The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial

Bolam, A; Manandhar, Dharma S; Shrestha, Purna Devi; Ellis, Matthew; Costello, Anthony

doi:10.1136/bmj.316.7134.805

Cited by 135 publications

(161 citation statements)

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“…conducted by Ellis and co-workers 14 and others who found that the use of touch led to underestimation of neonatal hypothermia (Table 4). 22,25 WHO recommends the use of a low-reading mercury-in-glass thermometer, but it is fragile and difficult to obtain in many parts of the world.…”

Section: Recognition Of Hypothermia Measurement and Detectionmentioning

confidence: 93%

“…3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Uniform adoption and application of the standard WHO definition is fundamental to coordinated advancements in detection and management, but hypothermia continues to be variably defined, leading to under-recognition and under-reporting, and inadvertent denial of care to those who are misclassified but in need of care.…”

Section: Definitionmentioning

confidence: 99%

“…The incidence of primary hypothermiaFan independent morbidity that presents as a result of cold stressFis high immediately following birth in hospital settings. [11][12][13][14]16,20,[58][59][60] Few studies have addressed aspects surrounding the birth and postpartum care that can put the newborn at risk for hypothermia. 9,16,57,61 In one village-based study in India, 11% of 189 neonates were found to be hypothermic (<35.6 1C) based on a single temperature reading taken within the first 24 h after birth.…”

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

“…14 The risk of death among hypothermic newborns in an urban Indian hospital was highly correlated with the length of time it took to transfer and admit the newborn from the delivery ward to the neonatal intensive care unit. 70 Silveira et al 71 recommend in utero transport whenever possible, encouraging women to deliver in a hospital to reduce the possibility of a post-labor transport if the baby requires extra care after birth.…”

Section: Transportmentioning

confidence: 99%

“…Evidence from studies on neonatal transport between wards within hospitals suggests that even in such controlled settings, risk of hypothermia during transport is high. 14,70 It is a common observation in developing countries that preterm and high-risk infants are referred soon after birth, rather than in utero. 73 This practice further aggravates the risk of cold exposure among rural populations who live far from health centers and have limited access to modern transportation.…”

Section: Risk During Transportmentioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Section: Recognition Of Hypothermia Measurement and Detectionmentioning

confidence: 93%

Section: Definitionmentioning

confidence: 99%

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

Section: Transportmentioning

confidence: 99%

Section: Risk During Transportmentioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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Support for breastfeeding mothers

Britton¹,

McCormick²,

Renfrew³

et al. 2007

Cochrane Database of Systematic Reviews

394

362

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Support for healthy breastfeeding mothers with healthy term babies

McFadden

Gavine

Renfrew

et al. 2012

Cochrane Database of Systematic Reviews

454

354

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Background There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended infants be exclusively breastfed until six months of age, with breastfeeding continuing as an important part of the infant’s diet till at least two years of age. However, breastfeeding rates in many countries currently do not reflect this recommendation. Objectives To assess the effectiveness of support for breastfeeding mothers. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (3 October 2011). Selection criteria Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Main results Of the 67 studies that we assessed as eligible for inclusion, 52 contributed outcome data to the review (56,451 mother-infant pairs) from 21 countries. All forms of extra support analysed together showed an increase in duration of ‘any breastfeeding’ (includes partial and exclusive breastfeeding) (risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.88 to 0.96). All forms of extra support together also had a positive effect on duration of exclusive breastfeeding (RR at six months 0.86, 95% CI 0.82 to 0.91; RR at four to six weeks 0.74, 95% CI 0.61 to 0.89). Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Maternal satisfaction was poorly reported. Authors’ conclusions All women should be offered support to breastfeed their babies to increase the duration and exclusivity of breastfeeding. Support is likely to be more effective in settings with high initiation rates, so efforts to increase the uptake of breastfeeding should be in place. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies that rely mainly on face-to-face support are more likely to succeed. Support that is only offered reactively, in which women are expected to initiate the contact, is unlikely to be effective; women should be offered ongoing visits on a scheduled basis so they can predict that support will be available. Support should be tailored to the needs of the setting and the population group.

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The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial

Abstract: Objectives: To evaluate impact of postnatal health education for mothers on infant care and postnatal family planning practices in Nepal.

Cited by 135 publications

References 10 publications

Neonatal hypothermia in low resource settings: a review

Neonatal hypothermia in low resource settings: a review

Support for breastfeeding mothers

Support for healthy breastfeeding mothers with healthy term babies

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