The World Health Organization (WHO) is launching its “First Embrace” campaign today in Viet Nam, highlighting simple steps that will save thousands of newborn lives and prevent hundreds of thousands of complications each year from unsafe or outdated practices in newborn care in Viet Nam.
Viet Nam has made great strides in the last two decades to reduce the number of children under-5 dying within the first month of life, reaching the UN Millennium Development Goal target of reducing child mortality. However, in 2012, over 17,000 newborns still died within the first month of life. For this reason, First Embrace highlights early essential newborn care, or EENC. This package of actions and interventions address the most common causes of newborn death or disease, such as prematurity (being born too soon), low birth weight and severe infection such as pneumonia or diarrhoea.
“We lose far too many newborn infants to preventable factors, such as disease,” explains Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “First Embrace addresses this challenge by urging women and health care providers across Viet Nam to take simple steps to protect babies during the crucial time immediately after birth.”
Saving newborn babies, one step at a time
Early essential newborn care is a series of simple and cost-effective measures designed to prevent newborn deaths by changing harmful medical practices.
EENC begins with the First Embrace or sustained skin-to-skin contact between the mother and child shortly after birth. This simple act transfers warmth, placental blood and protective bacteria, and encourages exclusive breastfeeding.
“Separation of the mother and child immediately after birth is an age-old practice. But it occurs during a crucial time when babies are programmed to look for their mother’s breast in order to breastfeed,” notes Dr Maria Asuncion Silvestre, a paediatric neonatologist who consults for WHO.
In addition, customs and beliefs among some communities and health care providers may act as a barrier to full implementation of EENC. Changing practices requires a supportive environment, informed families and individuals that insist on best practices from health care providers.
Skin-to-skin contact should be followed by proper clamping and cutting of the umbilical cord with sterile instruments. Breastfeeding then initiates naturally at feeding cues, such as drooling, tonguing, and biting the hand. Early initiation of breastfeeding is especially important because colostrum, or “first milk”, contains essential nutrients, antibodies and immune cells.
Other routine steps such as the provision of vitamin K, eye prophylaxis, immunizations, weighing and a complete examination of the baby’s health, should be performed after the first breastfeeding. These steps must be performed in proper sequence for maximum benefit.
EENC can be performed in all birth settings without the need for complicated preparations or expensive technology. Early essential newborn care can thus also be applied in district and community health centres in remote or hard to reach areas in Viet Nam. These areas experience a disproportionately high number of newborn deaths.
“Health workers may be unaware of these relatively simple steps to protect newborns. In addition, customs and beliefs among some communities and health-care providers may act as a barrier to full implementation of EENC. Through the First Embrace campaign we promote to change current practices and inform families and individuals to insist on best practices from health-care providers,” explains Dr Hoang Thi Bang, WHO Technical Officer for reproductive, maternal, newborn and child health with WHO Viet Nam.
The First Embrace campaign
WHO, with support of the Ministry of Health of Viet Nam, launches the First Embrace campaign in Viet Nam simultaneously at three hospitals this week: Tu Du Hospital in Ho Chi Minh City, The Obstetrics and Paediatrics Hospital in Da Nang, and the National Obstetrics and Gynaecology Hospital in Hanoi. These three hospitals are early essential newborn care Centres of Excellence in Viet Nam where First Embrace practices are already in use.
WHO supports the development of these Centres of Excellence by providing coaching and training to nurses and doctors, and also by creating an enabling environment for mothers and newborns to receive early newborn care in the hospital.
WHO’s First Embrace campaign is part of a broader effort to improve access to and quality of maternal, newborn and child health care services across Viet Nam and WHO’s Western Pacific Region.
For more information, the website http://thefirstembrace.org offers many resources, including The First Embrace, a short film on the importance of child and mother bonding immediately after birth.