MANILA, Philippines—The current practice of handling newborns, like clamping and cutting the umbilical cord and washing the baby right after birth, have been known to actually contribute to the high incidence of neonatal deaths and illnesses in the country.

Doctors are introducing a new way of caring for newborns in the first few minutes of life, which could cut by almost half the number of newborn deaths estimated at 40,000 each year.

“This is a paradigm shift,” was how Director Honorata Catibog, head of the Department of Health (DoH) task force on the rapid reduction of maternal and neonatal mortality, described the new program introduced by the DoH and the World Health Organization.
Proponents of the Essential Newborn Care (ENC) are changing the protocol currently observed by childbirth practitioners.

The ENC protocol prioritizes drying the newborn and initiating skin contact with the mother before clamping and cutting the umbilical cord. It prescribes a proper sequence of interventions that even a single health worker could perform and calls for initiating breastfeeding within the first hour of life.

“What should be done [immediately] after birth is to dry the baby because hypothermia can lead to several risks,” Dr. Aleli Sudiacal of the DoH explained at a forum held at the Quirino Memorial Medical Center in Quezon City Tuesday.

She said delaying the cord clamping two to three minutes after birth (or waiting until the umbilical cord has stopped pulsing) has been shown to increase the baby’s iron reserves. It also reduces the risk of iron-deficiency anemia and improves blood circulation.

Instead of immediately washing the newborn, the baby should be placed on the mother’s chest or abdomen to provide warmth, increase the duration of breastfeeding, and allow the “good bacteria” from the mother’s skin to infiltrate the newborn.

“Delaying the start of breastfeeding is harmful,” Sudiacal stressed. She said a delay of one day could make the newborn 2.6 times more prone to infection.

“Washing should be delayed until after six hours because this exposes the newborn to hypothermia and removes the vernix (skin covering) which is a natural protective barrier against bacteria. Washing also removes the baby’s crawling reflex,” she said.

The ENC protocol is being practiced in three hospitals so far—Quirino Memorial Medical Center in Quezon City, and Fabella Memorial Medical Center and Philippine General Hospital in Manila.