Newborn Care Policy and Protocol DOH AO 2009-0025

Establish evidence-based essential newborn care focusing on the first week of life.
Guide healthcare workers in the implementation of newborn care.
Define roles and responsibilities of DOH offices and partners in newborn protocol implementation.

Applicable to the entire Department of Health (DOH) hierarchy and attached agencies.
Mandatory for public and private healthcare providers involved in maternal and newborn care.
Includes development partners working on Maternal, Newborn, and Child Health and Nutrition (MNCHN).

Attachment: Contact between baby's mouth and mother's breast during breastfeeding.
Kangaroo Mother Care (KMC): Skin-to-skin contact, exclusive breastfeeding, and support for mother-infant dyad, especially for premature babies.
Newborn Resuscitation: Actions to establish breathing in newborns with depressed vital signs.
Positioning: How the mother holds the baby for proper attachment.
Positive pressure ventilation: Critical intervention for newborn resuscitation.
PCPNC Guide: DOH-adapted guidelines for essential care during pregnancy, childbirth, postpartum and newborn first week.
Skin-to-skin contact: Placing naked newborn prone on mother’s bare chest, critical for breastfeeding success.
Small baby: Newborn weighing 1,500 to 2,499 grams.

Policies are evidence-based, aligned with international standards.
Integrated service delivery addresses needs of mothers and newborns as a unit.
Human rights-based approach ensures client participation and dignity.
Life-cycle approach delivers essential services at key life stages.
Collaboration with multiple sectors including government, NGOs, and educational institutions is essential.

Emphasis on care from birth up to six hours of life with a prescribed sequence of interventions.

A. Quality Time-Bound Interventions:

Within 30 seconds: Dry the newborn thoroughly to prevent hypothermia; avoid early bathing.
After drying: Initiate skin-to-skin contact to foster bonding and reduce infections.
Cord clamping delayed until pulsations cease (1-3 minutes), avoiding milking of cord.
Within 90 minutes: Support early initiation of breastfeeding and administer eye prophylaxis to prevent infection.

B. Non-Immediate Interventions (within 6 hours):

C. Newborn Resuscitation:

D. Special Care for Small Babies or Twins:

E. Avoidance of Unnecessary Procedures:

Routine suctioning discouraged unless airway obstruction exists.
Avoid early bathing to maintain body temperature and protective vernix.
Discourage footprinting for identification due to inadequacy.
No prelacteal feeds or pacifiers to avoid nipple confusion.
Avoid harmful cord stump practices like alcohol application and tight bandaging.

F. Discharge Instructions:

Educate mothers on signs requiring immediate hospital return: jaundice, feeding difficulty, convulsions, abnormal breathing, abnormal temperature.
Schedule routine newborn check-ups at 48-72 hours, 7 days, and 6 weeks (immunization).

Governance: Utilize MNCHN service delivery network with community and facility-level teams.
Financing: Funding through PhilHealth accreditation and mixed public-private sources.
Service Delivery: Uphold standards from related manuals; integrate newborn protocols in training; promote community-based home care and behavior change communication.
Regulation: Implement standards via PHIC Benchbook and advocate adoption by medical societies and institutions.

Comprehensive roles assigned to various DOH centers, hospitals, LGUs, PhilHealth, professional societies, and development partners.
Responsibilities include policy formulation and dissemination, capacity building, training, financing, monitoring and evaluation, advocacy, and technical assistance.
Emphasis on collaboration, integration of policies, and ensuring adequate resources and equipment.

The order takes effect immediately upon posting and publication in the DOH intranet for 15 days after filing with UP Law Center.