Maternal, Newborn, and Child Health
MNCH Nutrition Interventions
Maternal, Newborn, and Child Health
MNCH Nutrition InterventionsNutrition in Labor & Delivery
Ensuring Adequate Nutrition from the Moment of Birth
Nutrition at birth encompasses the critical feeding practices and nutritional interventions that occur immediately after delivery and during the first hours and days of life, when newborns are most vulnerable and require optimal nutrition to survive and thrive. This includes early initiation of breastfeeding within the first hour of birth, exclusive breastfeeding with colostrum (the first milk rich in antibodies and nutrients), and essential newborn care practices that support successful feeding and prevent malnutrition.
These immediate nutritional interventions form the foundation for healthy growth and development, with proper nutrition at birth being fundamental to reducing neonatal mortality and establishing lifelong health outcomes.
What Are the Benefits of Good Nutrition during Labor and Delivery?
- Dramatically Reduces Neonatal Mortality and Morbidity: Early breastfeeding within the first hour protects newborns from life-threatening infections and could save over 820,000 children under age 5 annually.
- Provides Immediate Immune Protection and Optimal Nutrition: Colostrum delivers essential antibodies, immune cells, and perfectly balanced nutrients that protect against infections and meet all nutritional requirements during the most critical period.
- Establishes Successful Long-Term Feeding Patterns: Early skin-to-skin contact and immediate breastfeeding promote bonding, regulate body temperature and breathing, and increase the likelihood of exclusive breastfeeding for six months.
- Provides Cost-Effective, Sustainable Intervention with Lifelong Benefits: Requires minimal resources but delivers immediate survival benefits and long-term health outcomes, including reduced chronic disease risk, improved cognitive development, and better life outcomes.
How to Implement
1. Initiate Early Breastfeeding
- Encourage breastfeeding within the first hour (this time period may vary based on your country guidelines) to:
- Provide colostrum, which boosts the newborn’s immune system.
- Stimulate oxytocin release, helping the uterus contract and reducing postpartum hemorrhage in the mother.
2. Establish Facility Policies and Staff Training
- Develop written infant feeding policies that:
- Mandate immediate skin-to-skin contact and breastfeeding initiation within one hour of birth for all deliveries.
- Train all delivery room staff, midwives, and nurses on essential newborn care practices using WHO’s Essential Newborn Care Course materials and Baby-Friendly Hospital Initiative guidelines.
3. Prepare Delivery and Immediate Postpartum Care Protocols
- Ensure delivery rooms are equipped for immediate essential newborn care including support for early breastfeeding initiation.
4. Implement the “Ten Steps to Successful Breastfeeding”
- Follow WHO/UNICEF Baby-Friendly Hospital Initiative protocols including:
- Support mothers to recognize infant feeding cues.
- Avoid supplemental feeds unless medically indicated.
- Provide skilled breastfeeding support and counseling throughout the hospital stay.
5. Establish Community Linkages and Discharge Planning
- Train community health workers on essential newborn care and exclusive breastfeeding support.
- Develop referral systems for feeding difficulties.
- Ensure mothers receive postnatal care visits to support continued optimal feeding practices.
What’s the Evidence?
- WHO Infant and Young Child Feeding Fact Sheet: Early nutrition interventions at birth dramatically reduce mortality in LMICs where morbidity and mortality due to diarrhea, pneumonia and malnutrition are prevalent, early initiation of breastfeeding within 1 hour of birth protects newborns from acquiring life-threatening infections and reduces newborn mortality.
- WHO/ UNICEF: Capture the Moment: Early Initiation of Breastfeeding: According to a meta-analysis of five studies from four countries, including more than 130,000 breastfed newborns, those who began breastfeeding between 2 and 23 hours after birth had a 33 per cent greater risk of dying compared with those who began breastfeeding within one hour of birth.
Key Indicators
- Rate of breastfeeding initiation within the first hour of birth.
- Exclusive breastfeeding rates in first 2-3 days – Proportion of newborns receiving only breast milk (no water, formula, or other liquids) during the critical first hours of life.
- Percentage of deliveries where immediate and uninterrupted skin-to-skin contact between mother and newborn occurs within the first hour.
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Tips
- Support immediate skin-to-skin contact for all births, including cesarean deliveries.
- Focus on the critical first-hour window.
- Have lactation counselors or trained staff available 24/7 to help mothers with positioning, latching difficulties, or concerns about milk supply.
- Establish clear protocols for when medical supplementation may be necessary while maintaining breastfeeding.
- Link nutrition at birth interventions with antenatal care, skilled birth attendance, postnatal care visits, and immunization services.
Challenges
- Cultural Barriers: Work with community leaders and traditional birth attendants to educate about the importance of immediate and exclusive breastfeeding while developing culturally appropriate messaging.
- Staff Shortages and Inadequate Training: Implement cascaded training using WHO’s Essential Newborn Care Course materials and train community health workers to provide basic feeding support.
- Facility Constraints and Separation Practices: Reorganize delivery protocols to minimize separation and ensure routine care maintains skin-to-skin contact unless medically necessary.
Key Resources
- Infant and young child feeding. WHO 2023
- Breastfeeding. WHO
- Maternal and Child Undernutrition Progress. Lancet Series on Maternal and Child Undernutrition 2021
- e-Library of Evidence for Nutrition Actions (eLENA). WHO
