This thematic brief, jointly produced by WHO and UNICEF, summarizes why nurturing care is essential for every newborn, particularly during the critical first month of life. It outlines the five components of nurturing care, good health, adequate nutrition, safety and security, responsive caregiving, and opportunities for early learning, and explains why all five must be supported for newborns, including those born too soon, too small, or sick. The brief describes practical approaches such as infant- and family-centred developmental care, the Baby-friendly Hospital Initiative, kangaroo mother care, and zero separation of newborns from their caregivers, and outlines actions for policymakers, health care managers, and providers to strengthen health systems. It is illustrated with six country case studies from India, Sweden, the Philippines, Lebanon, Colombia, and a multi-country kangaroo mother care trial, showing what can be done to create a nurturing environment starting in the health facility and continuing at home.
Key Insights
Jointly published by WHO and UNICEF, building on the Nurturing Care Framework for Early Childhood Development.
Every year an estimated 140 million babies are born, and among these about 30 million need inpatient hospital care, with 8-10 million requiring neonatal intensive care.
Since 1990, global newborn mortality has more than halved, but in 2019 an estimated 2.4 million newborns still died in the first month after birth, mostly from preventable causes.
Globally, more than 80% of births take place in a health facility with a skilled attendant; one in ten infants is born preterm, and one in seven infants is born with a low birth weight.
Low birth weight contributes to 60-80% of all newborn deaths, and direct causes of death include prematurity, birth complications, neonatal sepsis, and congenital anomalies.
Currently only 42% of babies are exclusively breastfed in the first six months of life, despite breast milk containing all nutrients needed for most babies during this period.
India piloted a Family Participatory Care model in neonatal intensive care starting in 2014, later scaled nationwide, showing improved provider skills, parent participation in caregiving, and better detection of danger signs.
A multi-country randomized controlled trial in Ghana, India, Malawi, Nigeria, and the United Republic of Tanzania found that starting kangaroo mother care immediately after birth for babies weighing between 1.0 and 1.799 kg reduced mortality by 25%.
Every year around 20 million low-birth-weight babies (under 2,500 grams) are born, of whom 15 million are preterm, and an estimated 6.9 million babies are affected by possible serious bacterial infection or sepsis.
Sweden's Uppsala University neonatal intensive care unit practises zero separation directly after vaginal and caesarean births, including for preterm infants who can receive respiratory support and skin-to-skin contact with their mothers in the delivery room.
The Philippines incorporated kangaroo mother care into its national health insurance benefit package for preterm and small babies in 2017, building on facility-based programmes established from 1999 onward.
More than 80% of the human brain is formed in the first three years of life, and in low- and middle-income countries, 250 million children under age 5, more than 40% of children, are at risk of not reaching their developmental potential because of poverty and neglect.