Guideline

WHO recommendations on postnatal care of the mother and newborn

Year of Publication

2014

Issuing Institution

World Health Organization

Links

WHO IRIS,WHO IRIS

Recommendations

10 included recommendations

After an uncomplicated vaginal birth in a health facility, healthy mothers and newborns should receive care in the facility for at least 24 hours after birth.

Status

Retired

Recommended in favor

Conditional

Certainty of evidence

Low

If birth is in a health facility, mothers and newborns should receive postnatal care in the facility for at least 24 hours after birth. a If birth is at home, the first postnatal contact should be as early as possible within 24 hours of birth. At least three additional postnatal contacts are recommended for all mothers and newborns, on day 3 (48–72 hours), between days 7–14 after birth, and six weeks after birth

Status

Retired

Recommended in favor

Strong

Home visits in the first week after birth are recommended for care of the mother and newborn

Status

Retired

Recommended in favor

Strong

The following signs should be assessed during each postnatal care contact and the newborn should be referred for further evaluation if any of the signs is present: stopped feeding well, history of convulsions, fast breathing (breathing rate ≥60 per minute), severe chest in-drawing, no spontaneous movement, fever (temperature ≥37.5 °C), low body temperature (temperature <35.5 °C), any jaundice in first 24 hours of life, or yellow palms and soles at any age. The family should be encouraged to seek health care early if they identify any of the above danger signs in-between postnatal care visits

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Low

All babies should be exclusively breastfed from birth until 6 months of age. Mothers should be counselled and provided support for exclusive breastfeeding at each postnatal contact

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

Daily chlorhexidine (7.1% chlorhexidine digluconate aqueous solution or gel, delivering 4% chlorhexidine) application to the umbilical cord stump during the first week of life is recommended for newborns who are born at home in settings with high neonatal mortality (30 or more neonatal deaths per 1000 live births). Clean, dry cord care is recommended for newborns born in health facilities and at home in low neonatal mortality settings. Use of chlorhexidine in these situations may be considered only to replace application of a harmful traditional substance, such as cow dung, to the cord stump

Status

Retired

Recommended in favor

Strong

Certainty of evidence

Moderate

The use of antibiotics among women with a vaginal delivery and a third or fourth degree perineal tear is recommended for prevention of wound complications. The GDG considers that there is insufficient evidence to recommend the routine use of antibiotics in all low-risk women with a vaginal delivery for prevention of endometritis

Status

Retired

Recommended in favor

Strong

Certainty of evidence

Very low

Psychosocial support by a trained person is recommended for the prevention of postpartum depression among women at high risk of developing this condition

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Very low

The GDG considers that there is insufficient evidence to recommend routine formal debriefing to all women to reduce the occurrence/risk of postpartum depression

Status

Updated

Recommended against

Conditional

Certainty of evidence

Low

The GDG also considers that there is insufficient evidence to recommend the routine distribution of, and discussion about, printed educational material for prevention of postpartum depression

Status

Updated

Recommended against

Conditional

Certainty of evidence

Very low