Human milk is the best food for newborns, even if they are small, premature or sick. Breastfeeding improves infant survival, health and development. It is also associated with better neurodevelopmental outcomes and less obesity, hypertension and insulin resistance in adolescence, among many other benefits.
The daily application of chlorhexidine to the umbilical cord stump in the first postnatal week is a recommendation that depends on the settings.
The only scenario that supports its use is where traditionally noxious substances (e.g., animal manure) are used on the umbilical cord. In newborns with unhygienic cord care (defined as the use of noxious substances on the cord, such as dust, clay, mud, and animal manure), chlorhexidine reduced mortality.
In addition to the implementation of the International Code of Marketing of Human Milk Substitutes, other complementary actions are needed to promote the optimal feeding of infant and young children. The Breastfeeding Promotion Initiative led by WHO and UNICEF, aims to increase global commitment to breastfeeding. In addition to achieving full implementation of the code through strong legal measures, the initiative's call to action urges governments, donors and partners to do the following:
• Increase funding for breastfeeding promotion initiatives.
Regarding the administration of feeding the premature newborns in intensive care areas, the written breastfeeding policy should explicit issues related to the:
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.
Interventions to support responsive caregiving during the postnatal period should focus on promoting positive interactions and strengthening the caregiver/infant relationship.
Health care workers should encourage mothers, fathers, and other caregivers to be aware and responsive, responding to the child's needs, cues, clues, behaviors, and desires.
It is important to encourage caregivers to develop skills in the contexts of play, communication and feeding, such as breastfeeding on demand.
Universal newborn hearing screening (UNHS) with otoacoustic emissions (OAE) or automated auditory brainstem evoked potentials (ABEP-A) testing is recommended for early detection of permanent bilateral hearing loss (PBHL). UNHS should be accompanied by diagnostic and treatment services for infants in whom hearing loss is detected.
Conveying the right information, for the informed decision of mothers and families, is correct and ethical.
Considerable scientific evidence is available on breastfeeding and human milk feeding as a public health strategy given its myriad benefits for both newborns and breast feeders. However, breastfeeding is often perceived by some health care professionals as simply a lifestyle choice. They fear creating guilt in those who choose not to breastfeed by "pushing" for breastfeeding.
Human milk (HM) is recognized for its safety, efficacy, availability and cost/effectiveness. Consequently, it is the best food for newborns, even if they are small, premature or sick.
Breastfeeding improves child survival, health and development.
HM has the potential to reduce morbidities and improve health, especially in those born extremely prematurely, as it contains bioactive substances with bactericidal, immunomodulatory, and gut maturation-inducing properties.
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.