The World Health Organization (WHO) recognizes that newborns feel pain and discomfort and may experience emotional distress, especially when separated from their families in the first hours of life. Pain management and comfort care are WHO standards of care. (Standards in below, in "source")
Pain in newborns affects neurodevelopment, with potential short- and long-term effects.
The Pan American Health Organization's Evidence-Based Clinical Practice Guidelines for the Follow-up of Newborns at Risk recommend that the frequency of check-ups be, according to each aspect to be evaluated, as shown in the following table:
Beyond the age of 2, children at risk should continue to be monitored, at least until they enter school.
To ensure the quality and safety of the retinopathy of prematurity (ROP) screening exam, the Pan American Health Organization's Clinical Practice Guidelines emphasize the importance of preparing the infant for fundus examination, including appropriate pain management and comfort during the procedure.
Before the ROP screening exam, to dilate the newborn's pupil, it is recommended:
After discharge from neonatal care, specialized follow-up is recommended to maintain the care of at-risk newborns.
Based on their individual risk factors, specialized follow-up of babies helps maintain survival and allows for early detection, therapeutic management, and timely intervention of certain consequences associated with perinatal disorders that are not detected in the early stages.
Based on the highest level of evidence available, the Pan American Health Organization's Clinical Practice Guidelines recommend that the first ROP screening test be performed according to a schedule that considers gestational age and the time of the first ROP screening. In all cases, newborns at risk of ROP should have at least one ROP screening before being discharged from the neonatal unit.
Based on the best available scientific evidence, the Pan American Health Organization (PAHO) recommends the content of information for families before hospital discharge.
If the newborn’s clinical condition is favorable, skin-to-skin contact should be initiated immediately after birth.
The vital signs of mother and baby should be checked regularly to monitor their well-being. The person accompanying the patient, family member, doula or health care staff should monitor the woman’s wakefulness to protect the newborn’s safety in this vulnerable period.
Applying emollient or moisturizing creams or any other product on the skin of newborns is not recommended.
At birth, human skin is covered with an acid mantle, which is key to maintaining the baby’s defenses. Although there is no scientific evidence about the harmful effects of emollients, no benefits have been demonstrated in their application.
Therefore, it is not recommended to apply emollients or other products on the skin. If in doubt, it is always advisable to ask your health care team.
Routine application of topical emollients is not recommended for the prevention of skin conditions in healthy full-term infants.
This recommendation was developed by the WHO Guidelines Development Group (GDG). The GDG agreed that there was insufficient evidence on the beneficial and harmful effects of routine application of topical emollients on healthy term newborns to prevent skin conditions such as atopic dermatitis, dry skin and others.
After birth and during the first postnatal year, infants should be put in a supine position (on their backs) in a crib or bassinet to reduce sudden infant death syndrome.
The soles of the feet should be at the end of the crib and the body covered by a blanket or sheet up to the armpits, with the arms on the outside.
In addition, it is suggested that no pillow be placed under the head, as well as no other object next to the baby.
For safe sleep, it is also recommended that no one smoke in the room where children sleep.