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D. Chavez/World Bank © Credits Key facts
Who is most at risk?NeonatesGlobally 2.4 million children died in the first month of life in 2019. There are approximately 6 700 newborn deaths every day, amounting to 47% of all child deaths under the age of 5-years, up from 40% in 1990. The world has made substantial progress in child survival since 1990. Globally, the number of neonatal deaths declined from 5.0 million in 1990 to 2.4 million in 2019. However, the decline in neonatal mortality from 1990 to 2019 has been slower than that of post-neonatal under-5 mortality The share of neonatal deaths among under-five deaths is still relatively low in sub-Saharan Africa (36 per cent), which remains the region with the highest under-five mortality rates. In Europe and Northern America, which has one of the lowest under-five mortality rates among SDG regions, 54 per cent of all under-five deaths occur during the neonatal period. An exception is Southern Asia, where the proportion of neonatal deaths is among the highest (62 per cent) despite a relatively high under-five mortality rate. Sub-Saharan Africa had the highest neonatal mortality rate in 2019 at 27 deaths per 1,000 live births, followed by Central and Southern Asia with 24 deaths per 1,000 live births. A child born in sub-Saharan Africa or in Southern Asia is 10 times more likely to die in the first month than a child born in a high-income country. Top 10 countries with the highest number (thousands) of newborn deaths, 2019
CausesThe majority of all neonatal deaths (75%) occurs during the first week of life, and about 1 million newborns die within the first 24 hours. Preterm birth, intrapartum-related complications (birth asphyxia or lack of breathing at birth), infections and birth defects cause most neonatal deaths in 2017. From the end of the neonatal period and through the first 5 years of life, the main causes of death are pneumonia, diarrhoea, birth defects and malaria. Malnutrition is the underlying contributing factor, making children more vulnerable to severe diseases. Priority StrategiesThe vast majority of newborn deaths take place in low and middle-income countries. It is possible to improve survival and health of newborns and end preventable stillbirths by reaching high coverage of quality antenatal care, skilled care at birth, postnatal care for mother and baby, and care of small and sick newborns. In settings with well-functioning midwife programmes the provision of midwife-led continuity of care (MLCC) can reduce preterm births by up to 24%. MLCC is a model of care in which a midwife or a team of midwives provide care to the same woman throughout her pregnancy, childbirth and the postnatal period, calling upon medical support if necessary. With the increase in facility births (almost 80% globally), there is a great opportunity for providing essential newborn care and identifying and managing high risk newborns. However, few women and newborns stay in the facility for the recommended 24 hours after birth, which is the most critical time when complications can present. In addition, too many newborns die at home because of early discharge from the hospital, barriers to access and delays in seeking care. The four recommended postnatal care contacts delivered at health facility or through home visits play a key role to reach these newborns and their families. Accelerated progress for neonatal survival and promotion of health and wellbeing requires strengthening quality of care as well as ensuring availability of quality health services or the small and sick newborn. Essential newborn careAll babies should receive the following:
Families should be advised to:
Some newborns require additional attention and care during hospitalization and at home to minimize their health risks. Low-birth-weight and preterm babies:
Sick newborns
Newborns of HIV-infected mothers
WHO responseWHO is working with ministries of health and partners to: 1) strengthen and invest in care, particularly around the time of birth and the first week of life as most newborns are dying in this time period; 2) improve the quality of maternal and newborn care from pregnancy to the entire postnatal period, including strengthening midwifery; 3) expand quality services for small and sick newborns, including through strengthening neonatal nursing.; 4) reduce inequities in accordance with the principles of universal health coverage, including addressing the needs of newborns in humanitarian and fragile settings; 5) promote engagement of and empower mothers, families and communities to participate in and demand quality newborn care; and 6) strengthen measurement, programme-tracking and accountability to count every newborn and stillbirth. What is the purpose of injecting vitamin K to the newborn?Low levels of vitamin K can lead to dangerous bleeding in newborns and infants. The vitamin K given at birth provides protection against bleeding that could occur because of low levels of this essential vitamin.
When should the vitamin K injection be administered to newborns?The American Academy of Pediatrics recommends that all newborns, whether breastfed or formula fed, receive a one-time intramuscular shot of vitamin K within 6 hours after birth.
Where should vitamin K be injected in newborns?The injection is given in your baby's thigh within 6 hours of birth. One shot is all it takes to protect your baby from getting vitamin K deficiency bleeding. This is why, as pediatricians, we have recommended since 1961 that all newborns get a vitamin K shot at birth.
Which adverse effect would the nurse monitor for after administering vitamin K to a newborn?The most common ones include pain and erythema at the injection site, as well as a skin rash or urticaria. Other potential side effects include hypersensitivity reactions, as well as hyperbilirubinemia, which is more likely to occur in premature infants.
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