A mother in Kenya holds her newborn baby. Photo credit: Allan Gichigi/ Save the Children

5 priorities for involving parents and families in the care of small and sick newborns

Written by Mary Kinney, Senior Specialist, Global Evidence and Advocacy, Saving Newborn Lives at Save the Children 

Globally, nearly 30 million babies are born too soon, too small or become sick every year and need specialized care to survive. This staggering number was published in the report, Survive and Thrive: Transforming care for every small and sick newborn, by UNICEF, the World Health Organization, Save the Children and other partners at the end of 2018. Most of these babies can survive and live without major complications with quality and nurturing care.

Evidence indicates that involving parents and families or other caregivers in the care of the small and sick newborns benefits both the infants and parents including higher breastfeeding rates, earlier discharge from the hospital, increased weight gain, improved neurodevelopment, reduced parental stress and anxiety, and improved health-related knowledge and beliefs among parents and communities.

Here are five priorities from the report for involving parents and families in the care of small and sick newborns during hospitalization:

Promote Zero Separation

Evidence shows that the well-being and survival of both mother and newborn are inextricably linked and require a coordinated, integrated approach. This not only optimizes their health but also promotes greater efficiency, lowers costs and reduces the duplication of resources. For example, mother’s presence is crucial to establish breastfeeding and to promote Kangaroo Mother Care. Promoting zero separation reduces the risk for short- and long-term health and social problems, including parental depression and anxiety.

Intentionally Engage Men

While women have a unique role as mothers, evidence also shows that men also have a key role in the care of newborns, as partners/husbands, fathers, caregivers and community members. Men often determine health care seeking as well as provide care to the newborn and mother. Health services should accommodate men to accompany their partners, including service hours, physical space and privacy for care visits.

Involve Parents in the Care During Hospitalization

Parents or other caregivers make unique contributions by being able to observe, monitor and provide care to their small and sick newborns (when appropriate, under supervision and in partnership with the health-care team). A recent randomized control trial found that parental involvement during the inpatient neonatal intensive care benefits newborn health outcomes, including infant weight gain and increased frequency of exclusive breastmilk feeding at discharge, as well as a boon to parental mental health. Interventions, such as Kangaroo Mother Care, empowers families to care for their small newborns and shortens their length of stay in the hospital.

Practice Family-Centered Care

Family-centered care for small and sick newborns has a growing evidence base with demonstrated benefits for infants (such as weight gain and neurodevelopmental progress) as well as parents (such as decreased parental stress and anxiety and increased caregiving efficacy). This approach implements four basic principles: dignity and respect; information sharing; participation; and collaboration, and is recommended by the American Academy of Pediatrics. Hospitals and communities should provide space at the facility or nearby for parents or family members, as needed.

Empower Parents

Parents are powerful agents of change for small and sick newborn care supporting other parents and influencing policy and programs. Support forums for parents, including parent-led, peer-to-peer and health professional-led groups, improve the home environment, parental mental health and parental confidence in caring for their child. Parent advocacy and support organizations raise awareness and share their experiences to help others in the same situation through events like World Prematurity Day.

 

Thank to the generous support of our donors, Save the Children has a long-standing experience promoting family engagement in newborn care, such as with Kangaroo Mother Care, demand creation for community-based newborn care, and quality improvement activities. In order to transform care for small and sick newborns, intentional efforts must be made to involve parents, and we remain committed to this effort as part of our broader approach to improve maternal and newborn health. That means that together, we have the chance to make a lifetime of change for millions of newborn babies.

To learn more about the work Save the Children has done to save newborn lives, visit our website.

Get involved by donating your birthday and help a baby live to see their first birthday – and many more. DONATE YOUR BIRTHDAY TODAY!

Keeping a Baby Close to Your Heart

Alicia Adler

Program Officer at Save the Children Malawi

January 9, 2016

Imagine spending at least 20 hours a day, 7 days a week with a baby strapped to your chest. Imagine you must eat, sleep, work and care for your other children along with a tiny baby who depends on your continuous skin-to-skin contact and exclusive breastfeeding for survival. This is the basis of kangaroo mother care (KMC), a costeffective intervention to help meet a premature or low-birthweight babys basic needs for warmth, nutrition, stimulation and protection from infection.blog2

For Malawi, with the highest preterm birth rate in the world (18 per 100 live births), KMC is a critical lifesaving intervention. But too few premature babies receive KMC due to lack of awareness, limited resources, and stigma against both KMC and premature/low-birthweight infants. It is not surprising, then, that direct complications of preterm birth are the second leading cause of child deaths after pneumonia, and result in more than 14 newborn deaths every day in Malawi. 

To commemorate World Prematurity Day 2016 on November 17th, Save the Children staff in Malawi accepted the KMC Challenge. Participants practiced KMC with a baby doll for 24 hours – holding the doll throughout work hours, around town and at home for the night. The challenge was accepted by other partners across the country and globe.

Jessie Lwanda, an IT coordinator said, “By doing this challenge, we are saying, ‘let’s give these babies a chance to survive by showing them love and carrying them close to our heart.’”

I have a passion for every child to survive, said Mavis Khondiwa, a Save the Children grants coordinator based in the United States. Through this challenge I could understand what kind of burden those mothers with premature babies face. I really feel for them.

blog1Over the course of the day, 20 men and women got a glimpse into the life of a mother with a premature baby and all the issues it presents. Through what I experienced as a man doing the challenge, I think women need more help, said Nyashadzashe Kaunda, an awards management officer. Men should also be taking care of the child and helping throughout the whole KMC process, he said

At the end of the 24 hours, colleagues returned the dolls and resumed their normal lives. For women around the country, it isnt so easy, though, as their childs life depends on their continued commitment to practice KMC until the baby reaches a healthy weight. In a country where neonatal mortality accounts for 40 percent of all death in children under age 5, it is everyones responsibility to champion KMC, and not just on World Prematurity Day, but every day. 

Save the Children is helping shift norms around the value of newborns in Malawi through the government’s social and behavior change communication (SBCC) campaign, Khanda ndi Mphatso (A Baby is a Gift: Give it a Chance), helping establish KMC sites of excellence in district hospitals, and collaborating with the Ministry of Health to develop a national routine reporting system for KMC services in health facilities.

To learn more about our work to improve newborn survival, click here.

Alicia Adler is a program officer and Global Health Corps fellow with Save the Children in Malawi.

Nafy’s Story: Kangaroo Mother Care in Mali

R10-MA__-70a Dr. Nialen Kaba, Save the Children, project assistant for newborn survival and health

Bamako, Mali

April 14, 2010

I met Nafy on a visit to the Kangaroo Mother Care unit at Gabriel Toure Hospital in Bamako, Mali this past December. She was proud to be carrying her newborn son on her chest.

At delivery, Nafy was upset when the midwife told her that her baby was very small, weighing only 1200 grams (2.6 pounds). When her husband Adama learned of the baby’s condition, his joy quickly faded and he decided not to give the child a name. So, Nafy named him Ismael.

The day after Ismael was born, he was transferred to the pediatrics unit of the hospital. Expecting the worst, Nafy was relieved to learn that her baby had no abnormalities. However, because he was born premature, he would need to be kept warm to help him gain weight and grow.

She was told about Kangaroo Mother Care, a recently accepted practice in Mali that when coupled with a mother’s determination could help Ismael survive. 

View a photo essay featuring moms and babies in the Kangaroo Mother Care ward at Gabriel Toure Hospital in Bamako, Mali.

Nafy quickly adopted the Kangaroo Mother Care method in hopes of seeing her baby survive. She was forced to cope with Ismael alone because her husband Adama and his family were convinced that her efforts would be in vain. 

Their reaction only reinforced Nafy’s resolve. She practiced Kangaroo Mother Care and Ismael gained weight day by day. 

Her slogan was, “She who gives birth to a snake, attaches him to her waist.” The slogan means: Whatever the physical and mental condition of her baby, a mother is always ready to do whatever it takes to help her child survive. 

Each year, about 900,000 newborns worldwide die due to premature births. In Mali, more than 14 percent of newborns are born premature, according to the 2006 Mali Demographic Health Survey. But since the kangaroo care center opened 20 months ago, sover 550 babies have benefitted.

Learn how more than 50 percent of newborn deaths could be saved through Kangaroo Mother Care.

On the day I visited Nafy, Ismael was entering his third week of life.  He weighed 2800 grams (6 pounds) and wiggled to break free from the chest of his mother, who never stopped smiling.

Learn more about Survive to 5, Save the Children's campaign to save the lives of children under 5.