Newborn Health and Survival

The first days and weeks of life are critical for the future health and survival of a child. Nearly two-thirds of the of 6.5 million infant deaths each year occur within the first four weeks of life, and about two-thirds of those occur within the first week. Tragically, 98 percent of these deaths occur in developing countries. The immediate causes of newborn death include infection, birth asphyxia, complications related to premature birth, and congenital anomalies. Low birthweight, poor maternal nutrition, maternal reproductive tract infections, and a family’s access to health services are contributing factors to newborn death.

Newborn and maternal health and survival are closely linked, therefore, it is important to treat mothers and their child as a diad through all phases of pregnancy and delivery. Healthy mothers who have access to proper nutrition and health care throughout the continuum of pregnancy and postpartum care are less likely to suffer from ill health or death, and their babies face a lower risk of disease and premature death. But keeping a newborn alive and well requires more than proper care for mothers. Newborns themselves require special attention separate from that of their mothers to assure a healthy start to life.

An essential newborn care package consists of both basic and special health care services provided to mothers and newborns during antenatal care, labor and delivery, and postpartum. Trained health providers, behavior change communication techniques and community mobilization activities are key conduits for providing basic care. Specialized care for newborns and mothers with specific needs often require advanced levels of care.

Antenatal
Labor and Delivery Care
Postpartum Care

Antenatal Care

Basic Care for All Newborns: During her pregnancy, a mother should receive preventive health care interventions such as tetanus toxoid immunizations; iron and folate supplements, and where necessary, iodine supplements; malaria prophylaxis where necessary, and syphilis screening and treatment. In addition, mothers require education and counseling on HIV/AIDS/STI prevention during and after pregnancy, breastfeeding, birth preparedness, and prevention of mother-to-child transmission (PMTCT) of HIV/AIDS in endemic areas. Nutrition education and access to an adequate diet during pregnancy are also essential for both mother and newborn.

Special Care for Sick Newborns: When maternal or fetal complications occur during pregnancy, special services may be required. For example, HIV-positive mothers require PMTCT counseling and appropriate interventions. Other obstetric and neonatal complications may also require individual management or referrals to expert care services.

Labor and Delivery Care

Basic Care for All Newborns: Skilled attendance during labor and delivery plays a key role in basic newborn care. Essential services include a clean delivery, prevention of hypothermia, immediate breastfeeding (with special counseling for HIV-positive mothers), preventive eye care, and PMTCT interventions.

Special Care for Sick Newborns: Birth asphyxia and injuries, low birth weight, and complications of prematurity require additional care. Those attending the birth should be trained in resuscitation, newborn warming, hygiene, and assisted feeding techniques and care. Providers should also be aware and prepared to refer mother and newborn to higher level health care.

Postpartum Care

Basic Care for All Newborns: Care for mothers and newborns does not stop after delivery. Postpartum care and follow-up are essential for the health of the mother and her child. Basic care include exclusive breastfeeding, warmth for the newborn, hygienic cord care, immunizations, maternal nutrition and counseling, birth spacing services and information, and PMTCT interventions as necessary.

Special Care for Sick Newborns: Maternal and newborn postpartum infection, congenital anomalies, and other health problems should be addressed promptly. Postpartum care services should include antibiotics, supportive care, ARV therapy where available for HIV-positive mothers, PMTCT follow-up care for newborns born to HIV-positive mothers, and referral to more advanced health care services.