WHO Calls for Immediate Kangaroo Care for Survival of Preterm Babies

The World Health Organization (WHO) has launched new guidelines to improve survival and health outcomes for preterm babies. 

According to the guidelines, skin-to-skin contact with a caregiver known as kangaroo mother care should start immediately after birth, without any initial period in an incubator. This marks a  change from earlier guidance and common clinical practice, reflecting the immense health benefits of ensuring caregivers and their preterm babies can stay close, without being separated, after birth.

“Preterm babies can survive, thrive, and change the world but each baby must be given that chance,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General in a statement shared alongside the guidelines on Tuesday.

Tedros said the guidelines show that improving outcomes for tiny babies is not always about providing the most high-tech solutions, but rather ensuring access to essential healthcare that is centered around the needs of families.

Prematurity is an urgent public health issue. Every year, an estimated 15 million babies are born preterm, amounting to more than 1 in 10 of all births globally, and an even higher number – over 20 million babies – have a low birth weight. 

WHO says this number is rising and prematurity is now the leading cause of death of children under 5.

Also, depending on where they are born, there remain significant disparities in a preterm baby’s chances of surviving. While most born at or after 28 weeks in high-income countries go on to survive, in poorer countries survival rates can be as low as 10%.

The statement notes that most preterm babies can be saved through feasible, cost-effective measures including quality care before, during, and after childbirth, prevention and management of common infections, and kangaroo mother care and exclusive breastfeeding.

Because preterm babies lack body fat, many have problems regulating their own temperature when they are born, and they often require medical assistance with breathing. 

For these babies, previous recommendations were for an initial period of separation from their primary caregiver, with the baby first stabilized in an incubator or warmer. This would take on average, around 3-7 days. However, experts at the WHO now say that starting kangaroo mother care immediately after birth saves many more lives reduces infections and hypothermia, and improves feeding.

“The first embrace with a parent is not only emotionally important but also absolutely critical for improving chances of survival and health outcomes for small and premature babies,” said Dr. Karen Edmond, Medical Officer for Newborn Health at WHO. 

“These new guidelines stress the need to provide care for families and preterm babies together as a unit, and ensure parents get the best possible support through what is often a uniquely stressful and anxious time.”

The new guidelines however call for rethinking how neonatal intensive care is provided to ensure that babies are not separated from their parents. Currently, however, neonatal intensive care units do not reserve space for mothers even as they are allowed to visit at specified intervals. 

Earlier this year, WHO released related recommendations on antenatal treatments for women with a high likelihood of preterm birth. These include antenatal corticosteroids, which can prevent breathing difficulties and reduce health risks for preterm babies, as well as tocolytic treatments to delay labor and allow time for a course of corticosteroids to be completed.

Together, these are the first updates to WHO’s preterm and low birth weight guidelines since 2015.

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