Health promotion

INFLUENZA
•Pregnant women are at increased risk of influenza illness and its complications; so are their infants.
•Influenza vaccines are effective in preventing infection and reducing illness severity in the mother and the newborn. Influenza vaccines have been used for decades and their safety has been well documented. Communication strategies that encourage influenza vaccination is of utmost importance in order to promote its application.

Tetanus is a life-threatening noncommunicable disease caused by a potent neurotoxin produced by the bacterium Clostridium tetani.
Neonatal tetanus can be prevented through vaccination of women before or during pregnancy, which protects the mother and the baby through a transfer of tetanus antibodies. Hygienic childbirth practices are also important to prevent neonatal and maternal tetanus (NNT).

Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), is a leading cause of human disease and death, particularly in developing countries.
Worldwide, TB is intimately linked to poverty, making the control of TB a matter of justice and human rights.
In some areas with a high burden of TB, existing strategies for TB control cannot keep pace with the rising number of cases of TB occurring in parallel with the HIV/AIDS pandemic.
Emerging mycobacterial drug resistance further complicates the situation.

If the mother is HIV positive, the newborn should first be tested for HIV: if the child tests negative for HIV at 5 weeks of birth, he/she can get vaccinated with BCG.
In the case of hepatitis B vaccine, whether the mother or the baby are positive for HIV, the newborn can safely receive this vaccine as soon as possible after birth.

Maternal and neonatal immunization refers to immunization prior to pregnancy, during pregnancy, and during the post-partum period that is intended to provide protection to both the mother and her child.
This is a critical concept, as neonates and premature infants are particularly vulnerable to infections with vaccine-preventable diseases. Additionally, their immature immune systems cannot mount protective immune responses to specific vaccine antigens until several weeks or months after birth. This creates a gap during which newborns are extremely vulnerable.

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.
 

The following are recommendations to consider when hospital discharge after neonatal admission, and even if the baby was born healthy and at term:
· avoid exposing the patient to crowds of people;
· avoid passive exposure to smoke from parents and other family members;
· limit contact between newborns and infected people as much as possible.
If parents and close caregivers present signs of flu or a cold:
· increase personal hygiene precautions, including hand hygiene;
· put a mask or a handkerchief over the mouth and nose while caring for newborns;

Mothers with normal babies (including those born by caesarean section) should stay with them in the same room day and night, from the moment they come to their room after delivery (or from when they were able to respond to their babies in the case of caesareans) except for periods of up to an hour for hospital procedures.
This practice rooming-in should start no later than one hour after normal vaginal deliveries. Normal postpartum mothers should have their babies with them or in cots by their bedside unless separation is indicated for medical reasons.

Breastfeeding provides both short- and long-term benefits to the child and the mother.

For the child, breastfeeding provides optimal nutrition and reduces incidence of disease and death. Breastfeeding, particularly exclusive breastfeeding, protects children from diarrhea and pneumonia, the two leading causes of death among children under age five. Other infections, including otitis media, Haemophilus influenzae meningitis, and urinary tract infections, are less common and less severe in infants who are breastfed.

The Ten Steps involve changes in maternity services. Every facility providing maternity services
should have a breastfeeding policy and carry out structural changes and train all health care staff in skills necessary to implement this policy. They are aimed to protecting, promoting, and supporting breastfeeding in facilities that provide maternity services.