UNANG YAKAP
Essential Newborn Care (ENC)
• a simple, cost-effective newborn care intervention that
can improve neonatal as well as maternal care.
• an evidence-based intervention that :
– emphasizes a core sequence of actions, performed
methodically (step-by-step)
– is organized so that essential time bound interventions are
not interrupted
– fills a gap for a package of bundled interventions in a
guideline format
• a series of time bound, chronologically-ordered,
standard procedures that a baby receives at birth
Unang Yakap
• A campaign that seeks to engage national and
local sectors, public and private health sectors,
individuals and organizations, mothers,
fathers and families, to embrace the Essential
Newborn Care Protocol to ensure a bright and
healthy future for our newborns.
Rationale
• Every year approximately 40,000 Filipino
neonates die, mostly from preventable causes.
• The majority die within the first week.
• The high mortality and morbidity rates in
newborns are directly related to inappropriate
hospital and community practices currently
employed throughout the Philippines.
TIME BAND: At perineal bulging
INTERVENTION: Prepare for the
delivery
• Check temperature of the delivery room
– 25-28C
– Free if air drafts
• Notify appropriate staff
• Arrange needed supplies in a linear fashion
• Check resuscitation equipment
• Wash hands with clean water and soap
• Double glove just before delivery
Four Core Steps of Essential
Newborn Care
• Immediate and thorough drying
• Early skin to skin contact
• Properly timed cord clamping
• Non-separation of the newborn and mother
for early initiation of breastfeeding
TIME BAND: Within the 1st 30
seconds
INTERVENTION: Immediate and
thorough drying
• Call out time of birth
• Dry the newborn thoroughly for at least 30
seconds
– wipe the eyes, face, head, front and back, arms
and legs
• Remove the wet cloth
st
Within the 30 seconds:
1
Immediate and thorough
drying
• Do a quick check of breathing while drying
**Do not ventilate unless the baby is
floppy/limp and not breathing.
** Do not suction unless the mouth/ nose are
blocked with secretions or other material
If after 30 seconds of drying,
newborn is not breathing or is
gasping
• Intervention: Reposition, suction and
ventilate
• Action:
– Clamp and cut cord immediately
– Call for help
– Transfer to a warm, firm surface
– Inform the mother that the baby has difficulty
breathing and that you will help the baby breathe
– Start resuscitation protocol
TIME BAND: After 30 seconds of
drying
INTERVENTION: Early Skin to
Skin Contact
• If newborn is breathing or crying:
– Position the newborn prone on the mother’s
abdomen or chest
– Cover the newborn’s back with a dry blanket
– Cover the newborn’s head with a bonnet
– Place identification band on ankle (not wrist)
• Do not separate the newborn from mother
• Do not put the newborn on a cold or wet
surface.
• Do not wipe off vernix if present.
• Do not bathe the newborn earlier than 6
hours of life.
• If the newborn must be separated from
his/her mother, put him/her on a warm
surface, in a safe place close to the mother
Time Band: 1-3 mins
Properly Timed Cord
Clamping
• Remove the first set of gloves
• After the umbilical pulsations have stopped,
clamp the cord using a sterile plastic clamp or
tie at 2 cm from the umbilical base
• Clamp again at 5 cm from the base
• Cut the cord close to the plastic clamp
• Notes
– Do not milk the cord towards the baby; After the
first clamp- you may strip the cord of blood before
applying the 2nd clamp
– Cut the cord close to the plastic clamp so that
there is no need for a 2nd trim
– Do not apply any substance to the cord
Time Band: With 90 mins
Non separation of Newborn
from Mother for Early
Breastfeeding
• Leave the newborn in skin to skin contact
• Observe for feeding cues, including tonguing,
licking, rooting
• Point out these to the mother and encourage
her to nudge the newborn towards the breast
Time Band: With 90 mins
Non separation of
Newborn from Mother for
Early Breastfeeding
• Counsel on positioning
– Newborns neck is not flexed nor twisted
– Newborn is facing the brest
– Newborns body is close to mother’s body
– Newborns whole body is supported
Time Band: With 90 mins
Non separation of Newborn
from Mother for Early
Breastfeeding
• Counsel on attachment and suckling
– Mouth wide open
– Lower lip turned outwards
– Baby’s chin touching the breast
– Suckling is slow, deep with some pauses
• Notes
– Minimize handling by healthworkers
– Do not give sugar water, formula or other
prelacteals
– Do not give bottles or pacifiers
– Do not throw away colostrum
Time Band: With 90 mins
Non separation of
Newborn from Mother for
Early Breastfeeding
• Weighing, bathing, eye care, examinations,
injections (hepatitis B, BCG) should be done
after the first full breastfeed is completed
• Postpone washing until at least 6 hours
