4th. Week

Responsive care encompasses both sensitivity and responsiveness with which a young infant is assisted. Sensitivity is awareness, from birth, of a young child’s acts and vocalizations as communicative signals to indicate needs and wants. Responsiveness is the capacity of parents and caregivers to respond appropriately to these signals. Caregivers enable infants to participate in human communication and exchanges by playing their own part in the interaction as well as helping the infant engage.

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.

The Baby Friendly Hospital Initiative (BFHI) was launched in 1991 by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), with the goal of protecting, promoting, and supporting breastfeeding in facilities that provide maternity services, ensuring that the facilities follow the WHO/UNICEF “Ten Steps to Successful Breastfeeding” (the Ten Steps) and adhere to the 1981 International Code of Marketing of Breast-milk Substitutes.

Nurturing Care refers to a stable environment created by parents and other caregivers that ensures, with policy, service and community support children's good health and nutrition, protects them from threats, and gives young children opportunities for early learning, through interactions that are emotionally supportive and responsive.
At birth, the nervous system of newborns, even after a full-term gestation, is not fully developed. The human brain continues to grow and develop postnatally at a rapid rate and becomes increasingly complex as growth progresses.

All infants should receive their first dose of hepatitis B vaccine as soon as possible after birth, preferably within 24 hours.
When not feasible, the birth dose can still be effective in preventing perinatal transmission if given within 7 days, particularly within 3 days, although somewhat less than if given within 24 hours, but with declining effectiveness with each passing day. Even after 7 days, a late birth dose can be effective in preventing horizontal transmission and therefore remains beneficial.

Mothers with confirmed or suspected COVID-19 are advised to wear a medical mask, but even if this is not possible, breastfeeding should be continued.
It is important to replace medical masks as soon as they become damp and dispose of them immediately. Masks should not be reused or touched in the front but to remove it from behind.
It is important to follow other infection prevention measures, such as washing hands, cleaning surfaces, and covering the mouth and nose with a tissue when sneezing or coughing.

In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also improves the health of mothers. Transmission of active COVID-19 (virus that can cause infection) through breast milk and breastfeeding has not been detected to date. Therefore, there is no reason to avoid or discontinue breastfeeding.

To support countries in adapting their response to different COVID-19 scenarios, the World Health Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey literature. The objective was to identify interventions implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions.