k. Care for the Infant.
(1) The nurse should cradle the infant against his (the nurse's) body with the
infant's head supported by the palm of his hand and the body supported by the forearm.
This method allows the nurse a free hand.
(2) The infant should be held with his head tilted downward to facilitate the
drainage of mucus and amniotic fluid from the upper airway.
(3) The infant should be held at or below the level of the uterus until the
umbilical cord stops pulsating to prevent loss of neonatal blood to the placenta.
The infant may cry or breathe spontaneously or with the clamping of the cord.
(4) If the infant does not begin spontaneous respiration, he should be
stimulated to breathe. You should place the infant on a flat surface and rub his back
briskly. This can be achieved with the same motions required to dry the infant. Slap the
soles of the infant's feet if more aggressive stimulation is required.
(5) Do not "slap" the infant's buttocks. This action may produce sufficient
bruising of a large surface area and may result in compromising circulatory volume.
(6) Never suspend the infant by his feet. This action hyperextends the
infant's spine which has been flexed throughout fetal development. Also, it increases
the intracranial pressure and may cause capillary rupture and increases the chances of
dropping the infant.
(7) Dry and wrap the infant immediately to prevent heat loss. In an
emergency setting, place wrapped infant in the mother's arms to be held close to her
body to maintain warmth.
Check the infant frequently to assess for regular respirations.
Determine one (1) and five (5) minute APGAR scores.
Assist with Delivery of the Placenta.
Never tug on the cord to attempt to speed delivery. This may evulse or
tear the cord from the placenta. It may, also, encourage the uterus to
(1) Observe for signs of placenta separation. There may be a sudden gush
of blood, sudden lengthening of the cord, or a sudden rise in position of the uterus. This
usually occurs 5 to 10 minutes after delivery.