High

Early skin-to-skin contact and early breastfeeding are two closely linked interventions that should be carried out immediately after birth.
Immediate and prolonged skin-to-skin contact facilitates lactation, enriches the microbiome of newborns, prevents hypothermia and hypoglycemia, and stabilizes respiratory function.
Early suckling at the breast stimulates the activation of milk secretion and transfers colostrum, rich in immunoactive substances, especially important for those born prematurely.

Early skin-to-skin contact and early breastfeeding are two closely linked interventions that should be carried out immediately after birth.
Immediate and prolonged skin-to-skin contact facilitates lactation, enriches the microbiome of newborns, prevents hypothermia and hypoglycemia, and stabilizes respiratory function.
Early suckling at the breast stimulates lactogenesis II (activation of milk secretion) and transfers colostrum, rich in immunoactive substances, especially important for those born prematurely.

The hospitalization of premature, small and/or sick newborns poses multiple challenges to breastfeeding, including:

In neonatal hospitalization areas, the unrestricted admission of mothers and fathers facilitates close contact with their newborns, the development of bonding and the provision of care for which they will be primarily responsible after discharge.

When a child is born prematurely, some things are important to initiate and sustain the mother’s milk production:

- In the birthing area:
• Immediate, direct and continuous skin-to-skin contact, whenever clinically possible.
• Extraction of colostrum for administration into the newborn’s oropharynx.

The first days after birth, jaundice (yellow color of the skin and mucous membranes) is treated light therapy, also known as phototherapy. Wearing only a diaper, the baby is placed under a device that delivers blue light. This light is the specific therapy because it changes the chemical structure of bilirubin, rendering it easier to eliminate.
If a newborn requires phototherapy because of high blood bilirubin levels, it should be administered in a timely manner to prevent any injury to the central nervous system.

The yellowish color of the skin in newborns is called "jaundice". It may occur on the first days of life due to the accumulation of bilirubin, a pigment present in red blood cells.

The liver is the organ that sends bilirubin from the bloodstream to the gut, which in turn expels it from the body through the stools. The first days of life, the liver functions slowly; bilirubin is not cleared fast enough; it builds up in the blood, and enters all organs, including skin and brain. If bilirubin reaches very high levels in the brain, it can damage the neurons.

A healthy, full-term newborn should not be bathed until at least 24 hours after birth.
A bath can be a stressful procedure for a newborn. Early bathing can trigger hypothermia, potentially leading to hypoglycemia, hypoxia and pulmonary hemorrhage.
There is no evidence to support the need for a first bath soon after birth.
Neonatal hypothermia is a common condition affecting from 32% to 85% of newborns at the hospital.

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.

Depression and anxiety are common mental health problems in the postpartum period.
It is very important to systematically address the mother’s mental health and social well-being. Psychosocial interventions should be part of every postnatal visits, along with referral to a qualified professional to address conditions that require more intensive support, through strategies such as psychoeducation, cognitive-behavioral therapy, and interpersonal psychotherapy.