Immediate newborn care practices delay thermoregulation and breastfeeding initiation
Howard L Sobel1, Maria Asuncion A Silvestre, Jacinto Blas V Mantaring
1WHO Representative's Office in the Philippines, Manila, Philippines.
Acta Paediatrica (Oslo, Norway : 1992)
|March 8, 2011
Summary
Immediate newborn care in Philippine hospitals falls below WHO standards, increasing infection risks. Key interventions like skin-to-skin contact and delayed bathing are often neglected, impacting neonatal survival.
Area of Science:
- Neonatal care
- Infectious disease epidemiology
- Public health policy
Background:
- Neonatal sepsis poses a significant mortality risk, highlighted by a nosocomial outbreak in the Philippines.
- Essential newborn care practices include drying, skin-to-skin contact, delayed cord clamping, breastfeeding, and delayed bathing to prevent infection-related mortality.
Purpose of the Study:
- To evaluate immediate newborn care practices in Philippine hospitals.
- To inform policy changes, strategic planning, and hospital reform to improve neonatal outcomes.
Main Methods:
- Observational study of 481 consecutive deliveries across 51 hospitals.
- Trained physicians used a standardized tool to record immediate newborn care procedures and their timing.
Main Results:
- While basic procedures like drying and vitamin K were common, skin-to-skin contact was rare (9.6%).
- Interventions were often poorly sequenced (e.g., immediate cord clamping, delayed drying, early bathing).
- High rates of unnecessary suctioning (94.9%) were observed, particularly by doctors trained in neonatal resuscitation.
Conclusions:
- Immediate newborn care performance and timing in the observed hospitals fall below World Health Organization standards.
- Current practices deprive newborns of crucial protections against infection and mortality.
- Urgent reforms are needed to align hospital practices with evidence-based guidelines for neonatal survival.
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