Health professional

There is evidence about aspects that influence the population's acceptance of vaccines. These should be strategically considered by members of the health team and by those who manage resources for vaccination campaigns.
These aspects include:
Trust: In the efficacy and safety of vaccines and in the delivery system.
Indifference: Some people have a low perception of the risk of vaccine-preventable diseases, leading them to believe immunization is unnecessary. Indifference may be determined by underestimation of their benefit (efficacy or safety) or by knowledge gaps.

Sometimes, several vaccines must be administered simultaneously during pregnancy; such is the case of Tdap (tetanus and diphtheria toxoids with acellular pertussis vaccine) and influenza vaccine, for instance.
In studies that enrolled non-pregnant individuals to assess the safety of concurrent administration of Tdap and influenza vaccines, compared to their separate use, there was no evidence of increased risk of adverse events.

Several vaccines can be safely administered during pregnancy. In 2014, the WHO Global Advisory Committee on Vaccine Safety conducted a comprehensive assessment of the existing scientific data on the safety of vaccines during pregnancy, concluding that:
- Pregnancy should not prevent pregnant women from receiving a vaccine.
- Although live or attenuated microbial vaccines, such as the MMR vaccine, might pose a theoretical risk to the fetus, no major vaccination-associated adverse outcomes have been reported.

Having a written breastfeeding policy allows to:

- Make the various actors at the facilities agree to comply with practices that favor breastfeeding.
- Make the medical and nursing staff take ownership of the topic.
- Have recommendations applicable to specific environments.
- Monitor, evaluate and obtain data on breastfeeding practices and their effects, e.g., through audits.
- Exchange views within and outside the institution, involving more actors, sharing experiences and facilitating the replication of good practices.

The development of the breastfeeding policy varies broadly; it should include breastfeeding experts and avoid commercial links with products and companies regulated by the International Code of Human Milk Substitutes.

A committee including high-level representation from all stakeholders may be appointed to develop the policy. Once the necessary agreements are reached, the committee should continue to monitor the proper implementation of the policy.

Standards and policies to strengthen breastfeeding at birthing facilities should be written. This feature is important to sustain unanimity of criteria in practices.

Furthermore, the policy should consider the 10 steps set forth by the World Health Organization for successful breastfeeding, i.e.

- available for consultation by all personnel

- visibly displayed in all areas of the hospital

- written in the language(s) most frequently understood by patients and staff.

Early learning is defined as any opportunity for an infant, toddler, or older child to interact with a person, place or object around them. Such (positive or negative) interactions, or lack thereof, contribute to brain development and lay the foundation for later learning.
Infants and children should engage in early learning activities with their fathers, mothers and other caregivers between 0 and 3 years after birth.
Activities that support early learning in the neonatal period include making eye contact, smiling, talking, singing, and gently massaging the infant.

Universal screening for neonatal hyperbilirubinemia with transcutaneous bilirubinometer (TcB) is recommended at the time of discharge from the health center.
Physicians should ensure that all newborns are systematically monitored to rule out the potential occurrence of jaundice during the stay in the health center.

The postnatal age for universal TcB screening at discharge should be based on when the baby is discharged from the health center.

It is recommended to consider gentle whole body massage for healthy full-term newborns because of its potential benefits for growth and development.

Gentle whole body massage involves the use of the hands for tactile stimulation, slowly rubbing and stroking parts of the body or passive full range movement at the joints of the extremities.

Since 2011, November 17 has been recognized as the World Prematurity Day in order to give visibility to this problem, raise awareness of the needs and rights of premature babies and their families, sensitize decision makers, health teams and the whole society about the importance of experience and quality care, to advance policies that guarantee the full rights of both babies and families.