Pediatrics
RCH Programs and Newborn Care
RCH programme and newborn care for MBBS: RCH I and II evolution, antenatal care, Golden Minute resuscitation and essential newborn care, mapped to NMC codes PE18.1 to PE18.8.
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RCH Programs and Newborn Care
RCH programme and newborn care for MBBS: RCH I and II evolution, antenatal care, Golden Minute resuscitation and essential newborn care, mapped to NMC codes PE18.1 to PE18.8.
This chapter covers the Reproductive and Child Health programme and its evolution, together with antenatal care, intranatal care, newborn resuscitation and essential newborn care. It emphasises preventive interventions for child survival and safe motherhood and the practical numbers of newborn care.
High-yield: RCH Programs and Newborn Care
- The Reproductive and Child Health programme evolved from RCH I in 1997 to RCH II under NRHM in 2005, which added ASHA workers and Janani Suraksha Yojana.
- Later initiatives added Janani Shishu Suraksha Karyakram, PMSMA antenatal care days, LaQshya for labour-room quality and SUMAN for assured maternal and newborn care.
- Naegele's rule estimates the expected date of delivery as the last menstrual period plus 9 months and 7 days.
- The symphysio-fundal height in centimetres roughly equals the gestational age in weeks (plus or minus 2 cm) from 20 to 36 weeks.
- Rh-negative mothers receive anti-D prophylaxis at 28 weeks and within 72 hours of delivery.
- In newborn resuscitation, the initial steps should be completed within the Golden Minute of 60 seconds.
- The positive pressure ventilation rate in newborn resuscitation is 40 to 60 breaths per minute.
- The chest compression to ventilation ratio in newborn resuscitation is 3 to 1, not 15 to 2.
- Chest compressions are started if the heart rate stays below 60 beats per minute after 30 seconds of effective positive pressure ventilation.
- Normal newborn vitals are a heart rate of 120 to 160 per minute, a respiratory rate of 30 to 60 per minute and a temperature of 36.5 to 37.5 degrees Celsius.
- The umbilical cord normally has two arteries and one vein, and a single umbilical artery prompts screening for renal anomalies.
- Vitamin K 1 milligram is given intramuscularly to every newborn at birth to prevent vitamin K deficiency bleeding.
- Essential newborn care includes breastfeeding within one hour, exclusive breastfeeding for six months and thermal care.
- The oral rehydration solution used is low-osmolarity ORS with an osmolarity of 245 milliosmoles per litre, and zinc is given for 10 to 14 days in diarrhoea.
Newborn resuscitation and care essentials
- **Golden Minute:** Complete initial resuscitation steps within 60 seconds.
- **PPV and compressions:** PPV rate 40 to 60/min; compression:ventilation ratio 3:1.
- **Heart-rate threshold:** Start compressions if HR < 60 after 30 s of effective PPV.
- **Vitamin K:** 1 mg intramuscular to every newborn at birth.
NMC competencies in this chapter
- **PE18.1:** RCH programme: components, plan, outcomes and monitoring
- **PE18.2:** Preventive interventions for child survival and safe motherhood
- **PE18.3:** Antenatal examination and at-risk approach
- **PE18.4:** Intranatal care and normal delivery
- **PE18.5:** Newborn resuscitation in a simulated environment
- **PE18.6:** Essential newborn care and identifying deviations
- **PE18.7:** Principles of care of a well baby
- **PE18.8:** Antenatal exercises, breastfeeding and child rearing
Frequently Asked Questions
What is the Golden Minute in newborn resuscitation?
The Golden Minute refers to completing the initial steps of newborn resuscitation, including drying, stimulating and, if needed, starting positive pressure ventilation, within the first 60 seconds of life for a non-breathing newborn.
What is the chest compression to ventilation ratio in newborns?
In newborn resuscitation the chest compression to ventilation ratio is 3 to 1, not the 15 to 2 used in older children. Compressions start when the heart rate remains below 60 per minute after 30 seconds of effective ventilation.
How does Naegele's rule estimate the delivery date?
Naegele's rule estimates the expected date of delivery by adding 9 months and 7 days to the first day of the last menstrual period, assuming a regular 28-day cycle.
Why is vitamin K given to newborns?
Vitamin K 1 milligram is given intramuscularly to every newborn at birth to prevent vitamin K deficiency bleeding, which is a risk because newborns, especially breastfed ones, have low vitamin K stores.
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