WHO recommends skin-to-skin contact for premature babies

The World Health Organization (WHO) recommends direct immediate contact at birth for premature babies, “skin-to-skin” with their caregivers and no initial period in the incubator, in new guidelines on the well-being of newborns that it gave to know this Tuesday, November 15.

Skin-to-skin contact

Tedros Adhanom Ghebreyesus, Director-General of the WHO, said: "These guidelines demonstrate that improving outcomes for these very young babies do not mean always offering the most technological solutions, but ensuring access to essential health care that is focused on the needs of the families".

“Premature babies can survive, thrive and change the world, but every baby must be given that chance,” Tedros said as he launched the guidelines as a contribution to newborns' chances of survival and health.

The new guideline marks a significant departure from previous practice, "as it reflects the immense health benefits of ensuring that caregivers - typically mothers - and premature babies can stay close after birth," the report said.

The WHO recommends that skin-to-skin contact, also known as "kangaroo mother care," begins immediately after the little ones take their first breath, with no initial period in an incubator.

Latest guidelines

The guidelines were released ahead of World Prematurity Day, which is celebrated annually on November 17, at the WHO headquarters in this Swiss city.

They also offer recommendations for emotional, financial, and employment support for families who may face extraordinary stress and difficulties due to the intense demands of caregiving and anxiety about the health of their babies.

It is estimated that every year 15 million premature babies are born in the world, that is, before the 37th week of pregnancy, which is approximately one in 10 births. And 20 million have a low birth weight, of less than 2.5 kilos.

The figures are increasing, which makes prematurity the main cause of death in children under five years of age, and an urgent public health problem.

In terms of survival, there are significant disparities based on the place of birth of premature babies. While most of those born at or after 28 weeks in the richest countries survive, the rate in the poorest countries can be as low as 10%.

The WHO affirms that the majority of premature babies can be saved with measures such as quality care before, during and after delivery, prevention and treatment of the most common infections, and kangaroo mother care.

Temperature at birth

The proposed new 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 have trouble regulating their temperature at birth, often requiring medical assistance to breathe.

Previous recommendations called for these babies to be stabilized first in an incubator or warmer, for an average of three to seven days, which is an initial separation from their primary caregiver.

However, the WHO states that research now shows that starting skin-to-skin contact immediately after birth saves many more lives, reduces infections and hypothermia, and improves feeding.

For premature and small babies, "the first hug with a parent is not only emotionally important, but it's also absolutely critical to their survival and health," said Karen Edmond, chief medical officer for infant health. of newborns from WHO.

“During the covid-19 pandemic, many women were unnecessarily separated from their babies, which could be catastrophic for the health of premature babies,” she recalled.

The guidelines also strongly recommend breastfeeding to improve health outcomes for preterm and low birth weight infants, as it reduces risks of infection, compared to infant formula.

Donor milk is the next best alternative if breast milk is not available, although fortified “preemie formula” can be used if donor milk banks are not accessible.

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