Cross sectional, community based study of care of newborn infants in Nepal

Osrin, David; Tumbahangphe, Kirti Man; Shrestha, Deepti; Mesko, Natasha; Shrestha, Bhim; Manandhar, Madan; Standing, Hilary; Manandhar, Dharma S; Costello, Anthony

doi:10.1136/bmj.325.7372.1063

Cited by 134 publications

(159 citation statements)

References 8 publications

(6 reference statements)

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“…Further, because it takes place before the beneficial actions of the colostrum on the gut, unpasteurized substances are introduced when the gut is at its most permeable and vulnerable to contaminants. The calculated rate of 60 % prelacteal feeding in Kossoye is intermediate among reported prevalence rates, which range from approximately 15 % (12,17) to 100 % (24,27) . Getahun et al (35) report that unsalted butter is given to newborns in Gondar (20 miles south of Kossoye) 'in the belief that it will clean the stomach'.…”

Section: Prelacteal Feedingmentioning

confidence: 56%

Colostrum avoidance, prelacteal feeding and late breast-feeding initiation in rural Northern Ethiopia

Rogers

Abdi

Moore

et al. 2011

Public Health Nutr.

112

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Objective: To identify specific cultural and behavioural factors that might be influenced to increase colostrum feeding in a rural village in Northern Ethiopia to improve infant health. Design: Background interviews were conducted with six community health workers and two traditional birth attendants. A semi-structured tape-recorded interview was conducted with twenty mothers, most with children under the age of 5 years. Variables were: parental age and education; mother's ethnicity; number of live births and children's age; breast-feeding from birth through to weaning; availability and use of formula; and descriptions of colostrum v. other stages of breast milk. Participant interviews were conducted in Amharic and translated into English. Setting: Kossoye, a rural Amhara village with high prevalence rates of stunting: inappropriate neonatal feeding is thought to be a factor. Subjects: Women (20-60 years of age) reporting at least one live birth (range: 1-8, mean: ,4). Results: Colostrum (inger) and breast milk (yetut wotet) were seen as different substances. Colostrum was said to cause abdominal problems, but discarding a portion was sufficient to mitigate this effect. Almost all (nineteen of twenty) women breast-fed and twelve (63 %) reported ritual prelacteal feeding. A majority (fifteen of nineteen, 79 %) reported discarding colostrum and breast-feeding within 24 h of birth. Prelacteal feeding emerged as an additional factor to be targeted through educational intervention. Conclusions: To maximize neonatal health and growth, we recommend culturally tailored education delivered by community health advocates and traditional health practitioners that promotes immediate colostrum feeding and discourages prelacteal feeding.

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Section: Prelacteal Feedingmentioning

confidence: 56%

Colostrum avoidance, prelacteal feeding and late breast-feeding initiation in rural Northern Ethiopia

Rogers

Abdi

Moore

et al. 2011

Public Health Nutr.

112

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“…10 A community-based newborn study conducted in Nepal concluded that less than 50% of women receive any ANC and over 90% of births occur at home, of which approximately 85% are attended to by untrained birth attendants. 11 Three-fourths of all deliveries in India take place at home with less than 40% being attended to by a trained provider. 12 According to Bang et al, 13 women in rural Gadchiroli, India, underfed themselves during pregnancy to avoid having a large baby and ensure an easy delivery.…”

Section: Discussionmentioning

confidence: 99%

“…It was observed that 45% of those participating in the study had discarded colostrum. 11 Results from a study carried out in Haryana, India, showed that only 5 to 8% of women exclusively breastfed their babies between the age of 4 and 6 months, and 75% of newborns were given prelacteal feeds of honey, tea and diluted milk. 14 Babies are often not breastfed during the first 3 days and are often given sweetened water.…”

Section: Discussionmentioning

confidence: 99%

Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

et al. 2007

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Objective: To learn about household maternal and newborn health knowledge and practices to aid the design of newborn programming within Save the Children's Haripur Program.Study Design: In April, we conducted 43 semi-structured interviews (SSIs) and 34 focus group discussions among men, women of reproductive age and health service providers; in September, we added 21 SSIs among new mothers, new fathers and dais. Two investigators analyzed the findings according to themes within six care types: antenatal, delivery, immediate newborn, routine postpartum, special maternal and special newborn.Result: Findings indicated poor maternal diet and antenatal careseeking. Home delivery with an untrained dai was the norm. Respondents knew about benefits of clean delivery, but rarely put knowledge into practice. Knowledge and practices for maintaining the newborn's warmth were good. Delayed initiation of breastfeeding, avoidance of colostrum and prelacteal feeding were almost universal. Unhygienic cord care, including an unclean cut and application of ghee on the cord-stump, was the norm. After delivery, mothers often maintained low fluid intake but otherwise reported healthy nutritional practices. Knowledge of some danger signs in newborns was common, but timely action upon recognition was not. Conclusion:Although the findings illustrate some beneficial practices, many reported practices are harmful to the newborn. These findings, consistent with the sparse existing data in Pakistan, inform program interventions for household-level behavioral change.

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“…66 In a study of 5411 home births in Nepal, 4% were wrapped within 5 min of birth. 64 Newborn is bathed soon after birth…”

Section: Newborn Is Not Dried or Wrapped Immediatelymentioning

confidence: 99%

“…66 In Nepal, where bathing is nearly universal, a study of 5411 newborns documented that 92% were bathed within an hour of birth. 64 Oil massage…”

Section: Newborn Is Not Dried or Wrapped Immediatelymentioning

confidence: 99%

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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Cross sectional, community based study of care of newborn infants in Nepal

Cited by 134 publications

References 8 publications

Colostrum avoidance, prelacteal feeding and late breast-feeding initiation in rural Northern Ethiopia

Colostrum avoidance, prelacteal feeding and late breast-feeding initiation in rural Northern Ethiopia

Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

Neonatal hypothermia in low resource settings: a review

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