Each year four million babies die in the first 28 days of life (the neonatal period). 99% of these deaths are in developing countries. Death rates of children under five years old have being going down in recent years, but those of neonatal infants have not, despite there being a number of simple ways to reduce deaths.
A baby is 30 times more likely to die in the first month of life than in the 11 months after that, but 75% of these neonatal deaths happen in the first week of life, and 50% within 24 hours of delivery. So the period immediately after birth is by far the most important in terms of an infant’s health and survival.
As well as access to ante-natal care during pregnancy, a few key measures can make all the difference to neonatal health – delivery by a skilled birth attendant, access to emergency care immediately after birth, and visits by a community healthcare worker to mother and baby during the first week. As a mother’s health is critical for the health of her baby, she also needs to be at the centre of support services.
With over 90% of babies delivered at home among the poorest households in developing countries, it is really important that care is available to new mothers and infants wherever the birth takes place. At the moment, over 40% of women receive no care or support after birth.
Most neonatal deaths are caused by infections, birth asphyxia, and complications from premature birth, but three-quarters of these deaths could be prevented with simple, low cost care. This includes drying and keeping the baby warm, starting breastfeeding as soon as possible, feeding the baby exclusively breast-milk, and helping mothers and other carers to spot complications and infections early in order to get medical help if needed. Young children can die very quickly if infections or complications aren’t seen to. With only a little support, families and community health workers can provide all this care themselves.
Exclusive breastfeeding is usually the best source of nutrition and the best way to protect a baby from diarrhoea and other infections, but breastfeeding can also pass HIV from mother to child. So if a mother is HIV-positive, she will need skilled advice to weigh up the risks to her child.
Health Poverty Action says:
- A mother’s health is critical to the health of her baby, so care must focus on both mother and child.
- Neonatal health must be a stronger part of existing maternal and child health services.
- Where health services are weak, families and communities, supported by outreach services can be an effective basis for neonatal care.
- Neonatal care should link with services to prevent transmission of HIV from mother to child – to ensure appropriate advice on breastfeeding.