{"id":33613,"date":"2018-11-01T12:43:42","date_gmt":"2018-11-01T16:43:42","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=news-item&p=33613"},"modified":"2018-11-01T12:45:45","modified_gmt":"2018-11-01T16:45:45","slug":"for-preterm-infants-skin-to-skin-contact-affects-hormone-levels-and-may-promote-parental-engagement","status":"publish","type":"news-item","link":"https:\/\/www.healthynewbornnetwork.org\/news-item\/for-preterm-infants-skin-to-skin-contact-affects-hormone-levels-and-may-promote-parental-engagement\/","title":{"rendered":"For preterm infants, skin-to-skin contact affects hormone levels — and may promote parental engagement"},"content":{"rendered":"

For premature infants in the neonatal intensive care unit (NICU), skin-to-skin contact with parents influences levels of hormones related to mother-infant attachment (oxytocin) and stress (cortisol) — and may increase parents’ level of engagement with their infants, reports a study in Advances in Neonatal Care, official journal of the National Association of Neonatal Nurses.<\/p>\n

Promoting early contact and parental engagement might help to lessen the risk of neurodevelopmental delay associated with preterm birth and NICU care, according to the exploratory study by Dorothy J. Vittner, PhD, RN, CHPE, of University of Connecticut School of Nursing and colleagues. They write, “Parental touch, especially during skin-to-skin contact (SSC) has potential to reduce adverse consequences.”<\/p>\n

Study Attempts to Measure Benefits of Skin-to-Skin Contact for Preterm Infants<\/h3>\n

The pilot study included 28 preterm infants, average gestational age 33 weeks. All infants were in stable condition while receiving NICU care. Infants underwent periods of SSC on two consecutive days: once with the mother and once with the father. Saliva samples were collected from infants and parents to measure levels of oxytocin, a hormone that has been linked to maternal-infant attachment; and the stress-related hormone cortisol.<\/p>\n

“Oxytocin facilitates social sensitivity and attunement necessary for developing relationships and nurturance for emotional and physical health,” the researchers write. Cortisol plays an important role in the “fight or flight” reaction to fear or stress.<\/p>\n

Levels of both hormones changed in response to SSC. “Oxytocin significantly increased and cortisol levels decreased for mothers, fathers, and infants during SSC as compared to baseline,” Dr. Vittner and coauthors write. The changes indicate the “calming and beneficial impact of SSC for both parents and infants.”<\/p>\n

Parents also completed a questionnaire called the “PREEMI” (Parent Risk Evaluation and Engagement Model and Instrument) scale, designed to measure attachment between parents and their preterm infants. Overall PREEMI scores indicated a “moderate to high” level of parental engagement for all participants.<\/p>\n

Increased oxytocin and decreased cortisol levels during SSC were associated with higher PREEMI scores by the time the infant was discharged from the hospital. “We believe these findings suggest that parents with a lower salivary cortisol as seen with SSC (decreased stress) may facilitate increased parental engagement,” Dr. Vittner and colleagues write.<\/p>\n

Mothers and fathers had similar increases in oxytocin during SSC. In mothers, the rise in oxytocin was related to increased parental engagement. Unexpectedly, however, increased oxytocin during SSC in fathers was negatively related to parental engagement. Dr. Vittner and colleagues note that for many fathers, the study SSC intervention was the first time they had held their infants.<\/p>\n

The study provides new evidence of how SSC might work to promote attachment between parents and premature infants. “The changes in oxytocin and cortisol levels provide robust support to advocate for increased SSC during infancy, especially for the vulnerable infant in the NICU,” the researchers write. They note that further studies will be needed to understand these relationships, and how they affect parent-infant relationships — especially in overcoming the obstacles posed by having a premature infant who need NICU care.<\/p>\n

The results also suggest that the PREEMI questionnaire can provide a “window into parent engagement,” potentially useful in identifying parents who may need interventions to increase engagement with their premature infant. Dr. Vittner and coauthors conclude: “Uncovering the bio-behavioral basis of early parent-infant interactions is an important step in developing therapeutic modalities to improve infant health outcomes.”<\/p>\n

Story Source:<\/strong>
\nMaterials provided by Wolters Kluwer Health<\/a>.<\/p>\n

Journal Reference:<\/strong>
\nDorothy Vittner, Samantha Butler, Kelsey Smith, Nefeli Makris, Elizabeth Brownell, Haifa Samra, Jacqueline McGrath. Parent Engagement Correlates With Parent and Preterm Infant Oxytocin Release During Skin-to-Skin Contact.<\/strong> Advances in Neonatal Care, 2018;<\/em> 1 DOI: 10.1097\/ANC.0000000000000558 <\/a><\/p>\n","protected":false},"author":7211,"featured_media":33616,"template":"","acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/for-preterm-infants-skin-to-skin-contact-affects-hormone-levels-and-may-promote-parental-engagement\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"For preterm infants, skin-to-skin contact affects hormone levels - and may promote parental engagement - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"For premature infants in the neonatal intensive care unit (NICU), skin-to-skin contact with parents influences levels of hormones related to mother-infant attachment (oxytocin) and stress (cortisol) — and may increase parents’ level of engagement with their infants, reports a study in Advances in Neonatal Care, official journal of the National Association of Neonatal Nurses. 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While many preterms survive in high-income countries, in low- and middle-income countries a lack of adequate newborn care puts the lives of many preterm babies at risk.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">15<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666023383014{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of babies born prematurely (2014)<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10.6<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666023354144{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">rate of premature babies worldwide (2014)<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">89<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667425699228{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8850944\/pdf\/jogh-12-04011.pdf\">preterm births<\/a> that occur in sub-Saharan Africa and South-Asia (2012 - 2016)<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][vc_empty_space][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"Preventing preterm birth\" color=\"custom\" accent_color=\"#cccccc\"][vc_column_text]\r\n<p style=\"text-align: center;\">Although we still do not have a full understanding of the causes of preterm birth, several interventions may reduce the risk of a woman delivering early, including high-quality\u00a0antenatal care; good nutrition; screening and management of maternal infections, diabetes, and hypertension; smoking cessation; family planning; and prenatal care for adolescents. If a woman presents in preterm labor, administration of antenatal corticosteroids may\u00a0reduce mortality from respiratory distress, and antibiotics can reduce a baby\u2019s risk for infection.<\/p>\r\n[\/vc_column_text][vc_column_text]<strong>Key resources:<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/who-recommendations-for-care-of-the-preterm-or-low-birth-weight-infant\/\">WHO recommendations for care of the preterm or low-birth-weight newborn (2022)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/joint-statement-international-recommendations-interventions-improve-preterm-birth-outcomes\/\" target=\"_blank\" rel=\"noopener noreferrer\">Joint Statement: International WHO Recommendations on Interventions to Improve Preterm Birth Outcomes<\/a><\/li>\r\n \t<li><a href=\"http:\/\/dx.doi.org\/10.1016\/S2214-109X(18)30565-5\">National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis<\/a><\/li>\r\n \t<li><a href=\"http:\/\/dx.doi.org\/10.1016\/S2214-109X(19)30041-5\">Low birthweight: will new estimates accelerate progress?<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/Nurturing-Care-Evidence-Review-and-Case-Studies-13Aug2019.pdf\">Nurturing care for small and sick newborns: Evidence review and country case studies<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/07\/DNH_TechBrief_HumanMilkFeeding_7.9.19Final.pdf\">Safe and effective human milk feeding for small and sick newborns<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.nature.com\/articles\/pr2013204\">Preterm birth\u2013associated neurodevelopmental impairment estimates at regional and global levels for 2010<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/BornTooSoon-Report-April2012.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Born too soon<\/a><\/li>\r\n \t<li><a href=\"http:\/\/ptb.srhr.org\/\">Latest global, regional and national estimates of levels of preterm birth<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.thelancet.com\/series\/preterm-birth\" target=\"_blank\" rel=\"noopener noreferrer\">Lancet preterm birth series<\/a>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2808%2960074-4\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Epidemiology and causes of preterm birth<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2808%2960108-7\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2808%2960136-1\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">An overview of mortality and sequelae of preterm birth from infancy to adulthood<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/initiatives\/every-newborn-action-plan\" target=\"_blank\" rel=\"noopener noreferrer\">Every Newborn Action Plan<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/9789241508988_eng.pdf\">WHO recommendations on interventions to improve preterm birth outcomes (2015)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Preterm birth complications","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"preterm-birth-complications","to_ping":"","pinged":"","post_modified":"2022-11-16 18:35:44","post_modified_gmt":"2022-11-16 23:35:44","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=310","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":128,"post_author":"7211","post_date":"2015-10-21 15:19:45","post_date_gmt":"2015-10-21 15:19:45","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]Transforming care for the 30 million newborns who require medical care, and who are currently being left behind, is a smart investment in the health and development of future generations. Kangaroo Mother Care (KMC) is one of the leading proven interventions that can radically improve inpatient care for small and sick newborns, leading to shorter hospitalizations and improved health outcomes.<\/p>\n<p>KMC refers to the practice of providing early, continuous, prolonged skin-to-skin contact between mother and baby, exclusive breastmilk feeding, and follow-up care with high-risk newborns. It has shown to decrease mortality and morbidity in preterm and low birthweight infants by providing protection from infection; regulating temperature, breathing, and brain activity; and encouraging mother-baby bonding. In many cases, newborns who receive KMC are able to be discharged early from the hospital and KMC can be continued at home. When delivered as a complete package, it is highly effective at reducing newborn mortality \u2013 up to 40% according to recent data.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">14.7<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690899267181{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of infants with low birthweight globally (2020)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">27<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666024070330{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of infants who were not weighed at birth globally (2014-2020)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">40<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1466618727036{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percentage reduction in mortality of low birthweight infants (<2000g) who receive KMC compared to conventional neonatal care*<\/h3>\n<p>[\/vc_column_text][vc_column_text css=\".vc_custom_1545998791435{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h6 style=\"text-align: center;\"><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD002771.pub4\/full\"><span style=\"font-weight: 400; color: #808080;\">*\u00a0Conde\u2010Agudelo and Diaz\u2010Rossello. 2016<\/span><\/a><\/h6>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452735746534{padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>KMC implementation<\/h4>\n<p><img class=\"wp-image-1622 size-full alignnone\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-kmcimplementation.jpg\" alt=\"\" width=\"570\" height=\"230\" \/><\/p>\n<p>The World Health Organization (WHO) <a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/mca-documents\/nbh\/standards-for-improving-the-quality-of-care-for-small-and-sick-newborns-in-health-facilities-2020.pdf?sfvrsn=f2da583c_1\">recommends KMC<\/a> for the routine care of newborns weighing 2000 grams or less at birth, regardless of availability of incubator care. <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2026486\">Recent studies<\/a> are showing a significant decrease (25%) in morbidity and mortality for newborns who begin KMC immediately after birth, especially in newborns weighing between 1 kg and 1.79 kg. KMC can and should be started as soon as possible following birth, and can occur while stabilizing care is provided to the mother and newborn (eg, newborn receiving continuous positive airway pressure (CPAP) for respiratory distress). Additionally, <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/effect-of-community-initiated-kangaroo-mother-care-on-postpartum-depressive-symptoms-and-stress-among-mothers-of-low-birth-weight-infants-a-randomized-clinical-trial\/\">recent studies<\/a> have shown that KMC can be effectively implemented at home for newborns who are born outside of a facility, although all small newborns should receive post-natal care and follow-up with health care providers.<\/p>\n<p>There is a global push advocating for skin-to-skin contact between mother and newborn for one hour immediately following birth for all newborns, regardless of size at birth. While skin-to-skin contact is a key component of KMC, skin-to-skin alone is not sufficient for small newborns. All small newborns should receive complete KMC care, depending on facility and national protocols.<\/p>\n<p>KMC is considered a part of family-centered, respectful newborn and maternal care. It can be implemented during the full continuum of care, and is especially effective transitioning from the facility to the household. Providers should be trained to educate mothers and fathers in home-based continued KMC, and encourage its use at the home following discharge. Additionally, early and immediate KMC can also support positive early development, beyond the physical health benefits and morbidity prevention.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Accelerating KMC uptake<\/h4>\n<p><img class=\"wp-image-1621 size-full alignnone\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-acceleratingthisintervention.jpg\" alt=\"\" width=\"570\" height=\"230\" \/><\/p>\n<p>Despite the many benefits of KMC, country-level adoption and implementation have been limited, and only a small proportion of newborns who could benefit from KMC receive it. Barriers to KMC implementation at the facility level include inadequate facilities and supplies for KMC, insufficient staffing in facilities, lack of training and prioritization of KMC by facility staff, and inadequate policy and professional commitment to KMC. At the family and community level, barriers include cultural norms that make practice of skin-to-skin care difficult, lack of family and financial support for mothers to practice KMC, limited understanding of KMC, and stressors related to extended hospitalization.<\/p>\n<p>The COVID-19 pandemic was and continues to be a barrier for implementation of KMC in most settings. Infection prevention measures during the pandemic led to more newborns being separated from their mothers immediately following birth, even low birthweight and preterm newborns who would benefit from KMC. It is critical that infection prevention policies and government agencies do not recommend separation of mother and newborn, so that all vulnerable newborns receive KMC, even during COVID-19 outbreaks and infections.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_cta h2=\"Small and Sick Newborn Community of Practice\" txt_align=\"center\" color=\"sandy-brown\"]KMC features prominently as one of the core elements of care for the small or sick newborn.\u00a0 A new community of practice, the Small and Sick Newborn CoP (SSNB CoP) is an interactive platform that enables practitioners and experts to exchange ideas, share lessons learned, disseminate and discuss implementation research results and evidence regarding KMC and the other essential interventions comprising quality care of small for sick newborns.\u00a0<a href=\"https:\/\/ibpnetwork.org\/topics\/14356\">Click here<\/a>\u00a0to register for SSNC CoP and access webinars, networking, resources, events and much more.[\/vc_cta][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Key resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"2\/3\"][vc_column_text]<strong>Guidance<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/global-position-paper-on-kangaroo-mother-care\/\" target=\"_blank\" rel=\"noopener\">Global Position Paper on Kangaroo Mother Care: A transformative innovation in healthcare (2023)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kangaroo-mother-care-implementation-strategy-for-scale-up-adaptable-to-different-country-contexts\/\" target=\"_blank\" rel=\"noopener\">Kangaroo Mother Care: Implementation strategy for scale-up adaptable to different country contexts (2023)\u00a0<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/who-recommendations-for-care-of-the-preterm-or-low-birth-weight-infant\/\">WHO recommendations for care of the preterm or low-birth-weight infant (2022)<\/a><\/li>\n<li><a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/mca-documents\/nbh\/standards-for-improving-the-quality-of-care-for-small-and-sick-newborns-in-health-facilities-2020.pdf?sfvrsn=f2da583c_1\">Standards for improving the quality of care for small and sick newborns in health facilities (2020)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/survive-and-thrive-transforming-care-for-every-small-and-sick-newborn\/\">Survive and Thrive: Transforming care for every small and sick newborn (2018)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/joint-statement-international-recommendations-interventions-improve-preterm-birth-outcomes\/\">Joint Statement: International WHO Recommendations on Interventions to Improve Preterm Birth Outcomes (2017)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kmcjointstatement\/\">Kangaroo Mother Care Joint Statement (2016)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kangaroo-mother-care-challenge-brief\/\">Kangaroo Mother Care challenge brief (2016)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kangaroo-mother-care-implementation-guide\/\">Kangaroo Mother Care Implementation Guide (2012)<\/a><\/li>\n<\/ul>\n<p><strong>Research<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/effect-on-neonatal-sepsis-following-immediate-kangaroo-mother-care-in-a-newborn-intensive-care-unit\/\">Effect on neonatal sepsis following immediate kangaroo mother care in a newborn intensive care unit: a post-hoc analysis of a multicentre, open-label, randomised controlled trial (2023)<\/a><\/li>\n<li><a href=\"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-021-03646-3\">Barriers and facilitators of facility-based kangaroo mother care in sub-Saharan Africa: a systematic review (2021)<\/a><\/li>\n<li><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2026486\">Immediate \u201cKangaroo Mother Care\u201d and Survival of Infants with Low Birth Weight (2021)<\/a><\/li>\n<li><a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(19)32223-8\/fulltext\">Effect of community-initiated kangaroo mother care on survival of infants with low birthweight: a randomised controlled trial (2019)<\/a><\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4750435\/\">Kangaroo mother care: a systematic review of barriers and enablers (2015)<\/a><\/li>\n<\/ul>\n<p><strong>Country Specific Resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/scaling-up-kangaroo-mother-care-in-ethiopia-and-india-a-multi-site-implementation-research-study\/\">Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study (2021)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/mother-newborn-care-unit-mncu-experience-in-india-a-paradigm-shift-in-care-of-small-and-sick-newborns\/\">Mother\u2011Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns (2022)<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][vc_column width=\"1\/3\"][vc_single_image image=\"20053\" img_size=\"medium\" onclick=\"custom_link\" link=\"https:\/\/www.healthynewbornnetwork.org\/kangaroo-mother-care-toolkit\/\"][vc_btn title=\"Kangaroo mother care toolkit\" color=\"1\" link=\"url:https%3A%2F%2Fwww.healthynewbornnetwork.org%2Fkangaroo-mother-care-toolkit%2F|||\"][\/vc_column][\/vc_row]<\/p>\n","post_title":"Kangaroo Mother Care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"kangaroo-mother-care","to_ping":"","pinged":"","post_modified":"2023-08-01 10:14:43","post_modified_gmt":"2023-08-01 14:14:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=128","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":134,"post_author":"7211","post_date":"2015-10-21 15:20:44","post_date_gmt":"2015-10-21 15:20:44","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>The first hours and days after birth are the riskiest for both mothers and newborns.<\/h2>\r\nThere are important interventions and practices during this period that can reduce these risks. There are also\u00a0opportunities at multiple points in time to help ensure high coverage for these interventions and practices. For example, contacts during pregnancy can be used for counseling and health education on newborn care and care-seeking for danger signs in the postnatal period. This support may be especially important in settings where births still take place at home.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">75<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456333677270{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of newborn deaths that occur in the first week of life<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">48<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456333713404{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of hours after birth when a newborn is at highest risk of death<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][vc_column_text]Postnatal care can also include assessment and counseling provided to the mother before discharge after giving birth in a health facility, as well as later contacts during home visits by community health workers or postnatal visits to a health facility. Broadly, the major elements of postnatal care include:\r\n<ul>\r\n \t<li>counseling and health education on recognition of danger signs and appropriate care-seeking (for both mother and newborn)<\/li>\r\n \t<li>counseling and health education on routine care practices such as exclusive breastfeeding and good thermal care practices<\/li>\r\n \t<li>dispensing and related counseling for routine preventive interventions (such as chlorhexidine for cord-stump care and postnatal iron supplementation)<\/li>\r\n \t<li>assessment and case-management and referral for any identified complications or risk conditions<\/li>\r\n<\/ul>\r\nIt is through the same contacts that we have opportunities to improve outcomes for both mother and newborn, so programs and services\u00a0should focus on needed care for both. This more integrated perspective is reflected in the most recent guidance from\u00a0the World Health Organization\u00a0(see Resources below).\r\n\r\nHome visitation by community health workers has been promoted as a postnatal care strategy based on promising pilots in South Asia that demonstrated potential for reducing newborn deaths. However, it has proven difficult to achieve comparable benefits under more routine conditions at scale.\r\n\r\nWith the marked increases in institutional deliveries seen in many settings in recent years, there is increasing attention being given to taking better advantage of the time before discharge to ensure delivery of key aspects of postnatal care. Challenges to taking optimal advantage of this contact include the very high volume of births in some centers and the common practice of early discharge.\r\n\r\nFollow-up visits to the health facility for postnatal care can provide an important opportunity to ensure assessment, care, and provision of important counseling. Suitable timing and content of such care will depend on the overall configuration of postnatal care services specific to the setting.[\/vc_column_text][vc_text_separator title=\"Key Resources\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/who-recommendations-on-maternal-and-newborn-care-for-a-positive-postnatal-experience\/\">WHO recommendations on maternal and newborn care for a positive postnatal experience (2022)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Postnatal care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"postnatal-care","to_ping":"","pinged":"","post_modified":"2022-10-17 18:49:11","post_modified_gmt":"2022-10-17 22:49:11","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=134","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[],"countries":[]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/33613"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/news-item"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/33613\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/33616"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=33613"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}