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We have taken every care to ensure that drug dosages and related medical advice in this book are accurate. However, drug and disinfectant dosages can change and are updated often, so always double-check dosages and procedures against a reliable, up-to-date formulary and the given drug’s documentation before administering it.

Newborn Care: Managing normal and high-risk infants in the newborn nursery

First published in 2009 by Bettercare. Updated March 2011, March 2012, March 2014, August 2014, February 2015 (layout), May 2017 (significant changes). This version produced on 26 February 2025.

Text © Perinatal Education Trust 2009
Cover photograph © Harris Steinman
Illustrations by Mary Hann and Anne Westoby

ISBN (paperback): 978-1-920218-28-7
ISBN (international paperback edition): 978-1-717898-19-7
ISBN (reflowable ebook): 978-1-928313-08-3

Excluding content explicitly credited to others, this book is published under a Creative Commons Attribution Non-Commercial No Derivatives License. For details, see creativecommons.org/licenses/by-nc-nd/4.0.

This licence means you may share, copy and redistribute the material in any medium or format under the following terms:

  • Attribution — You must give appropriate credit, provide a link to the licence, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • Non-Commercial — You may not use the material for commercial purposes.
  • No Derivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.

For any other uses, please contact Bettercare.

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      1. Home
      1. How to use our books
      2. Buy printed books
      3. About Bettercare
      4. FAQs
      5. Contact us
      1. Acknowledgements
      2. Introduction
        1. About Bettercare
        2. Why decentralised learning?
        3. Free Bettercare Online Learning Platform
        4. Learning programmes
        5. Format of the courses
        6. Contributors
        7. Updating the course material
        8. Contact information
        9. Registration
      3. 1 Failure to breathe at birth and resuscitation
        1. Objectives
        2. Assessing the infant at birth
        3. Neonatal resuscitation
        4. Preventing meconium aspiration
        5. Neonatal encephalopathy
        6. Case studies
      4. Skills: Neonatal resuscitation
        1. Objectives
        2. Assessing the Apgar score
        3. Giving mask ventilation
        4. Tracheal intubation
        5. Chest compressions
      5. 2 Assessing gestational age and size at birth
        1. Objectives
        2. Assessing an infant’s gestational age at birth
        3. Assessing an infant’s size at birth
        4. Grouping infants by their weight for gestational age
        5. Case studies
      6. Skills: Gestational age and weight
        1. Objectives
        2. Assessing the gestational age
        3. Measuring weight and head circumference
        4. Plotting weight and head circumference
        5. References
      7. 3 The routine care of normal infants
        1. Objectives
        2. Managing normal infants
        3. Common minor problems
        4. Discharging a normal infant
        5. Case studies
      8. Skills: Clinical history and examination
        1. Objectives
        2. Introduction
        3. Taking a perinatal history
        4. The physical examination of a newborn infant
        5. The road-to-health booklet
      9. 4 Feeding normal infants
        1. Objectives
        2. Introduction to infant feeding
        3. The benefits of breastfeeding
        4. Promoting breastfeeding
        5. Teaching mothers to breastfeed
        6. Managing breastfeeding problems
        7. Formula-feeding newborn infants
        8. The baby friendly initiative
        9. Feeding the HIV-exposed infant
        10. Case studies
      10. 5 Care of high-risk and sick infants
        1. Objectives
        2. Classification of infants on the basis of risk
        3. Managing a sick infant
        4. Monitoring a high-risk or sick infant
        5. The management of shock
        6. The management of fits
        7. The management of acidosis
        8. Case studies
      11. Skills: Clinical notes and observations
        1. Objectives
        2. Writing good clinical notes
        3. Recording routine observations
        4. Recording fluid intake and output
      12. 6 Feeding sick or high-risk infants
        1. Objectives
        2. Fluid requirements
        3. Intravenous fluids
        4. Milk feeds for sick or high-risk infants
        5. Vomiting
        6. Case studies
      13. Skills: Feeding sick or high-risk infants
        1. Objectives
        2. Passing a nasogastric tube
        3. Nasogastric feeding
        4. Preparation of formula feeds
        5. Starting a peripheral intravenous infusion
        6. Using a fluid controller
      14. 7 Temperature control and hypothermia
        1. Objectives
        2. Measuring body temperature
        3. Heat production and loss
        4. Hypothermia
        5. Pyrexia
        6. Case studies
      15. Skills: Temperature control and hypothermia
        1. Objectives
        2. The telethermometer
        3. The closed incubator
        4. The overhead radiant warmer
      16. 8 Glucose control and hypoglycaemia
        1. Objectives
        2. Glucose control
        3. Hypoglycaemia
        4. Hyperglycaemia
        5. Case studies
      17. Skills: Glucose control and hypoglycaemia
        1. Objectives
        2. Measuring the glucose concentration in capillary blood with reagent strips
        3. Measuring the glucose concentration in capillary blood with a glucose meter
        4. Inserting an umbilical vein catheter
      18. 9 Jaundice, anaemia and polycythaemia
        1. Objectives
        2. Jaundice
        3. Haemolytic disease
        4. Phototherapy
        5. Anaemia
        6. Polycythaemia
        7. Case studies
      19. Skills: Jaundice and phototherapy
        1. Objectives
        2. Measuring the packed cell volume
        3. Using a phototherapy unit
      20. 10 Respiratory distress and apnoea
        1. Objectives
        2. Respiratory distress
        3. Hyaline membrane disease
        4. Wet lung syndrome
        5. Meconium aspiration syndrome
        6. Pneumonia
        7. Pneumothorax
        8. Heart failure and patent ductus arteriosus
        9. Apnoea
        10. Case studies
      21. Skills: Respiratory distress and apnoea
        1. Objectives
        2. Using an apnoea monitor
        3. Transillumination of the chest
        4. Emergency needling of a pneumothorax
        5. Inserting a chest drain
      22. 11 Oxygen therapy
        1. Objectives
        2. Oxygen therapy
        3. Measuring the amount of oxygen
        4. The advantages and disadvantages of extra oxygen
        5. Administering oxygen safely
        6. Providing continuous positive airways pressure (CPAP)
        7. Case studies
      23. Skills: Oxygen therapy
        1. Objectives
        2. Using a flow meter with humidifier
        3. Using a blender or venturi
        4. Using an oxygen monitor
        5. Using a pulse oximeter (oxygen saturation monitor)
        6. Providing nasal cannula oxygen
        7. Providing nasal CPAP
      24. 12 Infection
        1. Objectives
        2. Preventing infection
        3. Minor infections
        4. Major infections
        5. Chorioamnionitis
        6. Chronic intra-uterine infection
        7. Syphilis
        8. HIV infection
        9. Case studies
      25. 13 Trauma and bleeding
        1. Objectives
        2. Trauma
        3. Bleeding
        4. Case studies
      26. 14 Congenital Disorders
        1. Objectives
        2. Introduction to congenital disorders
        3. Common structural congenital disorders
        4. Serious structural congenital disorders
        5. Major neurological defects
        6. Important syndromes
        7. Managing parents of infants with a congenital disorder
        8. Case studies
      27. 15 Communication
        1. Objectives
        2. Communication with parents
        3. Parental bonding
        4. Managing the family of a sick or dying infant
        5. Bereavement
        6. Communicating with colleagues at other hospitals and clinics
        7. Transferring newborn infants
        8. Assessing the perinatal health-care status in your region
        9. Case studies
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