Illness

Delays in the neonatal transfer system can have an impact on mortality. The “three delays” model (Thaddeus and Maine, 1994) describes a conceptual framework for the factors and phases of delay that influence timely access to specialized emergency care. The model makes it possible to analyze delays in the process at each stage of neonatal transfers.
In most cases, neonates are transferred from a primary care center to a referral center, but it can also occur from the community, from a facility or from within the same center.

The mortality burden associated with congenital defects (CD) is relevant globally and regionally. In 2016, the global prevalence of CD reached 82,890,000 cases. One out of five deaths within the first 28 days of life is due to CD. In addition to neonatal mortality due to CD, it contributes to fetal mortality.

Safely transferring sick newborns to health facilities with the level of complexity required to treat their condition contributes to the reduction of neonatal morbidity and mortality rates. Reducing these rates is essential to achieve the global goals for child survival in the coming decades. Efforts to prevent the main causes of neonatal mortality must be complemented by the development of systems to care for sick newborns, including safe neonatal transport.

Congenital defects (CDs) are the second leading cause of neonatal mortality and a very important cause of disease and disability.
In Latin America and the Caribbean, there are more than 15 million births every year. According to estimates published in 2018, approximately 15 out of every 1,000 will be at risk of dying before their first birthday and 10 in 1,000 before their first month of life.
One in 5 of the deaths occurring within the first 28 days of life is due to some CD.

The involvement of fathers/partners and families is important to support mothers in providing Kangaroo Care while in the facility and at home after discharge.

Father and family involvement is especially important when the mother is medically unstable or recovering from surgery.

In the neonatal intensive care unit, parents are not visitors. Families are the true protagonists in the care of their babies

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.

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.