Adejuyigbe Ebunoluwa Aderonke, Bee Margaret Helen, Amare Yared, Omotara Babatunji Abayomi, Iganus Ruth Buus, Manzi Fatuma, Shamba Donat Dominic, Skordis-Worrall Jolene, Odebiyi Adetanwa, Hill Zelee Elizabeth
Obafemi Awolowo University, Ile-Ife, Nigeria.
Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
BMC Pediatr. 2015 Oct 14;15:156. doi: 10.1186/s12887-015-0470-0.
Recommendations for care in the first week of a newborn's life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries.
Data were collected in the same way in each site and included 16-20 narrative interviews with recent mothers, eight observations of neonatal bathing, and in-depth interviews with 12-16 mothers, 9-12 grandmothers, eight health workers and 0-12 birth attendants in each site.
We found similarities across sites in relation to understanding the importance of warmth, a lack of opportunities for skin to skin care, beliefs about the importance of several baths per day and beliefs that the Vernix caseosa was related to poor maternal behaviours. There was variation between sites in beliefs and practices around wrapping and drying after delivery, and the timing of the first bath with recent behavior change in some sites. There was near universal early bathing of babies in both Nigerian sites. This was linked to a deep-rooted belief about body odour. When asked about keeping the baby warm, respondents across the sites rarely mentioned recommended thermal care practices, suggesting that these are not perceived as salient.
More effort is needed to promote appropriate thermal care practices both in facilities and at home. Programmers should be aware that changing deep rooted practices, such as early bathing in Nigeria, may take time and should utilize the current beliefs in the importance of neonatal warmth to facilitate behaviour change.
新生儿出生后第一周的护理建议包括保暖护理措施，如擦干、包裹、皮肤接触、尽早母乳喂养和延迟洗澡。本文研究了三个非洲国家与新生儿保暖护理相关的观念和做法。
在每个地点以相同方式收集数据，包括对近期分娩的母亲进行16 - 20次叙述性访谈、对新生儿洗澡进行8次观察，以及对每个地点的12 - 16位母亲、9 - 12位祖母、8名医护人员和0 - 12名助产人员进行深入访谈。
我们发现各地点在理解保暖的重要性、缺乏皮肤接触护理机会、认为每天多次洗澡很重要以及认为胎脂与母亲不良行为有关等方面存在相似之处。各地点在分娩后包裹和擦干以及首次洗澡时间的观念和做法上存在差异，一些地点近期出现了行为变化。在尼日利亚的两个地点，几乎普遍存在早期给婴儿洗澡的情况。这与对体味的根深蒂固的观念有关。当被问及如何给婴儿保暖时，各地的受访者很少提及推荐的保暖护理措施，这表明这些措施未被视为重要事项。
需要在医疗机构和家庭中做出更多努力来推广适当的保暖护理措施。项目规划者应意识到，改变根深蒂固的做法，如尼日利亚的早期洗澡习惯，可能需要时间，并且应利用当前对新生儿保暖重要性的观念来促进行为改变。
