1. Prepare all equipments at the cord dressing room.

Sterile gloves Sterile plastic clamp Cherries with betadine Surgical blade Sterile gloves clean clothes for dying and wrapping babys clothes identification band thermometer

2. Wash hands with appropriate antiseptic solution.

3. Put on sterile gloves

4. Dry skin and provide warmth to the baby

5. Do skin to skin contact

6. Do delayed or non-immediate cord clamping

7. Reposition and if needed, suction. (If after 30 seconds of thorough drying baby is not breathing or grasping)

Suction first the mouth then the nose

8. Put on identification band.

9. Record the Apgar Score

APGAR SCORING CHART COMPONENTS Heart Rate Respiratory Effort Muscle Tone Reflex irritability Response to catheter, nostril or Slap to sole of foot Color 0 Absent Absent Flaccid No response 1 <100 beats per minute Slow, irregular, weak cry Some flexion of extremities Grimace 2 >100 beats per minute Good,strong cry Well flexed Cough/ sneeze

No response Blue, pale

Grimace Body normal pigment, extremities blue

Cry and withdrawal of foot Normal skin coloring

Interpretation: 0-3: severely depressed, needs CPR and NICU admission 4-6: moderately depressed, needs additional suctioning and oxygen administration 7-10: good or healthy

10. Weigh the newborn

The infant is placed on a clinical scale and weighed to the nearest tenth of a kilogram.

11. Take the anthropometric measurements a. Head circumference (32-37cm) wrap a flexible measuring tape around the broadest part of your babys forehead, just above the ears and at the midpoint of the back of the head. b. Chest circumference
The infant lies on back. Measure the circumference of the chest at the level of the nipples during normal breathing.

c. Abdominal circumference
Make the infant lie on back with legs fully extended. Measure the circumference just below the umbilicus.

d. Length
Infant lies on back with legs extended. Measure the distance from heel to the top of head.

e. Mid-arm circumference
Wrap the tape around at the midpoint of the infant. Make sure the tape is flat around the skin.

12. Check patency of anus

Slowly insert the thermometer to the babys anus about 1 inch.

13. Put on babys clothes and diaper.

14. Inject 0.1 Vitamin K IM at the left anterolateral thigh

15. Inject 0.5 Hepa B Vaccine IM at right anterolateral thigh.

16. Give BCG Immunization intradermally at left deltoid.

The needle should only be inserted approximately 2mm into the superficial layers of the dermis

17. Apply oxytetracycline ointment on both eyes as Credes prophylaxis

It is injected into each eye from the inner to outer canthus immediately after birth

18. Wrap the newborn 19. Place newborn on crib with droplights on 20. Place crib tag 21. Document procedure and all data.