LAC 46:XLV.5347. Required Newborn Care [Formerly §5359]

A. The licensed midwife practitioner shall be responsible for care immediately following the delivery only. Subsequent infant care should be managed by a pediatrician or primary care physician. This does not preclude the midwife from providing counseling regarding routine newborn care and breastfeeding and arranging for the neonatal tests required by state law. If any abnormality is suspected, the newborn must be sent for medical evaluation as soon as possible. B. Immediately following delivery the midwife shall: 1. wipe face, then suction (with bulb syringe) mouth and nose if necessary; 2. prevent heat loss by the neonate; 3. determine Apgar scores at one and five minutes after delivery; 4. observe and record: skin color and tone, heart rate and rhythm, respiration rate and character, estimated gestational age (premature, term, or post-mature), weight, length, and head circumference. C. The midwife shall insure that Vitamin K is available at the time of delivery and take appropriate measures designed to prevent neonatal hemorrhage. D. The midwife is responsible for obtaining a PKU test and all other neonatal tests required by state law, including all required metabolic newborn screens, between 24 hours and no later than 14 days after birth. If the parents object to such tests being performed on the infant, the midwife shall document this objection and notify and refer the newborn to the infant’s pediatrician or primary care physician and notify appropriate authorities. E. The midwife shall leave clear instructions for follow-up care including signs and symptoms of conditions that require medical evaluation, especially fever, irritability, generalized rash and lethargy. F. The midwife is responsible for performing a glucose check for a newborn if weight is greater than 9 pounds, 4 ounces.