Congratulations, you are now a new mom! While you receive care from the hospital, so shall your new baby.

The first few minutes are the most critical in a newborn baby’s life. From a compact, fluid-filled warm environment, baby is quickly expelled into a brand new, cold, noisy one. Let’s not forget that he is just learning to breathe!  

The procedures done during childbirth are geared towards helping the baby transition to the external environment. However, while some of the old practices were convenient to the healthcare provider (midwife, nurse or doctor), they were not exactly baby-friendly since these involved separating the baby from the mother as quickly as possible so that the initial physical examination could be given within the first minute of life. It also entailed prolonged observation in the nursery by the doctors and nurses, but consequently hampered breastfeeding and bonding with the parents. Research done by the World Health Organization (WHO) revealed that the newborn death rate was high with these old practices, and they sought to change that.

Essential Newborn Care
The WHO launched the Essential Newborn Care protocol, a simple, concise and straightforward guideline that is backed by solid research in order to decrease newborn deaths. To align with this initiative, the Department of Health (DOH) launched the Unang Yakap campaign locally in December 2009. The protocol guidelines are categorized into time bound, non-time bound and unnecessary procedures, and emphasize a core sequence of four actions that are performed step-by-step.

Time-bound procedures should be routinely performed first and they include:
-    Immediate drying of the baby
-    Skin-to-skin contact with the mother
-    Clamping of the cord after 1-3 minutes
-    Non-separation of the newborn from the mother, and
-    Breastfeeding initiation

After the first successful breastfeeding, which is anywhere from 30 minutes to 2 hours, post-natal care (non-time bound) is given, which includes:
    * Vitamin K injection -  to prevent Vitamin K deficiency bleeding
    * Eye prophylaxis – to prevent eye infections
    * Delayed bathing until 6 hours of life
    * BCG and the first dose of Hepatitis B Immunization
    * Newborn screening

Lastly, the unnecessary procedures include:
-    Routine suctioning
-    Routine separation of newborn for observation
-    Administration of prelacteals like glucose water or formula

Based on studies, the first four time-bound steps are all important in the successful transition of the baby to the external environment. Immediate and thorough drying warms the newborn and stimulates breathing. The second step (early skin to skin contact between the mother and the newborn) and delayed washing for at least 6 hours prevents hypothermia, or a state when the body temperature gets too cold. Skin-to-skin contact also prevents infection and allows maternal-infant bonding. The third step is properly-timed cord clamping and cutting, which prevents anemia. Lastly, non-separation of mother and baby for early breastfeeding protects the infant from infection.