CARING THE BABY

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.

Universal neonatal screening for eye anomalies is recommended. This should be accompanied by diagnostic and treatment services for infants in whom an abnormality is detected.
An estimated 1.14 million children aged 0-15 years are blind or have severe visual impairment due to eye conditions. The main causes of blindness are congenital and developmental cataracts, corneal scarring, congenital ocular anomalies, retinal dystrophies, glaucoma, and retinopathy of prematurity.

The following signs should be assessed during each postnatal care contact and the newborn should be referred for further evaluation if any of the signs is present:
- stopped feeding well
- history of convulsions
- fast breathing
- severe chest in-drawing
- no spontaneous movement
- temperature >37.5 or <35.5 °C
- jaundice in the first 24 hours of life, or yellow palms and soles at any age.
The family should be encouraged to seek health care early if they identify any of the above danger signs in-between postnatal care visits.
 

Bathing should be delayed to after 24 hours of birth. If this is not possible at all due to cultural reasons, bathing should be delayed for at least 6 hours. Appropriate clothing of the baby for ambient temperature is recommended, this should be 1–2 layers more than adults and a hat.
The mother and baby should not be separated and should stay in the same room 24 hours a day

After an uncomplicated vaginal birth in a health facility, healthy mothers and newborns should receive care in the facility for at least 24 hours after birth.
If birth is at home, the first postnatal contact should be as early as possible within 24 hours of birth.
At least three additional postnatal contacts are recommended for all mothers and newborns, on day 3 (48–72 hours), between day 7–14, and 6 weeks after birth.