2nd. Week

It is very important to control the temperature of the newborn baby. Cold hands and feets are characteristic of healthy babies; it does not mean that they feel cold.
The permanent proximity of the mother facilitates skin-to-skin contact, a situation favoring the maintenance of the baby's temperature.
It is recommended that bathing be delayed, if possible over 24 hours after birth, and that the environment where the newborn baby is placed be free of air currents.

When there is a medical indication to administer a human milk substitute for a specific situation, it must be prepared under safe conditions.
• Wash hands.
• Boil filtered water (after it begins to boil, wait 15 minutes), and then allow to cool to room temperature.
• Use the quantity of water corresponding to the quantity of feed desired; for every 30 ml of water add one level measure of milk powder.
• Shake the feeding bottle until the powder is totally dissolved.
• Milk should be prepared at the time of each feeding.

Skin irritations can be caused by prolonged contact with urine and feces. To avoid them, the diaper should be changed as often as needed. It is important to clean the baby with water and neutral soap after bowel movements, and to keep the diaper region dry.
• Change diaper frequently.
• Wash the region with neutral soap.
• Keep the skin clean and dry, especially in folds and grooves.
• After washing, dry the area well and powder with dry cornstarch in the affected region.

• Choose a location for the bath without drafts, during the warmest part of the day.
• Have all necessary items ready in advance and close at hand: towel, soap, clothes, diaper, blanket.
• Bathe daily or more than once a day, if necessary (if the newborn is restless, crying, hot, feverish...).
• Do not use alcohol in bath water; it dries the skin and irritates the mucous membranes. and it is dangerous.
• Do not use lotions, perfumes, talcum powder, or ointments.
• Dry skinfolds thoroughly.

• Remove excess feces with the disposable diaper.
• Take the baby to water for a cleaning, removing all feces, or use a cloth diaper moistened with lukewarm water to clean, avoiding friction. When cleaning infant girls, it is important to wipe from the vagina toward the anus rather than the reverse (to prevent urinary infection).
• Dry thoroughly and put on a clean diaper. Use cornstarch but avoid talcum powders, which can cause allergies
• Avoid the use of premoistened wipes, which can cause allergic reactions in the child.

It is essential to ensure that all newborns are routinely monitored for the development of jaundice and that serum bilirubin should be measured in those at risk:
• in all babies if jaundice appears on day 1
• in preterm babies (<35 weeks) if jaundice appears on day 2
• in all babies if palms and soles are yellow at any age
Term and preterm newborns with hyperbilirubinaemia should be treated with phototherapy or exchange transfusion guided by the following cut-off levels of serum hyperbilirubinaemia shown in the table.

To reduce transmission of respiratory viruses during rooming-in and after hospital discharge, provide guidance to health professionals and family members on the following precautions:
• health professionals: disinfect hands before and after contact with patients.
• isolate patients hospitalized with suspicion of respiratory infection, with precautions that include:
· hand washing before and after contact with patients and their personal items;
· use of gloves and apron for contact with patients;

Responsive care encompasses both sensitivity and responsiveness with which a young infant is assisted. Sensitivity is awareness, from birth, of a young child’s acts and vocalizations as communicative signals to indicate needs and wants. Responsiveness is the capacity of parents and caregivers to respond appropriately to these signals. Caregivers enable infants to participate in human communication and exchanges by playing their own part in the interaction as well as helping the infant engage.

Breastfeeding provides both short- and long-term benefits to the child and the mother.

For the child, breastfeeding provides optimal nutrition and reduces incidence of disease and death. Breastfeeding, particularly exclusive breastfeeding, protects children from diarrhea and pneumonia, the two leading causes of death among children under age five. Other infections, including otitis media, Haemophilus influenzae meningitis, and urinary tract infections, are less common and less severe in infants who are breastfed.

The Ten Steps involve changes in maternity services. Every facility providing maternity services
should have a breastfeeding policy and carry out structural changes and train all health care staff in skills necessary to implement this policy. They are aimed to protecting, promoting, and supporting breastfeeding in facilities that provide maternity services.