{"id":7728,"date":"2014-08-04T11:41:37","date_gmt":"2014-08-04T15:41:37","guid":{"rendered":"http:\/\/www.healthynewbornnetwork.org\/blog\/addressing-obstacles-to-exclusive-breastfeeding-in-yemen\/"},"modified":"2023-11-06T13:23:55","modified_gmt":"2023-11-06T18:23:55","slug":"addressing-obstacles-to-exclusive-breastfeeding-in-yemen","status":"publish","type":"post","link":"https:\/\/www.healthynewbornnetwork.org\/blog\/addressing-obstacles-to-exclusive-breastfeeding-in-yemen\/","title":{"rendered":"Addressing Obstacles to Exclusive Breastfeeding in Yemen"},"content":{"rendered":"<p><strong><em>Photo:<\/em><\/strong><em>&nbsp;Dr. Ali Assabri<\/em><\/p>\n<p><em>This blog was originally published by <a href=\"http:\/\/www.mchip.net\/content\/addressing-obstacles-exclusive-breastfeeding-yemen\">MCHIP<\/a>. Written by Rae Galloway.&nbsp;<\/em><\/p>\n<p>If exclusive breastfeeding in the first six months of life prevents malnutrition, a subsequent pregnancy (as long as menses has not returned), and potential death from infections, why aren&rsquo;t more women worldwide choosing to do so? Babies who are not exclusively breastfed have a one- to two-fold greater risk of dying than breastfed babies (with the risk varying by the type of illness). And the risk of mortality is even greater (a two- to four-fold increase) when children receive food and other liquids in addition to breast milk, or are not breastfed at all (a two- to 14-fold increased risk of dying). &nbsp;<\/p>\n<p>While rates are higher in some countries than others, the unfortunate truth is that fewer than half of children are exclusively breastfed in most countries. In Yemen&mdash;which has one of the lowest rates of exclusive breastfeeding in the world&mdash;preliminary results from a recent national survey found that only 10% of infants are exclusively breastfed in their first six months.&nbsp;<\/p>\n<p>To uncover the factors impeding optimal maternal, infant and young child nutrition and family planning practices, including exclusive breastfeeding, <a href=\"https:\/\/www.healthynewbornnetwork.org\/partner\/maternal-and-child-health-integrated-program-mchip\">USAID&rsquo;s flagship Maternal and Child Health Integrated Program (MCHIP)<\/a> in partnership with the Ministry of Public Health and Population conducted formative research on the subject in two ecological zones of Dhamar Governorate. The study results illuminated a clear need among mothers, fathers and other family members for accurate information on how best to feed young children, as well as what women should eat during pregnancy and lactation.&nbsp;<\/p>\n<p>For example, within the study sample:&nbsp;<\/p>\n<ul>\n<li>Not one child under six months was being exclusively breastfed.<\/li>\n<li>Not one child 6-23 months had been exclusively breastfed.<\/li>\n<li>One infant had received only water, which the mother had provided to promote speech development, believing that &ldquo;water lubricates the jaw to make speech easier.&rdquo;<\/li>\n<li>Most mothers had introduced food or animal milk prior to six months, feeling their breast milk was &ldquo;not enough.&rdquo; Mothers often made the decision that their breast milk was insufficient because their baby cried after nursing, or other family members advised them that their baby needed additional food.&nbsp;<\/li>\n<li>All infants received liquids before six months&mdash;with animal or powdered milk, water and juice being the most common liquids given.<\/li>\n<li>More than half of babies younger than six months received food with crushed, sugary biscuits made into a paste with water or milk being a popular food to give to babies, even as young as one month of age.<\/li>\n<li>Some mothers gave food because it filled their baby&rsquo;s stomach, reportedly making them cry less and easier to manage.<\/li>\n<\/ul>\n<p>In reality, breastfeeding practices in the sample were not optimal, which contributed to inadequate breast milk supply and hungry, unhappy babies. Sub-optimal practices included infrequent feedings, short duration of feedings, feeding from only one breast, and not feeding babies at night time. These practices led to decreased breast milk supply and the introduction of liquids and food, which further reduced breast milk production. Introduction of liquids and foods increases risk of infection, which in turn increases risk of malnutrition and mortality. Half of the women reported some problem with breastfeeding&mdash;such as pain, redness, engorgement and cracked nipples&mdash;but women were able to manage these problems themselves or seek treatment for them.<\/p>\n<p>To improve infant and young child feeding, including exclusive breastfeeding, MCHIP is developing a package for health facility and community workers to use when counseling mothers. Because of the importance of family planning to the health, nutritional status, and survival of women and children, this package also will include messages about using the&nbsp;lactational amenorrhea method (LAM)&nbsp;in the first six months and transitioning to modern methods of family planning thereafter.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Yemen has one of the lowest rates of exclusive breastfeeding in the world.<\/p>\n","protected":false},"author":3421,"featured_media":7729,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Healthy 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\/blog\/addressing-obstacles-to-exclusive-breastfeeding-in-yemen\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Addressing Obstacles to Exclusive Breastfeeding in Yemen - 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In&nbsp;these positions she has&nbsp;advocated for, designed, implemented, supervised and evaluated nutrition&nbsp;components in health, education, social protection and agriculture projects in 30 countries in Africa, Asia, Central Asia, the Pacific and Latin America.","url":"https:\/\/www.healthynewbornnetwork.org\/blog\/author\/rae-galloway\/"}]}},"featured_image":"<img width=\"160\" height=\"160\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/BLOG_Breastfeeding_Yemen_4Aug2014_lowres.jpg\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/BLOG_Breastfeeding_Yemen_4Aug2014_lowres.jpg 160w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/BLOG_Breastfeeding_Yemen_4Aug2014_lowres-150x150.jpg 150w\" sizes=\"(max-width: 160px) 100vw, 160px\" \/>","author_name":"Rae Galloway","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"drupal_username":"","drupal_id":"32308","drupal_user_id":"27278","drupal_url":"\/blog\/addressing-obstacles-exclusive-breastfeeding-yemen","publication_date":"20140804","authors":false,"additional_authors":"","regions":[{"ID":249,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Middle East","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"middle-east","to_ping":"","pinged":"","post_modified":"2016-02-11 21:49:15","post_modified_gmt":"2016-02-11 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values=\"%5B%7B%22title%22%3A%222%25%20Diarrhoea%22%2C%22value%22%3A%222%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%221%25%20Tetanus%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%235472d2%22%7D%2C%7B%22title%22%3A%229%25%20Pneumonia%22%2C%22value%22%3A%229%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2239%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2239%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2224%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2224%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%226%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%226%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%227%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%227%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2212%25%20Other%20conditions%22%2C%22value%22%3A%2212%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686338493425{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&amp;source=gmail&amp;ust=1551964625737000&amp;usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686338303140{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">28.3<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686338340264{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">1.3<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686338426028{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">46<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686338353563{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">23.4<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686338470452{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">44.7\r\n<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1484679285081{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">53\r\n<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698697324764{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">6.8<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births &lt;37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686338449339{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">183<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1456713278772{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Yemen","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"yemen","to_ping":"","pinged":"","post_modified":"2023-10-30 16:20:42","post_modified_gmt":"2023-10-30 20:20:42","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&#038;p=243","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"partners":[{"ID":643,"post_author":"4007","post_date":"2010-03-01 00:39:54","post_date_gmt":"2010-03-01 00:39:54","post_content":"<p>&nbsp;MCHIP is the USAID Bureau for Global Health's flagship maternal, neonatal and child health (MNCH) program which focuses on reducing maternal, neonatal and child mortality and accelerating progress toward achieving Millennium Development Goals (MDGs) 4 and 5. Awarded to Jhpiego and partners in September 2008, MCHIP works with USAID missions, governments, nongovernmental organizations, local communities and partner agencies in developing countries to implement programs at scale for sustainable improvements in MNCH.<\/p>\r\n<h2>What we do<\/h2>\r\n<p><strong>MCHIP and Newborn Health<\/strong><\/p>\r\n<p>By focusing on the three main causes of death and supporting the introduction and scale-up of evidence-based prevention and treatment interventions, MCHIP aims to contribute to the global reduction of neonatal mortality. In the process, the Program will be contributing to the reduction in Millennium Development Goal 4, as well as to USAID&rsquo;s goal of reducing under-five mortality by 25% by 2013 in 30 priority countries, and to their newborn health pathway goals.<\/p>\r\n<p>The MCHIP strategy for newborn health will:<\/p>\r\n<ul>\r\n    <li>&nbsp;&nbsp; &nbsp; Follow the Paris Principles and work with partners including UNICEF, WHO and Saving Newborn Lives to provide catalytic inputs to support the introduction and expansion of evidence-based newborn care interventions;<\/li>\r\n    <li>&nbsp;&nbsp; &nbsp; Scale up evidence-based approaches to improve newborn health by focusing on 30 priority MCH countries;<\/li>\r\n    <li>&nbsp;&nbsp; &nbsp; Support integration of ENC packages into MCH systems;<\/li>\r\n    <li>&nbsp;&nbsp; &nbsp; Assure that evidence-based ENC programs are documented and promoted at scale;&nbsp;<\/li>\r\n    <li>&nbsp;&nbsp; &nbsp; Provide technical leadership in newborn health globally; and<\/li>\r\n    <li>&nbsp;&nbsp; &nbsp; Strengthen and support strategic alliances that support implementation of newborn health programs at scale.<\/li>\r\n<\/ul>","post_title":"Maternal and Child Health Integrated Program (MCHIP)","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"maternal-and-child-health-integrated-program-mchip","to_ping":"","pinged":"","post_modified":"2016-01-21 00:41:53","post_modified_gmt":"2016-01-21 00:41:53","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&#038;p=643","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"}],"issues":[{"ID":132,"post_author":"7211","post_date":"2015-10-21 15:20:24","post_date_gmt":"2015-10-21 15:20:24","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]<\/p>\n<h2>Early and exclusive breastfeeding for the first six months of a child\u2019s life reduces child mortality and has health benefits that extend into adulthood. Breastfeeding benefits not only the child but the mother and family also, as it is free of cost and reduces the risk of infection in newborns, enhances neurodevelopment, and reduces the risk of acquiring certain non-communicable illnesses in adulthood. Breastmilk substitutes and animal milk not only lack essential immune-building components, they also expose the infant to an increased risk of infection and morbidity.<\/h2>\n<p>[\/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\">44<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690991173051{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of infants under six months of age who are exclusively breastfed (2015-2020)<\/span><\/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\">800<\/span>k<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690991296488{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of infant deaths that can be <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6735804\/\">attributed to suboptimal breastfeeding practices<\/a><\/span><\/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\">20<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690991361409{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage reduction in risk of newborn death when <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5025980\/#:~:text=About%2020%25%20of%20all%20neonatal,the%20neonatal%20period%20%5B17%5D.\">breastfeeding is initiated within one hour of birth<\/a><\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/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\u00a0<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_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"More information\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]Human milk feeding and breastfeeding have immediate and long-term benefits for all babies, including the preterm and low birth weight. Feeding small and sick newborns is challenging because of immaturity or medical conditions that interfere with effective oral feeding. Moreover, small newborns are further affected by variation in the gut microbiome and increased risk for infections.<\/p>\n<p>They often need care in special or intensive care units, which commonly results in separation from their mothers, creating additional challenges to feeding. Care for small and sick newborns must include the promotion of safe and optimal use of human milk (with cup or nasogastric tube), and subsequent transition to breastfeeding, to achieve adequate gain weight and growth in these infants. Staff caring for these babies require specific knowledge and competencies, as well as sufficient supplies for feeding small and sick newborns.<\/p>\n<p>Studies have shown that Early Total Enteral Feeding (ETEF) is safe and decreases the incidence of infections, including necrotizing enterocolitis (NEC), enhances cognitive development, reduces days on parental nutrition, and helps shorten the time to achieve full feeds. Own mother\u2019s milk is the first choice for such babies. Delayed initiation of and infrequent breastmilk feeding can affect the establishment of milk supply and result in decreased milk supply and unnecessary use of breast milk substitutes. If the small baby cannot suckle at the breast, it is important to express, starting with the colostrum within an hour of birth to support the onset of lactation. Such mothers should continue to express every 2-3 hours for eight or more sessions during the day, including at night for ensuring no disruption of lactation and milk supply. To achieve low risk of contamination of expressed breast milk, it is very important to ensure hygienic milk collection, storage, and handling practices.<\/p>\n<p>When own mother\u2019s milk is not available, WHO and UNICEF promote the use of pasteurized donor human milk (PDHM) as the second option in preference to formulas. However, WHO has specified that, this \u201crecommendation (is) relevant for settings where safe and affordable milk-banking facilities are available or can be set up;\u201d The use of formulas as the next option requires counseling the mothers and families on their proper and clean preparation. The use of preterm formulas should only be recommended when the VLBW baby is not gaining weight on standard formula and if it can be afforded. For babies smaller than 1500gm, the WHO recommends adding vitamin D, calcium, phosphorus, and iron supplements.[\/vc_column_text][vc_column_text]<strong>Key resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/infant-and-young-child-feeding\">WHO Infant Feeding Recommendations<\/a><\/li>\n<li><a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/nutritionlibrary\/breastfeeding\/unicef-who-capture-the-moment-eibf-2018.pdf?sfvrsn=587210cf_2\" target=\"_blank\" rel=\"noopener noreferrer\">Early Initiation of Breastfeeding to Promote Exclusive Breastfeeding<\/a><\/li>\n<li><a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/question-and-answers-hub\/q-a-detail\/coronavirus-disease-covid-19-breastfeeding\">Coronavirus disease (COVID-19): Breastfeeding Q&amp;A (WHO)<\/a> + <a href=\"https:\/\/www.who.int\/news-room\/commentaries\/detail\/breastfeeding-and-covid-19\">Scientific Brief\u00a0<\/a><\/li>\n<li>Lancet Breastfeeding Series (2016)<\/li>\n<li><a href=\"http:\/\/www.who.int\/maternal_child_adolescent\/topics\/child\/nutrition\/breastfeeding\/en\/\" target=\"_blank\" rel=\"noopener noreferrer\">WHO Resources on Breastfeeding<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/breastfeeding-advocacy-toolkit\/\">Breastfeeding Advocacy Toolkit<\/a><\/li>\n<li>\n<p class=\"entry-title\"><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><\/p>\n<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n","post_title":"Breastfeeding and feeding of small and sick newborns","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"breastfeeding-and-feeding-of-small-and-sick-newborns","to_ping":"","pinged":"","post_modified":"2023-11-21 12:34:55","post_modified_gmt":"2023-11-21 17:34:55","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=132","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&#038;p=134","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":124,"post_author":"7211","post_date":"2015-10-21 15:18:57","post_date_gmt":"2015-10-21 15:18:57","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]<\/p>\n<h2>In order to meet our maternal and newborn health objectives, we need health professionals and community health workers that:<\/h2>\n<ul>\n<li>Are readily available where and when needed<\/li>\n<li>Have the necessary knowledge and skills for the services they are providing<\/li>\n<li>Are appropriately motivated to provide the needed service<\/li>\n<li>Are adequately supported and enabled with supervision, support systems (supply chain and\u00a0information systems), necessary infrastructure (space, water, electricity, and communications), and more<\/li>\n<\/ul>\n<p>Ensuring that this set of conditions is met depends on adequate human resources policy and management.[\/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\">82<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004009799{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of global births that were assisted by suitably qualified health workers between 2016 and 2021<\/span><\/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\">66<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004076215{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of women in least developed countries that were assisted by suitably qualified health workers during birth between 2016 and 2021<\/span><\/h3>\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> page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]Over the past decade and a half, considerable emphasis within global maternal-newborn health programs has been placed on \u201cskilled birth attendance,\u201d i.e., births assisted by suitably qualified health workers. This reflects the observation that for women delivering at home without ready access to emergency obstetrical care, support from traditional birth attendants proved inadequate to substantially reduce risk of death for the mother or newborn. Considerable effort has been expended in many settings to help ensure that women give birth with the assistance of qualified human resources, specifically a health worker, and generally in a health facility.<\/p>\n<p>However, in many instances there has not\u00a0been equal attention given to the actual substance of the care provided or the necessary supports to enable health workers to provide adequate care. In recent years, there has been increasing attention in program work to the quality and content of maternal-newborn services, particularly around the time of birth. This is reflected in current work at the World Health Organization on improving quality of maternal-newborn health care.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]Part of what is implied in the \u201cskilled birth attendance\u201d strategy is that assisting in childbirth does not necessarily require a physician. Many interventions related to maternal-newborn health can be competently delivered by categories of health workers with comparatively modest training.<\/p>\n<p>Accordingly, certain maternal-newborn services can be provided by categories of health workers labelled as \u201ccommunity health workers\u201d (CHWs). This is a broad designation that includes:<\/p>\n<ul>\n<li>Health auxiliaries with training sometimes approaching that of registered nurses<\/li>\n<li>Paid full-time workers with several months of basic training<\/li>\n<li>Non-salaried but financially \u201cincentivized\u201d workers, typically working less than full-time<\/li>\n<li>Volunteers providing services on a periodic or intermittent basis with little or no financial incentives<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_single_image image=\"13796\" add_caption=\"yes\" alignment=\"center\" css_animation=\"appear\"][vc_column_text]In some settings, there is more than one tier of CHWs.\u00a0When robustly supported (as they can be under project conditions), non-salaried and volunteer CHWs have been demonstrated as effective for various maternal- and newborn-related services. There are fewer examples of such work being effectively delivered at national scale, under non-project conditions. A very important but frequently neglected factor is the supports needed for effective programs.<\/p>\n<p>The issue is not so much,<\/p>\n<ul>\n<li><em><strong>can <\/strong>CHWs be effective for a particular service?<\/em><\/li>\n<\/ul>\n<p>But rather,<\/p>\n<ul>\n<li><em><strong>what supports are necessary<\/strong> for effectiveness?<\/em><\/li>\n<\/ul>\n<p>And,<\/p>\n<ul>\n<li><em><strong>are such supports feasible at scale<\/strong> under normal, non-project conditions?<\/em><\/li>\n<\/ul>\n<p>Program efforts commonly address health worker knowledge and skills. This is typically done primarily by training. Motivation is less often given focused attention. Certainly, some aspects of performance can be positively affected by financial incentives, although such incentives can also have unintended negative consequences. However, motivation is more than just a matter of incentives.<\/p>\n<p>In many settings, legitimate and illegitimate absences from work significantly undermine reliable access to services. This can be a consequence, for example, of frequent off-site trainings. There are also many settings where health workers are either frequently away from their posts without authorization or where they offer services only for very limited periods of time each day.<\/p>\n<p>Even when health workers are at their posts, their practices are affected not only by material they may have been exposed to in training but also by other influences on what they consider appropriate care. For example, health workers may be well aware of what treatments are recommended or authorized in national treatment guidelines but may -- for any number of reasons -- prefer to offer treatments not reflected in official protocols. For human resources program efforts to be effective in ensuring availability of appropriate care, they need to respond to the actual factors influencing health worker practices.<\/p>\n<p>Supervision is often mentioned as an important performance factor in health worker practices. Certainly under project conditions, there are numerous examples of \u201csupportive technical supervision\u201d or \u201cmentoring\u201d that appear to have made a positive contribution to quality of care. There are, however, far fewer examples of this function being effectively delivered under non-project conditions. Health-facility-level quality improvement efforts can serve a somewhat similar function, whereby groups of health staff work collectively to improve performance, holding each other accountable.[\/vc_column_text][vc_column_text]<strong>Key resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/77764\">WHO Recommendations: Optimizing health worker roles for maternal and newborn health<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Human resources for health","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"human-resources","to_ping":"","pinged":"","post_modified":"2023-08-02 15:22:01","post_modified_gmt":"2023-08-02 19:22:01","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=124","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/7728"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/3421"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=7728"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/7728\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/7729"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=7728"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/categories?post=7728"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/tags?post=7728"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}