Whether you are a first-time mother or have many kids, health experts say it’s ideal to be taken through how to care for a new-born.

This is so because babies are different and each experience comes with its own challenges, therefore, knowing what to do is important.

A new-born infant is a child under 28 days of age. The word ‘neonatal’ is by common convention applied to the first 28 days of life, yet there has been a tendency recently to extend that definition to include a later part of the infant period. During these first 28 days of life, the child is at the highest risk of dying, therefore, critical care is needed to avoid this. 

Studies show that the vast majority of new-born deaths take place in developing countries where access to healthcare is low. 

A World Health Organization/UNICEF study released in the fall of 2018 found that globally in 2017, one million new-borns died during their first day of life, while nearly another million new-borns failed to survive their first week. In total, almost half (47%) of all under-5 child deaths occurred during those brief but crucial first 28 days.

Although sub-Saharan Africa remains the region with the highest global burden of maternal mortality, Rwanda is among the countries that have been considered to have achieved the Millennium Development Goal (MDG) 5, by having reduced the maternal mortality ratio by three-quarters in the past 25 years.

For instance, the 2015 findings from Rwanda Demographic and Health Survey (RDHS) show that there has been steady improvement when it comes to maternal healthcare.

What should caretakers do?

Dr Stephen Musiime, a paediatrician at Glamerc Polyclinic in Remera-Kigali, says promoting child survival requires building strong health services, ensuring that every birth is attended to by health experts and making hospital care available for emergencies.

He says that the first thing after the baby is born is that the healthcare provider should ensure that the baby is breathing properly.

"The infant is then supposed to be placed on the mother’s chest for bonding and the all-important skin-to-skin contact,” he says.

Another crucial aspect, Dr Musiime says, is for the mother to ensure early and exclusive breastfeeding. It is also essential to provide other care during this period, both to improve the child’s chances of survival and to lay the foundations for a healthy life.

"The best possible start in life for any new-born is to breastfeed at the earliest opportunity, ideally, this should start within thirty minutes after the child is born,” he adds.

Beyond survival, there is growing evidence that breastfeeding boosts children’s brain development and provides protection against overweight and obesity.

Dr Raymond Awazi, a paediatrician at Horebu Medical Clinic-Remera, says after birth, the child is given the first of a three-dose series to protect them against hepatitis B (HBV-1). There is also initial dose of oral polio vaccine (OPV-0) as well as vitamin K to prevent the bleeding from the baby’s umbilical cord.

"The new-born infant is usually given vitamin K after birth to prevent a life-threatening ailment called haemorrhagic disease of the new-born. Vitamin K deficiency is one of the most common causes of bleeding in healthy infants,” he says.

Dr Iba Mayale, a gynaecologist at Galien Clinic in Kimironko, points out that as much as child care is needed, it is also a fragile time for the mother as well, therefore providing the care needed for both is vital.

He says providing good care for both is imperative because it will lower risk of health complications, including infection, which can be fatal.

Statistics show that risk to a child’s life will never be greater than during its first 28 days—the four-week span known in the medical world as the neonatal period.

How else can you ensure safety?

Dr Musiime says parents or caregivers need to be made more aware of what they can do to promote the child’s wellbeing. While at home, the mother or caregiver should always be on the lookout if the baby is cold, and ensure they keep the infant warm all the time.

Dr Awazi says mothers should refrain from feeding the baby cow’s milk and instead breastfeed them so that they can develop a strong immune system.

"Breastfeeding can protect the child against allergies, cough and cold, bronchial problems, and et cetera. In later life, a child who was breastfed will have fewer chances of getting cancer, diabetes, or obesity,” he says.

Also, feeding (breastfeeding) the baby every two or three hours is important and that if they are not breastfeeding well, reaching out to a health professional is necessary.

Another vital aspect, Dr Awazi, says is to always maintain good hygiene by washing your hands before you handle the new-born, explaining that germs and bacteria reside on the skin of the hands, therefore, poor hygiene can cause health problems.

Dr Musiime says all this is important because the infant at that stage is so vulnerable due to their undeveloped immunity system.

Also, health complications such as neonatal infections, respiratory distress, and rapid breathing can occur within the first 28 days.

In Rwanda, some community health workers follow up on mothers at home just to ensure the infant and the mother are faring on well.