Considerations for development of recommendations
The GDG formulated its recommendations considering the following findings of the
evidence review:
● No RCTs have directly compared the effect of different numbers and timing of postnatal
contacts.
● About 40% of neonatal deaths occur in the first 24 hours of life. This period accounts
for a little less than three quarters of asphyxia-related and over 40% of prematurityrelated
deaths.
● About 40% each of prematurity-related and sepsis-related deaths and one quarter of
asphyxia-related deaths occur in the 1–7 day period.
● About 30% of sepsis-related deaths occur in the second week of life, and one quarter
occur in the last two weeks of the neonatal period.
● Almost all the studies that demonstrated beneficial effects of different interventions to
promote breastfeeding had at least one contact in the first week of life; many of them
had visits in the second week as well. The number of contacts varied from one to seven
in these studies.
● Two of the three studies that showed beneficial effects of cord chlorhexidine application
had seven contacts in the first 14 days of life.