Sunday, June 26

Lack of Skin-to-Skin Care for Young and Premature Babies Affects Survival Rates | Maternal health

Sick, small babies are at higher risk of dying from disruptions in care caused by the coronavirus, a survey of healthcare workers in 62 countries, primarily developing, found.

Each year, 2.5 million babies die within 28 days of birth and more than 80% of them have low birth weight. A technique for premature and young babies known as kangaroo maternal care (KMC), which involves early and prolonged skin-to-skin contact with their mothers and breastfeeding, can help reduce mortality.

But a survey of 1,100 health professionals, published in the British Medical Journal Global Health, conducted by an association of researchers led by the World Health Organization (WHO) and the London School of Hygiene and Tropical Medicine, found that this life-saving intervention was delayed or not used.

Staff told investigators they were not implementing the technique for fear of infection and mother-to-child transmission of Covid. Other concerns included PPE shortages, stress, and safety. In some hospitals, neonatal staff reported losing vital resources, including oxygen and nurses, in the Covid wards.

Two-thirds of those surveyed said they would not allow mothers whose Covid status was positive or unknown to practice KMC. A quarter said they would not allow breastfeeding. There was a lack of clarity on newborn care guidelines for mothers suspected or confirmed positive for Covid. Eighty-five percent of those surveyed practiced KMC routinely before the pandemic, compared with 55% during the pandemic.

“It’s fear for the baby, fear of infection in the room, and fear for themselves,” said Professor Joy Lawn, director of the Maternal and Child Health Center. London School of Hygiene and Tropical Medicine.

Mothers’ Covid status was often unknown – only a third of those surveyed reported that testing was available to highly pregnant women.

“The nurses are more stressed, they don’t have PPE, they aren’t vaccinated,” Lawn said. “They worry about doing it and during the pandemic they don’t want mothers in the room, they don’t want mothers to manipulate babies.”

A midwife cradles a baby in Mali, January 2020
A midwife cradles a baby in Mali, January 2020. Respondents in the study said there was a lack of clarity about guidelines during the pandemic. Photograph: Keïta / UNICEF / LSHTM

Separating newborns from their mothers can put them at greater risk, Lawn said.

“A premature baby dies in minutes if you are not doing the right thing. It was already a big problem. Then comes the pandemic. We are separating mothers and babies. Even more shocking, the oxygen teams and also the nurses are being removed from the wards. “

The survey, conducted in the last six months of 2020, did not include details on newborn mortality rates as a result of this change. But a separate study in The Lancet Clinical Medicine found that the benefit of KMC “far outweighs” the small risk that a newborn weighing less than 2 kg will die from Covid.

The Lancet study, conducted by a global collaboration that includes the University of California, San Francisco and led by WHO and the London School of Hygiene and Tropical Medicine, estimated that if KMC universal coverage were achieved, 125,000 would be saved just recently. newborns, while fewer than 2,000 newborns would die from Covid. In contrast, a 50% reduction in KMC could result in 12,500 more deaths, it found.

Professor Suman Rao, St John’s Medical College, Bengaluru, India, lead author of both studies, said: “KMC is one of our most cost-effective ways to protect small and sick newborns. It is now more important than ever to ensure that mothers are supported and that health professionals feel safe and comfortable to support them during labor. ”

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