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New research highlights the risks of separating newborns from their mothers during the COVID-19 pandemic

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New research by WHO and partners shows that the COVID-19 pandemic is seriously affecting the quality of care for small and sick newborns, resulting in unnecessary suffering and death.

Study published in Lancet EclinicalMedicine emphasizes the crucial importance of ensuring close contact of newborns with their parents after birth, especially for those born too early (with low birth weight) or prematurely (premature). However, in many countries, if COVID-19 infection is confirmed or suspected, newborns are routinely separated from their mothers, putting them at higher risk of death and lifelong health complications.

This is especially the case in the poorest countries where the highest numbers of premature births and newborns occur. According to the report, disturbances in the care of the kangaroo mother – which includes close contact between parents, usually mothers and newborn babies – will exacerbate these risks.

The lives of up to 125,000 babies could be saved with full coverage of the kangaroo mother’s care. For babies born prematurely or with low birth weight, mother kangaroo care (early, prolonged skin-to-parent skin contact and exclusive breastfeeding) is particularly critical. Among infants born prematurely or with low birth weight, it has been proven that caring for kangaroo mothers reduces infant mortality by as much as 40%, hypothermia by more than 70% and severe infections by 65%.

“Interruptions in the provision of basic health services during COVID-19 have seriously affected the quality of care for some of the most vulnerable babies, and this includes their right to the life-saving contact they need with their parents,” she said. Dr. Anshu Banerjee, Director for Mothers, Newborns, Children and Adolescent WHO Health and Aging. “Decades of progress in reducing child deaths will be jeopardized if we do not now work to protect and improve maternal and newborn care services and expand coverage with rescue interventions such as mother kangaroo care.”

The WHO advises that mothers should continue to share a room with their baby from birth and be able to breastfeed and practice skin-to-skin contact – even when COVID-19 infection is suspected or confirmed – and should be supported to ensure appropriate prevention practices. infections.

“Much more attention is needed to ensure that global health professionals and decision makers are aware of the need to keep mothers and babies together in these critical early days, especially for babies born prematurely or prematurely,” she said. Queen Dube, Director of Health at the Ministry of Health in Malawi, one of the authors of the report. “Caring for a kangaroo mother is one of our most cost-effective ways to protect small and sick newborns. According to our analysis, these risks far outweigh the small chances that a newborn will get a serious disease from COVID-19. “

“Mother kangaroo care is one of the best interventions to improve the chances of survival of premature babies or premature babies, especially in low-income countries,” she added.

Evidence suggests that disturbances in kangaroo maternal care are already worryingly widespread. A systematic review of 20 clinical guidelines from 17 countries during the COVID-19 pandemic found that one-third recommended separation of mothers and newborns if the mother has or may have COVID-19. In a global survey of thousands of neonatal health care providers, published today in a related paper in British Medical Journal (BMJ) Global Health, two-thirds of health workers in 62 countries reported not allowing mothers with confirmed or suspected COVID-19 to practice routine skin-to-skin contact, while nearly one-quarter did not allow breastfeeding, even to uninfected caregivers.

Studies have generally reported no symptoms or mild disease from COVID-19 in infected infants, with a low risk of neonatal death. This new study estimates that the risk of a newborn catching COVID-19 would result in less than 2,000 deaths.

However, infection during pregnancy can result in an increased risk of preterm birth, which means that it is even more important to provide adequate care to support preterm infants and their parents during the COVID-19 pandemic.

According to the latest estimates, 15 million babies are born prematurely (37 weeks ago) each year, and 21 million are born with low birth weight (below 2.5 kg). These babies face significant health risks, including disability, developmental delays and infections, while complications associated with prematurity are the leading causes of death in infants and children under 5 years of age.

About the study

The authors of the WHO contributed to the following work: Early care during the COVID-19 pandemic: a comparative risk analysis of neonates avoided by kangaroo maternal care in relation to SARS-CoV-2 infection mortality in Clinical Medicine Lancet. AND A related study by the COVID-19 Collaborative Group for the Care of Small and Sick Newborns was published today in the journal British Medical Journal,, Care for young and sick infants during the COVID-19 pandemic: a global survey and thematic analysis of the voice and experience of health care providers. BMJ GH. DOI: 10.1136 / bmjgh-2020-004347

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