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Recent trends about cord ressing and cord care New protocol on delivering babies issued To cut child death rate By JENNY F. MANONGDO December 13, 2009, 5:27pm The Department of Health (DoH) released recently an administrative order mandating the application of a new protocol on delivering babies that could bring a sharp decrease in the childhood death rate in the country.

Young babies die in the Philippines at an estimated rate of 40,000 annually, the Department of Health (DoH) said.

Based on the guidelines formulated by the World Health Organization (WHO) and the DoH, the Essential Newborn Care (ENC) is set to revolutionize the delivery practices in the country by applying delayed (umbilical) cord clamping, initiating skin-to-skin contact with the mother and early introduction to breastfeeding.

The ENC package prescribes appropriately-timed interventions beginning from the time the baby comes out of the womb, to six hours after birth and up to the time the mother and the baby are discharged from the hospital.

We believe that this protocol will pave the way for the solution on the problems we have on neonatal deaths. We are very positive that its adoption will directly reduce the count of newborn deaths in the country, DoH Secretary Francisco T. Duque III said during the conference held in Hotel Sofitel in Pasay City last week.

The administrative order said the Philippines is one of 42 countries accounting for 90 percent of all global deaths of under-five years old children.

Childhood death rates in the Philippines showed a downward trend from 1993 to 2003 with the decline slowing in the last 10 years. The under-five mortality rate decreased to only 32 per 1000 live births in 2003 from 52 to per 1,000 live births in 1988, Duque said.

The ENC protocol revises the age-old handling practices of newborn delivery and care, is guided by time and chronologically-ordered.

It prescribes the drying of babies and keeping them warm within the first 30 seconds to prevent hypothermia.

Hypothermia occurs when the persons temperature drops below normal when exposed to cold temperatures.

Put on double gloves just before delivery. Use a clean, dry cloth to thoroughly dry the newborn by wiping the eyes, face, head, front and back, arms and legsDo not put the newborn on a cold or wet surface. Do not bathe the newborn earlier than six hours of life. If the newborn must be separated from his or her mother, put him or her on a warm surface, in a safe place close to the mother, it says.

Right after birth, bawal yung baligtarin or paluin, said Dr. Aleli Sudiacal of DoH in an previous interview with the press at the Quirino Memorial Medical Center.

ENC also mandates the drying of the baby within the first 30 seconds after birth without wiping off the vernix, the mucus-like covering of newborns that is known to have an antibacterial property.

After drying the baby, rapid assessment of breathing during drying should be done as well as placing the baby on the mothers abdomen to initiate skin-toskin contact with parent and the child.

There are good bacteria on the mothers skin. When the baby comes out and you place him or her on the mommys abdomen, you are allowing the good bacteria from the mom to infiltrate the skin of the baby, pediatric expert Dr. Leslie May M. Madrazo of QMMC explained. 2. Recent trends about removal of vernix vs. non-removal of vernix: Vernix Babies are usually born with a white, cheesy coating on their skin called "vernix." This is a combination of skin secretions and skin cells. While excess vernix can be cleaned from the baby, it is not necessary to remove all of it as it has a protective effect on the baby's skin. Bathing is an ideal way of cleansing the newborn to remove blood and vernix and also to decrease exposure to maternal blood and thus to HIV and hepatitis B viruses. 3. Recent trends about vaccination of BCG as soon as birth. [Reasons for postponing anti-tuberculosis BCG vaccination of newborn infants]. [Article in Russian] Demeshko ND. Abstract Reasons for antituberculous BCG vaccination postponement in 1985 and those for BCG-M in 1986 and 1988 in 2 maternity homes of Moscow are analysed. All the newborns were divided into 3 groups each 3100 infants strong. A number of the postponed infants in every group for medical reasons appeared to be practically the same, i.e. in 1985-160 (5.16%), in 1986-172 (5.56%) and in 1988-180 (5.81%). After BCG-M vaccine which is less reactogenic, there was an increase in the number of infants with unduly indicated postponed vaccination (in 1985-28.1%, in 1986-44.6% and in 198841.7%). At the same time there was a decrease in the number of nonvaccinated infants since they were prematurely born, and as from 1986 the leading vaccination postponement reasons were nervous diseases which are not considered to be counterindications for antituberculous vaccination.