April 2015 www.mcsprogram.

org

Postnatal Care for Mothers and Newborns

Highlights from the World Health Organization 2013 Guidelines

Background
The days and weeks following
1
childbirth—the postnatal period—are
2
a critical
phase in the lives of mothers and newborn babies. Most maternal and infant deaths
3,4
occur in the first month after birth: almost half of postnatal maternal deaths occur
within the first 24 hours, and 66% occur during the first week. In 2013, 2.85
million newborns died in their first month of life─1 million of these newborns died
on the first day.
5
Considerable progress has been made globally in improving maternal health.
4

Around the world, 72% of women give birth attended by skilled personnel, and
the maternal mortality ratio has decreased
6 from 380 to 210 per 100,000 live births
between 2000 and 2013. Yet, in South-East Asia and sub-Saharan Africa only
67% and 48% of women give birth with the assistance of skilled personnel,
7 8,9
respectively. Postnatal care reaches even fewer women and newborns: less than
10
half of women receive a postnatal care visit within 2 days of childbirth. An
analysis of Demographic and Health Survey data from 23 sub-Saharan African
countries found that only 13% of women who delivered at home received
postnatal care within 2 days of birth.
The World Health Organization (WHO) recently updated global guidelines on postnatal care for mothers and
newborns through a technical consultation process. The new guidelines address the timing and content of
postnatal care for mothers and newborns with a special focus on resource-limited settings in low- and middle-
income countries. They complement other recommendations on maternal, perinatal and newborn health, as well
as those recommendations on which type of health care11worker can safely deliver key maternal and newborn
health care interventions, which went through a similar guidelines development process.
Although this brief focuses on postnatal care, the importance of selected to maximize population-level
antenatal and intrapartum care within a continuum is recognized to results in low-resource settings.
have the greatest impact on maternal and newborn survival.
This brief presents the WHO recommendations while highlighting changes
and recommended best practices. It is intended to assist policy-makers,
programme managers, educators, and providers involved in caring for
women and newborns after birth. Operationalization of these guidelines
may help end preventable death, improve health outcomes, strengthen
community-based health systems, address gender and equity issues, and
emphasize respectful and women-centred maternity care. Strategies to
improve quality and achieve equitable use of postnatal care should be
A Unifying Term—Postnatal Care Because the interchangeable use of the days).
terms “postpartum” referring to issues pertaining to the mother and
Source: WHO Technical Consultation on
“postnatal” referring to those concerning the baby creates sometimes Postpartum and Postnatal Care. WHO/MPS/10.03.
confusion, the adoption of just a single term “postnatal” should be used for all World Health Organization 2010
issues pertaining to the mother and the baby after birth up to 6 weeks (42

Best Practices: Postnatal Care for All Mothers and Newborns

• Provide postnatal care in the first 24 hours to all mothers and babies─regardless of where the birth
occurs. A full clinical examination should be done around 1 hour after birth, when the baby has had his/her
first breastfeed. The baby should be checked again before discharge. For home births, the first postnatal
contact should be as early as possible within 24 hours of birth and, if possible, an extra contact for home
births at 24–48 hours is desirable. Mobile phone-based postnatal care contacts between mothers and the
health

Postnatal Care Guidelines, March 1

2015
 Postnatal Care Highlights
system may
described in be
theuseful. Thesections.
next two content of postnatal care is
• Provide postnatal care in first 24 hours for every
• ─ Delay facility discharge for at least 24
Ensure healthy women and their newborns stay at a birth:
─ Visit women and babies with home births
hours.
the first 24 hours.
within
health facility at least 24 hours and are not • Provide every mother and baby a total of
postnatal visits on:
four
discharged early. This recommendation is an update ─ First day (24 hours)
from 2006, and the minimum duration of stay was ─ Day 3 (48–72 hours)
─ Between days 7–14
lengthened from 12 to 24 hours. Evidence suggests
discharge is acceptable only if a mother’s bleeding is providers or well-trained and supervised community
• health workers (CHWs).
controlled, mother and baby do not have signs of • Use chlorhexidine after home deliveries in high
newborn mortality settings.
infection or other diseases, and the baby is breastfeeding
• Re-emphasize and support elements of quality
well. postnatal care for mother and newborn, including
─ Six weeks

All mothers and babies need at least four postnatal • Offer home visits by midwives, other skilled
checkups in the first 6 weeks. This is a notable change
to the previous guidance, which recommended only two
postnatal checkups within 2 to 3 days and at 6 weeks
after birth. Now, in addition to postnatal care with two
full assessments on the first day, three additional visits
a

are recommended: day 3 (48–72 hours), between days 7– identification of issues and referrals.

14 and 6 weeks after birth. These contacts can be made

at home or in a health facility, depending on the context and the provider. Additional contacts may be needed
to address issues or concerns.
12
Table 1. Provision of Postnatal Care to Mothers and Newborns: Policy and Programme Actions Based
On the New WHO Guidelines

WHO Recommendation 2013

a Policy/Programme Action
RECOMMENDATION 1: Timing of discharge from a health facility after birth
After an uncomplicated vaginal birth in a health • Ensure respectful,
13 women-centred quality care is provided for
facility, healthy mothers and newborns should all births.
receive care in the facility for at least 24 hours
after birth.* (NEW in 2013) • Review if increased infrastructure (beds, etc.) and staff in postnatal
wards are required to provide care respectfully and comfortably
* For the newborn, this care includes an immediate for women to stay longer.
assessment at birth, a full clinical examination around
1 hour after birth and before discharge. • Align policies (such as national institutional delivery incentive
and insurance schemes) with recommendation.
RECOMMENDATION 2: Number and timing of postnatal contacts
• Adapt and use a simple discharge checklist.
If birth is in a health facility, mothers and • Ensure that national standards, quality improvement tools and
newborns should receive postnatal care in the training curricula promote three assessments in the first 24
facility for at least 24 hours after birth. (NEW hours for the newborn: an immediate assessment at birth; a full
in 2013) clinical examination around 1 hour after birth and again before
discharge.

• Coordinate postnatal care with the Baby-Friendly Hospital

Initiative to ensure that facility-based procedures and outreach

to the community support optimal breastfeeding practices.

• Update facility-based providers and promote best practices in

postnatal care including pre-discharge counselling, according to
the new guidelines.
If birth is at home, the first postnatal contact • Review current policies and programmes to strengthen delivery
should be as early as possible within 24 hours of and early postnatal care for home births by midwives, other skilled
birth. (NEW in 2013) providers and/or well-trained, supervised CHWs.
At least three additional postnatal contacts are • Ensure national standards, quality improvement tools, training
recommended for all mothers and newborns, on curricula and behaviour change communication (BCC)
day 3 (48–72 hours), between days 7–14, and 6 messages/materials to explicitly promote the three additional
weeks after birth. (NEW in 2013) postnatal care checkups (a total of four from birth in the first
6 weeks) through home visits and facility-based care.

• Review/revise national monitoring systems to include the

process indicator for postnatal care visits—number of
mothers/newborns who received postnatal within 2 days of
childbirth (regardless of place of delivery)—for all births.

2 Postnatal Care Guidelines

 WHO Recommendation 2013 Policy/Programme Action
RECOMMENDATION 3: Home visits for postnatal care
Home visits in the first week after birth are • Determine how best to integrate home visits for postnatal care
recommended for care of the mother and into responsibilities and training of midwives, other skilled
newborn. providers and/or well-trained, supervised CHWs.

• Explore appropriate mHealth strategies to communicate

with mothers who may be difficult to physically reach.
aWHO guidelines, Pregnancy, childbirth, postpartum and newborn care: A guide for essential practice, define this standard of care; they can be found
at

http://www.who.int/maternal_child_adolescent/documents/924159084x/en/.

Related Highlights from Other WHO Guidelines

• Encourage women to deliver with a skilled birth attendant at a health facility so they receive quality intrapartum
and postnatal care including administration of a uterotonic during the third stage of labour. Professional skilled
care is important for all women and newborns during labour, childbirth and the first day after birth.

• Promote respectful and women-centred maternity care where women are treated with kindness, dignity and respect.
Respectful maternity care is an essential part of postnatal care particularly in health facilities. It promotes best
practices (such as rooming in, unless separation is medically necessary), recognizes that women and their families
should be fully informed on all aspects of care, and values counselling as an opportunity to answer questions and
address concerns.

Best Practices: Postnatal Care for Newborns

• Strengthen postnatal care through home visits and at health facilities. Elements of postnatal care are re-
emphasized from the 2006 guidelines without many significant changes.
• At each of the four postnatal care checkups, newborns should be assessed for key clinical signs of
severe illness and referred as needed. Nine clinical signs (listed in Recommendation 4 in Table 2
below) have been identified as danger signs that can be identified at home by a CHW or by a skilled
provider in a health facility. Evidence suggests that simple algorithms are valid tools in both settings.
• Continue to promote early and exclusive breastfeeding (EBF) within delivery settings including
antenatal care, at delivery, and in all postnatal care visits. Consistent with previous WHO guidelines,
evidence shows EBF reduces the risks of mortality and morbidity in the first month of life (compared to
partial and predominant breastfeeding) and improves post-neonatal outcomes. It also encourages improved
birth spacing by delaying the return to fecundity. Given the increases in institutional deliveries in many
developing countries, policies and programmes should actively promote facility-based counselling and
support for EBF including counselling on common breastfeeding problems and ways to manage them if they
occur.
• Consider the use of chlorhexidine for umbilical cord care for babies born at home to reduce newborn
mortality. For newborns who are born at home in settings with high neonatal mortality (30 or more neonatal
deaths per 1,000 live births) it is recommended to apply chlorhexidine (7.1% chlorhexidine digluconate
aqueous solution or gel, delivering 4% chlorhexidine) daily to the umbilical cord stump during the first week
of life. This is a new recommendation, and clean, dry cord care remains the standard recommendation for
newborns born in health facilities and at home in low neonatal mortality settings. The use of chlorhexidine in
these situations may be considered only to replace application of a harmful traditional substance, such as cow
dung, to the cord stump.
• Reinforce key newborn care messages among families and providers. WHO re-emphasizes key elements
of newborn care including delayed bathing, skin-to-skin contact and immunization. Given the vulnerability of
preterm and low-birth-weight babies, interventions are needed to identify these newborns in home and
facility settings and ensure they receive special care.
Postnatal Care Guidelines 3
Table 2. Postnatal Care for Newborns: Policy and Programme Actions Based On the New WHO
Guidelines

WHO Recommendation 2013 Policy/Programme Action

RECOMMENDATION 4: Assessment of the baby
The following signs should be assessed during each • Review and adapt available community-based and facility-based
postnatal care contact, and the newborn should be job aids for clinical assessments (such as integrated management
referred for further evaluation if any of the signs is of childhood illness, integrated management of pregnancy and
present: stopped feeding well, history of convulsions, childbirth) based on simple clinical signs of severe newborn
fast breathing (breathing rate of ≥60 per minute), illnesses.
severe chest in-drawing, no spontaneous movement,
fever (temperature ≥37.5 °C), low body temperature • Integrate recognition of clinical signs into CHW and
(temperature <35.5 °C), any jaundice in first 24 hours skilled provider trainings.
of life, or yellow palms and soles at any age.
• Review/revise educational messages to emphasize newborn
The family should be encouraged to seek health danger signs and care-seeking in counselling of pregnant and
care early if they identify any of the above danger postnatal women, families and communities.
signs in- between postnatal care visits.
RECOMMENDATION 5: Exclusive breastfeeding (EBF)
All babies should be exclusively breastfed from • Reinforce early EBF and EBF messages during pregnancy and
birth until 6 months of age. Mothers should be during all postnatal care visits.
counselled and provided support for EBF at each
postnatal contact. • Ensure breastfeeding is actively promoted in all health facilities.

• Identify and address problems that prevent EBF (e.g., not initiating

breastfeeding within 1 hour after birth, not giving colostrum,

giving pre-lacteal feeds, breast health issues, mothers’ perceptions
that their breast milk is not sufficient, lack of knowledge about
breastfeeding frequently and from both breasts to ensure breast
milk supply).

• Integrate lactational amenorrhoea method (LAM) and EBF

messages to ensure LAM criteria are followed and the major
barriers to EBF are addressed that threaten the effectiveness
of LAM.
RECOMMENDATION 6: Cord care • Prepare mothers for transitioning their infants to complementary
Daily chlorhexidine (7.1% chlorhexidine digluconate • foods with with
In settings continued breastfeeding
high neonatal at 6 ensure
mortality, monthschlorhexidine
and modern is
aqueous solution or gel, delivering 4% family planning methods for mothers using LAM.
available for home births for immediate use by mothers. Related
chlorhexidine) application to the umbilical cord policy/programme issues may include: inclusion on the national
stump during the first week of life is recommended List of Essential Medicines for Children; drug registration; local
for newborns who are born at home in settings production or procurement; training; supply chain maintenance;
with high neonatal mortality (30 or more neonatal and training community midwives and health workers, etc.
deaths per 1,000 live births). (NEW in 2013)
• Reinforce community messages about clean, dry cord care and
Clean, dry cord care is recommended for newborns add chlorhexidine messages, as appropriate.
born in health facilities and at home in low neonatal
mortality settings. Use of chlorhexidine in these
situations may be considered only to replace
application of a harmful traditional substance, such
as cow dung, to the cord stump.
RECOMMENDATION 7: Other postnatal care for the newborn 14

Bathing should be delayed until 24 hours after • Review BCC messages and facility standards to ensure families
birth. If this is not possible due to cultural reasons, and providers are informed on these key newborn care
bathing should be delayed for at least 6 hours. messages.
Appropriate clothing of the baby for ambient
temperature is recommended. This means one to • Review national policies and standards with WHO guidelines
two layers of clothes more than adults, and use of and revise/strengthen as appropriate.
hats/caps. The
• Encourage skin-to-skin care as part of kangaroo mother care,
mother and baby should not be separated and but also to keep babies warm in cold environments and for all
should newborns for at least 1 hour after birth.

stay in the same room 24 hours a day.

Communication and play with the newborn should

be encouraged. Immunization should be promoted

as
4 Postnatal Care Guidelines
 WHO Recommendation 2013 Policy/Programme Action
Preterm and low-birth-weight babies should be • Develop approaches to identify and refer preterm and low-
birth- weight babies, appropriate
15 for home and facility births.
11
identified as soon as possible and should be
provided special care as per existing WHO • Review clinical standards to promote special care, such as
guidelines. feeding of low-birth-weight infants and kangaroo mother care.

POSTNATAL CARE-RELATED RECOMMENDATIONS ON NEWBORN CARE FROM OTHER WHO

GUIDELINES

• Immediately at birth, all babies should be dried thoroughly and their breathing assessed. The cord should be clamped
and cut only after 1–3 minutes, unless the baby needs resuscitation. Routine suctioning must not be done.

• During the first hour after birth, the baby should be in skin-to-skin contact with the mother for warmth and the
initiation of breastfeeding.

• A full clinical examination (including weight, danger signs, eyes, cord) and other preventive care should be done
around 1 hour after birth, when the baby has had his/her first breastfeed. This care includes giving vitamin K
prophylaxis and hepatitis B vaccination as soon as possible after birth (within 24 hours).

• When skilled health personnel attend the newborn, whether at home or in a facility, additional care should be
provided. This care includes basic newborn resuscitation with bag and mask for newborns not breathing
spontaneously and full clinical examinations at the recommended times.

Best Practices: Postnatal Care for Mothers

• Strengthen postnatal care for mothers through home visits and at health facilities. Elements of care are
re-emphasized from the 2006 guidelines without many significant changes. Postnatal care includes
counselling on family planning, maternal mental health, nutrition and hygiene, and gender-based violence.
Table 3. Postnatal Care for Mothers: Policy and Programme Actions Based On the New WHO Guidelines

WHO Recommendation 2013 Policy/Programme Action

RECOMMENDATION 8: Assessment of the mother
First 24 hours after birth: All postpartum women should have • Ensure that national standards and training curricula
for skilled birth attendants include these elements of
regular assessment of vaginal bleeding, uterine contraction, postnatal care.
fundal height, temperature and heart rate (pulse) routinely
during the first 24 hours starting from the first hour after • Introduce or re-emphasize standards at the facility
birth. Blood pressure should be measured shortly after birth. level using quality improvement tools and checklists.
If normal, the second blood pressure measurement should be

taken within 6 hours. Urine void should be documented within

6
Beyond 24 hours after birth: • Review national standards and trainings for skilled
hours. birth attendants and CHWs include these elements of
At each subsequent postnatal contact, enquiries should postnatal care.
continue to be made about general well-being and assessments
made regarding the following: urination and urinary • Introduce or re-emphasize standards at the facility
incontinence, bowel function, healing of any perineal wound, level and for home postnatal care visits using quality
headache, fatigue, back pain, perineal pain and perineal hygiene, improvement tools, job aids, and checklists.
breast pain, uterine tenderness and lochia.
Breastfeeding should be assessed at each postnatal contact. • Ensure national standards, quality improvement tools
and training curricula includes updated breastfeeding
policy about managing breastfeeding problems, Baby-
Friendly Hospital Initiative principles for facility
births, and community outreach.
At each postnatal contact, women should be asked about their • Review/revise national standards, quality
emotional wellbeing, what family and social support they have improvement tools and training curricula to include
and their usual coping strategies for dealing with day-to-day emotional wellbeing assessment.
matters. All women and their families/partners should be
encouraged to tell their health care professional about any
changes in mood, emotional state and behaviour that are
outside of the woman’s normal pattern.
Postnatal Care Guidelines 5
 WHO Recommendation 2013 Policy/Programme Action
At 10–14 days after birth, all women should be asked about • Review/revise national standards, quality
resolution of mild, transitory postpartum depression improvement tools and training curricula to include
(“maternal blues”). If symptoms have not resolved, the counselling for postpartum depression.
woman’s psychological well-being should continue to be
assessed for postpartum depression, and if symptoms persist, • Ensure linkages/referrals to available maternal
evaluated. mental health services for evaluation.
Women should be observed for any risks, signs and • Ensure linkages/referrals within facilities and at the
symptoms of domestic abuse. community level to available gender-based
violence services.
Women should be told whom to contact for advice
and management.
All women should be asked about resumption of sexual • Integrate messages on postpartum pregnancy risk
intercourse and possible dyspareunia as part of an assessment and family planning, including LAM and postpartum
of overall well-being 2–6 weeks after birth. intrauterine contraceptive device (IUD).

• Review national health management information

systems tools to construct new feasible postpartum
family planning indicator(s) to be tracked and reported
(e.g., percentage of postpartum women accepting a
contraceptive method prior to discharge
[disaggregated by method: LAM, postpartum IUD,
postpartum tubal ligation, condoms]; percentage of
women bringing children for vaccination who accept a
family planning method in the same visit).
If there are any issues ofa concern at any postnatal contact,
the woman should be managed and/or referred according to
other specific WHO guidelines.
RECOMMENDATION 9: Counselling
All women should be given information about the physiological • Review/revise national standards, quality
process of recovery after birth and told that some health improvement tools and training curricula for skilled
problems are common, with advice to report any health birth attendants and CHWs to include these
concerns to a health care professional, in particular, signs and elements of postnatal counselling and care,
symptoms of postpartum haemorrhage, pre-eclampsia/eclampsia, particularly the addition of screening for
infection and thromboembolism. (NEW in 2013) thromboembolism.

• Introduce or re-emphasize standards at the facility

level and for home postnatal care visits using quality
improvement tools, job aids, and checklists.

• Review/revise educational messages to emphasize

postnatal danger signs and care seeking in counselling
Women should be counselled on nutrition. • of
Emphasize
pregnantwith
and mothers
postnataland their families
women, family members
and
communities.
the importance of eating a greater amount and
variety of healthy foods.

• Review/revise national standards, quality improvement

tools and training curricula for providers to ensure
adequate counselling skills on nutrition in the context
of local practices and taboos, particularly adolescents
and very thin women.

• Review/revise CHW training curriculum, CHW job

aids and BCC materials to emphasize key postnatal
Women should be counselled on hygiene, • nutrition messages.
Review/revise CHW training curriculum, CHW job
especially handwashing. aids and BCC materials to emphasize hygiene and
handwashing for postnatal (especially if the woman
experienced a severe perineal tear), newborn, and
infant care.
Women should be counselled on birth spacing and • Integrate messages on postpartum pregnancy risk
family planning. Contraceptive options should be and family planning, including LAM.
discussed, and contraceptive methods should be
provided if requested.
Women should be counselled on safer sex including use
of condoms.
6
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 WHO Recommendation 2013 Policy/Programme Action
In malaria-endemic areas, mothers and babies should
sleep under insecticide-impregnated bed nets.
All women should be encouraged to mobilize as soon as • Review community messages for family members,
appropriate following the birth. They should be encouraged to such as partners and mothers-in-law, to encourage
take gentle exercise and make time to rest during the them to help ensure the woman eats enough and
postnatal period. avoids strenuous physical work.
RECOMMENDATION 10: Iron and folic acid supplementation
b
Iron and folic acid supplementation should be provided for • Review national standards, quality improvement
at least 3 months after delivery. tools, and training curricula on postnatal iron and
folic acid supplementation for postnatal mothers.

• Strengthen iron and folic acid distribution

16
and compliance among postnatal mothers.

• Review/update national standards to remove vitamin A

supplementation for postnatal women and transition
to promoting dietary sources of vitamin A for
RECOMMENDATION 11: Prophylactic antibiotics postnatal mothers.
The use of antibiotics among women with a vaginal delivery and • Review/revise national standards, quality improvement
tools, and training curricula to include use of
a third or fourth degree perineal tear is recommended antibiotics for women with a third or fourth degree
for prevention of wound complications. (NEW in 2013) perineal tear.
There is insufficient evidence to recommend the routine use
of antibiotics in all low-risk women with a vaginal delivery for
prevention of endometritis.
RECOMMENDATION 12: Psychosocial support
Psychosocial support by a trained person is recommended for • Review/revise national standards, quality
improvement tools, and training curricula on
the prevention of postpartum depression among women at high counselling for postpartum depression.
risk of developing this condition. There is insufficient evidence
to recommend routine formal debriefing to all women to • Ensure linkages/referrals to available maternal
reduce the occurrence/risk of postpartum depression or to mental health services for evaluation.
recommend the routine distribution of, and discussion about,
printed educational material for prevention of postpartum
Health professionals should provide an opportunity for
depression.
women to discuss their birth experience during their hospital
stay.
A woman who has lost her baby should receive • Review/revise national standards, quality improvement
additional supportive care. tools, and training curricula to integrate culturally
appropriate services (including counselling) for
women experiencing miscarriages, stillbirths, and
a
newborn deaths.
b The WHO guidelines, Pregnancy, childbirth, postpartum and newborn care: A guide for essential practice, that define this standard of care can be
found at http://www.who.int/maternal_child_adolescent/documents/924159084x/en/.

Currently, there is no evidence to change this recommendation. WHO is working on developing specific guidelines for maternal nutrition
interventions after birth.

Postnatal Care-Related Recommendations from Other WHO Guidelines

Continue to ensure all women who give birth receive active management of third stage of labour and close
monitoring immediately after birth as part of their delivery care that reduces the risk of postpartum haemorrhage in
the postnatal period.
Postnatal Care Guidelines 7
1
2 Every Newborn, An Executive Summary for The Lancet’s Series. May 2014.
3
Nour N. 2008. An Introduction to Maternal Mortality. Reviews in Obstetrics & Gynecology. 1:77–81.
4
5 The Inter-agency Group for Child Mortality Estimation (UN IGME). 2014. Levels & Trends in Child Mortality, Report 2014. United
6Nations Children’s Fund.

Lawn JE et al. 2014. Every Newborn: Progress, Priorities, and Potential Beyond Survival. Lancet 384:189–205.
7
WHO. 2014. World Health Statistics 2014. Geneva: WHO.
8

Warren C, Daly P, Toure L, and Mongi P. 2006. Postnatal Care. Pp. 79–90 in Opportunities for Africa’s Newborns: Practical Data Policy
9and
Programmatic Support for Newborn Care in Africa, edited by J. Lawn and K. Kerber. Cape Town, South Africa: Partnership for
Maternal, Newborn and Child Health.
10

11WHO. WHO Recommendations on Postnatal Care of the Mother and Newborn. October 2013. Geneva: WHO.
12
WHO. 2013. Recommendations on Maternal and Perinatal Health. Geneva: WHO. Guidelines on maternal, newborn, child and
adolescent
13 health approved by the WHO guidelines review committee.
14
Ibid.
15
16
WHO recommends optimizing health worker roles to improve access to key maternal and newborn health interventions through
task shifting (WHO, 2012).

For information and resources on respectful maternity care, see http://www.k4health.org/toolkits/rmc.

WHO guidelines recommend a safe childbirth checklist such as

http://www.plosone.org/article/info%3Adoi%2F10.137%2Fjournal.pone.0035151#s5.

http://www.who.int/nutrition/topics/bfhi/en/.

http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/924159084X/en/index.html.

WHO. 2011. Guidelines on Optimal Feeding of Low Birth-weight Infants in Low- and Middle-income Countries.

Vitamin A supplementation in postpartum women is not included in these guidelines. More information can be found
at http://whqlibdoc.who.int/publications/2011/9789241501774_eng.pdf.

This brief was made possible by the generous support of the American people through the United States Agency for
International Development (USAID) under the terms of the Leader with Associates Cooperative Agreement GHS-A-
00- 08-00002-00 and the Cooperative Agreement AID-OAA-A-14-00028. All reasonable precautions have been taken
by the World Health Organization and USAID to verify the information contained in this publication. However, the
published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for
the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be
liable for damages arising from its use. The contents are the responsibility of the Maternal and Child Survival Program
and do not necessarily reflect the views of WHO, USAID or the United States Government.

Requests for further information on this brief or permission to reproduce or translate this publication should be
addressed to MCSP Communications, e-mail: info@mcsprogram.org. For further information on the WHO guidelines,
please contact reproductivehealth@who.int or mncah@who.int.

© World Health Organization and Jhpiego 2015. All rights reserved. WHO/RHR/15.05.
 WHO Department of Maternal, Newborn, Child and Adolescent Health
http://www.who.int/maternal_child_adolescent
WHO Department of Reproductive Health and Research
http://www.who.int/reproductivehealth

8
Postnatal Care Guidelines