12 AAC 14.530. Infant care

(a) A certified direct-entry midwife shall consult with a physician concerning an infant who

(1) has an Apgar score of seven or less at five minutes;

(2) has a congenital defect;

(3) has tachycardia of 170 or above, bradycardia of 100 or below, or cardiac irregularities;

(4) develops jaundice within 24 hours of birth or significant scleral icterus within one week of birth;

(5) has an abnormal cry;

(6) shows signs of prematurity, dysmaturity, or postmaturity;

(7) had meconium stained fluid before birth other than very light;

(8) is lethargic or does not feed well;

(9) has edema;

(10) develops grunting respirations, retractions, central cyanosis, or apnea;

(11) has a pale, generalized cyanotic or grey color;

(12) weighs less than five and one half pounds or 2,500 grams, or more than 10 pounds or 4,500 grams;

(13) does not urinate or pass meconium within 24 hours of birth;

(14) requires resuscitation by bag and mask or cardiopulmonary resuscitation; or

(15) appears weak, flaccid, or abnormal in any other respect.

(b) Within two hours of birth, a certified direct-entry midwife shall administer appropriate eye prophylaxis to the newborn infant in accordance with 7 AAC 27.111.

(c) A certified direct-entry midwife shall offer, to one or both of the parents, to administer intramuscular vitamin K to the infant for the prevention of acute and late onset hemorrhagic disease. If a parent consents to the administration of the intramuscular vitamin K, the certified direct-entry midwife shall administer the vitamin K within two hours of birth. A certified direct-entry midwife shall note in the client's records a parent's acceptance or refusal of intramuscular vitamin K.

(d) A certified direct-entry midwife shall ensure that the newborn receives metabolic blood disorder screening in accordance with 7 AAC 27.510 - 7 AAC 27.580. The certified direct-entry midwife shall use a metabolic blood disorder screening kit obtained from the Department of Health and Social Services.

(e) A certified direct-entry midwife shall recommend to the client an evaluation of the infant by a physician within one week of birth or sooner if it becomes apparent that the infant needs medical attention.

(f) A certified direct-entry midwife shall complete and file a birth certificate within seven days after the birth in accordance with AS 18.50.160 .

History: Eff. 5/11/94, Register 130

Authority: AS 08.65.030

AS 08.65.140

AS 08.65.190

Editor's note: The metabolic blood disorder kits may be obtained from the Department of Health and Social Services, division of public health, section of child and family health, 1231 Gambell Street, Anchorage, Alaska 99501-4627.

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