THE CONTEXT
Immediate care of the newborn supports temperature maintenance, early breastfeeding, safe cord management, and reliable identification.
Observation and early skin-to-skin contact
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Observe the neonate during the transition.
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The cited newborn-care guidance recommends delivering healthy neonates onto the mother's abdomen and promoting skin-to-skin contact for at least 1 hour.
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Early skin-to-skin contact enables breast crawl, establishes early exclusive breastfeeding, and helps prevent hypothermia.
Cord clamping and stump care
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Clamp the cord 2–3 cm from the abdomen using a clamp, clean thread, or sterile rubber band.
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In term and preterm neonates, delay cord clamping for at least 30–60 seconds to allow additional placental blood transfer.
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In term infants, delayed clamping improves hemoglobin and iron stores and reduces clinical anemia at 2–6 months. In preterm infants, it is associated with reduced IVH and other morbidities.
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If the neonate is asphyxiated at birth, clamp the cord immediately and begin resuscitation without delay.
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Keep the cut stump away from the genitals to avoid fecal and urine contamination. Inspect the cord every 15–30 minutes during the initial few hours for oozing.
Cleaning and identification
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Dry and clean the newborn gently with a clean, sterile cloth, removing blood and meconium without vigorously removing vernix caseosa.
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Vernix is the whitish greasy material on the skin. It protects the skin, helps maintain temperature, and is absorbed spontaneously over a few days.
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Each infant must have an identity band containing the mother's name, hospital registration number, gender, and birth weight.