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Cold stress increases the need for oxygen, decreasing oxygen uptake by the lungs and oxygen to the tissues, and can deplete glucose stores.

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Cold infants may cry and appear restless.

Pale and mottled

Cool skin caused by increase in anaerobic glycolysis

decreased movement and alertness

poor feeding

respiratory rate increases and respiratory difficulty

oxygen consumption increases

pulmonary and peripheral vasoconstriction can occur

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Decrease in the PO2 and pH levels leading to metabolic acidosis.

Circumcision performed immediately after birth

hypoxia

hypoglycemia

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Respiratory acidosis can happen and excessive fatty acid can displace the bilirubin and from the albumin binding sites and exacerbate hyperbilirubinemia.

Respiratory acidosis occurs from a lack of oxygen for an extended time.

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Warm blanket to the baby

Keep baby skin to skin with mom

Place a cap on the baby's head

Place the baby under a radiant light if needed to promote thermoregulation.

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Keep extra clothing handy in case you get wet and need to change.

Avoid touching cold metal or wet surfaces with bare skin.

Do not overheat the baby.

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The liver is responsible for the conjugation of bilirubin, which results from the breakdown of RBC's.

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Jaundice

Higher RBC mass at birth

Total serum bilirubin (TSB) level exceeds 6-7 mg/dL

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Preventing injury / progression of condition

Provide support/ appropriate information to family

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It is important for patients who are receiving phototherapy to drink adequate fluids (breast milk). And should continue during phototherapy

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To prevent neonatal conjunctivitis (Inflammation caused by sexual transmitted bacteria acquired during passage through the mother’s birth canal.

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Vitamin K Prophylaxis- To prevent Vitamin K deficiency bleeding (VKDB)

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Erythromycin is usually admin. Within the first 1 hour of birth or up to 2 hours until the first breastfeeding  (recommended for both C-section and vaginal delivery)

Vit. K - recommend that every newborn receive a single dose of phytonadione delayed until after the first feeding

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Instillation of Medication into Eye of Newborn. Thumb and forefinger are used to open the eye; medication is placed in the lower conjunctiva from the inner to the outer canthus.

A pair of gloved hands administering medication in the eyes of a newborn. One hand is opening the eye as the other hand holds the medicine tube above the eye while instilling it.

Vit. K- Admin. Through injection

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Erythromycin is given as a prophylactic measure to prevent any vision changes caused by sexually transmitted diseases the mother may have. And Vit. K is admin. Because the newborn is unable to establish a normal intestinal flora until 7  days of age. This reduces the chances of serious bleeding issues.

Vit K.: encourage parents to use comfort measures for neonate such as skin-to-skin care before, during, and after injection.

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Yes, parents are refusing vitamin K injections, related to concerns about synthetic or toxic ingredients, excessive dose, side effects, and pain with administration; a desire to be natural; or believing in alternative methods of prophylaxis.

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Risk: Vitamin K: Many facilities have refusal forms that outline the risks versus benefits for parents to sign if they choose to refuse vitamin K for their newborn. Male infants who do not receive the vitamin K injection are significantly more likely to bleed post-circumcision, and many providers will decline performing this procedure when the newborn has not received vitamin K

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What to know if baby has high bilirubin and what to do

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What to know if baby has high bilirubin and what to do