New research highlights the risks of separating newborns from mothers during the COVID-19 pandemic

New research from WHO and partners shows that the COVID-19 pandemic is severely affecting the quality of care provided to small and sick newborns, resulting in unnecessary suffering and death.

A study published in the Lancet EclinicalMedicine highlights the critical importance of ensuring that newborn babies have close contact with their parents after birth, especially for very small (low birth weight) or very early (premature) babies. However, in many countries, if COVID-19 infections are suspected or confirmed, newborn babies are routinely separated from their mothers, which puts them at greater risk of death and health complications throughout life.

This is especially the case in the poorest countries, where the highest number of premature births and infant deaths occurs. According to the report, interruptions in care for the kangaroo mother – which involves close contact between a parent, usually the mother, and a newborn baby – will worsen these risks.

Up to 125,000 baby lives could be saved with full coverage of maternal-kangaroo care. For babies born prematurely or with low birth weight, care for the kangaroo mother (early and prolonged skin-to-skin contact with one parent and exclusive breastfeeding) is particularly critical. Among babies born prematurely or with low birth weight, care for the kangaroo mother has been shown to reduce infant deaths by up to 40%, hypothermia by more than 70% and serious infections by 65%.

“Disruptions to essential health services during COVID-19 have severely affected the quality of care provided to some of the most vulnerable babies, and that includes their right to the vital contact they need with their parents,” he said. Dr. Anshu Banerjee, Director of Maternity, Newborn, Child and Adolescent WHO Health and Aging. “Decades of progress in reducing child mortality will be undermined, unless we act now to protect and improve quality care services for mothers and newborns and expand coverage of life-saving interventions, such as care for the kangaroo mother.

WHO recommends that mothers continue to share a room with their babies from birth and are able to breastfeed and practice skin-to-skin contact – even when COVID-19 infections are suspected or confirmed – and should be supported to ensure appropriate practices infection prevention.

“Much more attention is needed to ensure that healthcare professionals and legislators around the world are aware of the need to keep mothers and babies together in these critical first days, especially for babies who are born too young or too early,” he said. Queen Dube, Director of Health, Ministry of Health, Malawi, one of the authors of the report. “The Kangaroo Mother Method is one of the most economical ways to protect small and sick newborns. According to our analysis, these risks far outweigh the small chance that a newborn baby will contract severe COVID-19 disease. “

“Kangaroo mother care is among the best interventions to improve the chances of survival for a premature or low birth weight baby, especially in low-income countries,” she added.

Evidence suggests that interruptions in kangaroo mother treatment may be worryingly widespread. A systematic review of 20 clinical guidelines from 17 countries during the COVID-19 pandemic found that one-third recommended separation of mothers and newborns if the mother has or can have COVID-19. In a global survey of thousands of neonatal health care providers, published today in a related article on British Medical Journal (BMJ) Global Health, two-thirds of health professionals in 62 countries reported that they do not allow mothers with confirmed or suspected COVID-19 to practice routine skin-to-skin contact, while almost a quarter do not allow breastfeeding, even by uninfected caregivers.

The studies mainly reported no mild symptoms or disease of COVID-19 in infected newborns, with a low risk of neonatal death. This new study estimates that the risk of newborns contracting COVID-19 would result in less than 2,000 deaths.

However, infection during pregnancy can result in an increased risk of premature birth, which means that it is even more important to ensure that correct care is given to support premature babies and their parents during the COVID-19 pandemic.

According to the most recent estimates, 15 million babies are born premature (before 37 weeks) each year and 21 million are born with low birth weight (less than 2.5 kg). These babies face significant health risks, including disabilities, developmental delays and infections, while complications related to prematurity are the main causes of death for newborns and children under 5 years of age.

About the study

WHO authors contributed to the following article: Preterm care during the COVID-19 pandemic: a comparative risk analysis of neonatal deaths avoided by maternal-kangaroo care versus mortality due to SARS-CoV-2 infection at the The Lancet Eclinical Medicine. ONE a related study by the Collaborative Group for the Care of Small and Sick Newborns of COVID-19 was published today in British Medical Journal, Care of small and sick newborns during the COVID-19 pandemic: global research and thematic analysis of the voices and experiences of health professionals. BMJ GH. DOI: 10.1136 / bmjgh-2020-004347