Prematurity

• 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.

Stopping neonatal resuscitation is recommended in the following situations:
In newly born babies with no detectable heart rate after 10 minutes of effective ventilation
In newly born babies who continue to have a heartrate below 60/minute and no spontaneous breathing after 20 minutes of resuscitation

In newly-born babies who do not start breathing despite thorough drying and additional stimulation, positive-pressure ventilation should be initiated within one minute after birth.
- In newly-born term or preterm (>32 weeks gestation) babies requiring positivepressure ventilation, ventilation should be initiated with air,using a self-inflating bag and mask.
- In newly-born babies requiring positive-pressure ventilation, adequacy of ventilation should be assessed by measurement of the heart rate after 60 seconds of ventilation with visible chest movements.

Immediately after birth, it is recommended to dry the baby and check if he/she is breathing or crying. When newborns do not breathe or do not cry spontaneously after complete drying, they should be stimulated by rubbing the back 2 to 3 times before the cord clamping. The drying procedure should be gentle, on the back, with a clean, dry compress.
If after rubbing the back 2 to 3 times the baby does not breathe or cry, clamping of the umbilical cord is recommended to initiate positive pressure-ventilation within the first postnatal minute.

All newborns should be given 1 mg of vitamin K intramuscularly after birth. Early administration of vitamin K prevents early bleeding due to vitamin K deficiency (hemorrhagic disease of the newborn) and prevents subsequent bleeding. Vitamin K should be applied immediately after the first postnatal hour during which skin-to-skin contact and the onset of breastfeeding should have occurred.

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.

Pre-term infants should be vaccinated at birth and subsequently follow the national hepatitis B vaccination schedule.
For preterm infants weighing under 2,000 g, the initial vaccine dose (birth dose) should not be counted as part of the vaccine series because of the potentially reduced immunogenicity of the hepatitis B vaccine in these infants; three additional doses of vaccine (for a total of four doses) should be administered beginning when the infant reaches one month of age.

Mothers with confirmed or suspected COVID-19 are advised to wear a medical mask, but even if this is not possible, breastfeeding should be continued.
It is important to replace medical masks as soon as they become damp and dispose of them immediately. Masks should not be reused or touched in the front but to remove it from behind.
It is important to follow other infection prevention measures, such as washing hands, cleaning surfaces, and covering the mouth and nose with a tissue when sneezing or coughing.