The World Health Organization (WHO) this Tuesday released two important updates to its recommendations and guidelines for improving the well-being of adults and children: on the one hand, relating to protecting and caring for premature babies; On the other hand, they are related to family planning, contributing to greater control of desired pregnancies.
New guidelines for premature babies recommend that babies have direct skin-to-skin contact with their caregivers soon after birth to improve their chances of survival and health.
This advice is a significant change from previous practice.Because it shows the immense health benefits of ensuring that caregivers – usually mothers – and premature babies can stay close after birth.
The United Nations agency recommends that skin-to-skin contact, also known as “kangaroo mother care,” begins soon after these young babies take their first breath, with no initial period in the incubator.
small revolutionary changes
“Premature babies can survive, thrive and change the world, but every child must be given that chance,” the UN agency’s director-general revealed the new recommendations.
“These guidelines demonstrate that improving outcomes for these very young children does not always mean offering the most technological solutions, but ensuring access to essential health care focused on the needs of families,” said Tedros Adhanom Ghebreyesus.
The guidelines are published ahead of the World Day of Prematurity, which is observed annually on 17 November.
They also offer recommendations to guarantee emotional, economic and employment support for families.who may face extraordinary stress and difficulties because of the intense demands of care and concern about the health of their children.
public health concern
It is estimated that 15 million premature babies are born every year in the world, that is, before the 37th week of pregnancy, which is about one in 10 births. What’s more, 20 million have low birth weight, less than 2.5 kg.
The numbers are rising, making it the leading cause of premature death for children under the age of five.and an urgent public health problem.
In terms of survival, there are significant disparities by place of birth among premature babies. While most people born at or after 28 weeks survive in the richest countries, the rate can be as low as 10% in the poorest countries.
save more lives
The World Health Organization states that most premature babies can be prevented with cost-effective measures such as quality care before, during and after delivery, prevention and treatment of the most common infections, and kangaroo mother care.
This practice combines skin-to-skin contact in a sling or special wrap that is worn for as long as possible, and exclusive breastfeeding.
Premature babies lack body fat, so many babies have trouble regulating their own temperature at birthAnd breathing often requires medical help.
Previous recommendations called for these infants to be stabilized in an incubator or warmer for an average of three to seven days prior to initial separation from their primary caregiver.
the first hug is critical
However, the UN agency claims that research now shows that starting skin-to-skin contact soon after birth, Saves many more lives, reduces infection and hypothermia, and improves nutrition,
For premature and young babies, the first hug with a parent is not only emotionally important, but absolutely vital to their survival and health, says Dr. Karen, WHO’s Chief Medical Officer for Newborn Health Edmund said.
The Frightening Isolation of COVID
“During the COVID-19 pandemic, many women were unnecessarily separated from their babies, which could be devastating to the health of premature babies,” he recalled.
“These new guidelines emphasize the need to care for families and premature babies together as a unit, and ensure that parents receive the best possible support at what is often a uniquely stressful and anxious time,
The guidelines also strongly recommend breastfeeding to improve health outcomes for premature and low birth weight infants, as it reduces the risk of infection compared to infant formula.
If breast milk is not available then donor milk is the next best option, although fortified “preemie formula” may be used if donor milk banks are not available.
Updated Family Planning Guide
WHO also released its new updated guidance on family planning today, promoting improved health and well-being through the empowerment of people, including wider access to self-administered contraceptives and increased use of digital technologies by healthcare providers Is.
WHO’s updated flagship family planning manual, released Tuesday, informs health workers on how to protect access to family planning services during emergencies, and provides policy makers with the most up-to-date information on contraceptive options.
“Family planning promotes self-actualization and empowerment as well as health and well-being, and Reduces maternal and infant mortality by preventing unwanted pregnancies and unsafe abortionssaid Pascal Allotti, director of sexual and reproductive health and rights at the United Nations agency.
Based on lessons learned, it also expands guidance for women and youth at high risk of HIV.
an important resource
Experience with recent HIV outbreaks shows that family planning services can be seriously compromised during emergencies.
During the early stages of the COVID-19 pandemic in 2020, nearly 70% of countries reported disruption to these critical services, which exacerbated the risks of unwanted pregnancy and sexually transmitted infections,
The manual advocates for the continuity of family planning support services during the pandemic, including access to self-administered contraceptives, pharmacy dispensing and multi-month supplies.
“This updated family planning manual is an important resource to help health workers support contraceptive users around the world to make informed decisions about the contraceptive options that are right for them,” Elote said.
Self-administered contraceptives include condoms, birth control pills, some diaphragms, spermicide, and more recently, the option of self-injecting a contraceptive called DMPA, which can now be safely delivered under the skin instead of the muscle.
Many women prefer private and non-intrusive injectable contraceptiveswhich only requires one intervention every two or three weeks, so it is likely that this option will increase its acceptance.
“The updated recommendations in this manual reflect that nearly all family planning methods can be used safely by all women and, therefore, All women should have access to a range of choices that meet their needs and life goalssaid Mary Gaffield, lead author of the guideline update.
high risk approach
For the first time ever, the 2022 edition includes A chapter dedicated to guiding family planning services for women and adolescents at high risk of becoming infected with HIVPeople living in areas of high HIV prevalence and having multiple sex partners or whose common partner is living with HIV.
While only condoms protect against HIV and other sexually transmitted infections, all contraceptive options — with the sole exception of the spermicide nonoxynol-9 — are now considered safe for women and young men at high risk of HIV because they have not been shown to Is. Increased risk of transmitting HIV or getting the infection.
For people at high risk of becoming infected with HIV, the manual indicates that first-line testing, counselling, clinical care and referral should be offered as part of family planning services.
“Family planning services can be delivered safely and affordably so that couples and individuals, regardless of where they live, can choose between safe and effective family planning methods,” said the lead author.
booklet Also includes the latest guidance on the prevention, screening and treatment of cervical cancer and pre-cancer, which can be provided through family planning services; management of sexually transmitted infections; and family planning in post-abortion care.
Now in its fourth edition, the manual is the most widely used reference guide on the subject worldwide, with over one million copies distributed or downloaded.
This is complemented by the Medical Contraceptive Eligibility Criteria Tool, which can also be downloaded as a dedicated app.