than
below the mouth.
Breastfeeding
Counsel on suckling
Signs of Effective Suckling:
• Slow deep sucks and swallowing
sounds
• Cheeks full and not drawn in
• Baby feeds calmly
• Baby finishes feed by himself and
seems satisfied.
Proper Breastfeeding Hold
• Look for a quiet place

• Find a most relaxed position for mother
• Provide adequate back
support
• Support feet
• Do not hunch shoulders
• Do not “scissor” the breast

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ESSENTIAL INTRAPARTUM AND

• Do not milk the cord towards the baby

Never leave the mother and baby

• eye movement under closed lids

• After delivery, mother is moved

Signs of Good attachment:

• Look for a quiet place

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