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Immediate newborn care practices delay thermoregulation and breastfeeding initiation
Article first published online: 7 MAR 2011
© 2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica
Volume 100, Issue 8, pages 1127–1133, August 2011
How to Cite
Sobel, H. L., Silvestre, M. A. A., Mantaring III, J. B. V., Oliveros, Y. E. and Nyunt-U, S. (2011), Immediate newborn care practices delay thermoregulation and breastfeeding initiation. Acta Paediatrica, 100: 1127–1133. doi: 10.1111/j.1651-2227.2011.02215.x
- Issue published online: 5 JUL 2011
- Article first published online: 7 MAR 2011
- Received 25 October 2010; revised 1 February 2011; accepted 8 February 2011.
- Breastfeeding initiation;
- Essential newborn care;
- Immediate newborn care practices;
- Neonatal sepsis
Aim: A deadly nosocomial outbreak in a Philippine hospital drew nationwide attention to neonatal sepsis. Together with specific infection control measures, interventions that protect newborns against infection-related mortality include drying, skin-to-skin contact, delayed cord clamping, breastfeeding initiation and delayed bathing. This evaluation characterized hospital care in the first hours of life with the intent to drive policy change, strategic planning and hospital reform.
Methods: Trained physicians observed 481 consecutive deliveries in 51 hospitals using a standardized tool to record practices and timing of immediate newborn care procedures.
Results: Drying, weighing, eye care and vitamin K injections were performed in more than 90% of newborns. Only 9.6% were allowed skin-to-skin contact. Interventions were inappropriately sequenced, e.g. immediate cord clamping (median 12 sec), delayed drying (96.5%) and early bathing (90.0%). While 68.2% were put to the breast, they were separated two minutes later. Unnecessary suctioning was performed in 94.9%. Doctors trained in neonatal resuscitation were 2.5 (1.1–5.7) times more likely to unnecessarily suction vigorous newborns. Two per cent died and 5.7% developed sepsis/pneumonia.
Conclusions: This minute-by-minute observational assessment revealed that performance and timing of immediate newborn care interventions are below WHO standards and deprive newborns of basic protections against infection and death.