The Golden Month: A Guide to Preventing Newborn Deaths After Delivery

A simple framework for newborn survival in the first 28 days.

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Our Question: "Can we save babies who die after a healthy delivery?"

The Expert Answer: YES. A huge number of these deaths are preventable. The solution is to extend our care focus to the first 28 days of life—the "Golden Month." This guide provides a simple framework for our counselors to teach families how to identify danger signs early and save lives.

The "SAFE" Framework: A Simple Tool for Lifesaving Counseling

To make it easy for families to remember, we can structure our advice around the word SAFE. Each letter represents a critical domain for newborn survival.

SSkin-to-Skin & Safe Warmth
AAirway & Awareness of Breathing
FFeeding (Exclusive Breastfeeding)
EEnvironment (Cleanliness) & Early Care-Seeking

A New Counseling Schedule: The First Week is Critical

For newborns, a monthly call is not enough. The highest risk of death is in the first 7 days. A more intensive, front-loaded schedule is needed for every "Delivered" case.

Call Timing Primary Focus
Day 2-3 (Post-Discharge) Establish breastfeeding, ensure warmth, review danger signs.
Day 5-7 Critical Jaundice Check. Check on feeding, weight gain perception, and umbilical cord care.
Day 14 Reinforce exclusive breastfeeding, check on mother's mental health, discuss vaccinations.
Day 28 (Closure Call) Conduct the full Post-Delivery & Well-being call as previously designed.

Detailed Counseling Guide using the SAFE Framework

Use these points during our calls in the first two weeks.

SAFE Component Why It's a Lifesaver What to Advise the Mother Danger Signs to Ask About
S - Safe Warmth Newborns lose heat very quickly. Becoming cold (hypothermia) is silent and extremely dangerous. It can lead to breathing problems and death.
  • Keep the baby skin-to-skin on our chest as much as possible.
  • Keep the baby's head covered with a cap.
  • Keep the room warm and free of drafts.
  • Delay bathing the baby for at least the first week.
  • "Does the baby's body, especially the hands or feet, feel cold when we touch them?"
  • "Is the baby less active than usual or lethargic?"
A - Airway & Breathing Breathing problems are a common cause of death and can develop quickly. Fast breathing is a key sign of pneumonia or other infections.
  • Watch our baby's breathing when they are calm. It should be easy and quiet.
  • Keep the baby's nose clear.
  • Always place the baby to sleep on their back.
  • "Is the baby breathing very fast? (Faster than we can easily count, more than 60 times in a minute)."
  • "When the baby breathes, is their chest pulling in deeply under the ribs?"
  • "Is the baby making any grunting sounds with each breath?"
F - Feeding Exclusive breastfeeding is the baby's first and most powerful vaccine. It provides perfect nutrition and protects against infections like diarrhea and pneumonia. It also helps clear jaundice.
  • Feed the baby ONLY our breast milk for the first 6 months. Do not give water, honey, or any other liquid.
  • Feed the baby whenever they show signs of hunger, at least 8-12 times in 24 hours.
  • Wake the baby for feeds if they sleep for more than 3-4 hours.
  • "Is the baby refusing to feed or not waking up for feeds?"
  • "Does the baby seem too weak or tired to breastfeed?"
E - Environment & Early Care A newborn's immune system is very weak. Germs that are harmless to us can be deadly to them. Seeking care EARLY is the most important factor in survival.
  • Handwashing is a lifesaver. Always wash our hands with soap before touching the baby.
  • Keep the umbilical cord stump clean and dry. Do not apply any oil, powder, or dung. Let it fall off on its own.
  • Trust our instincts. If we feel something is wrong, go to the hospital. It is always better to be safe.
  • (Jaundice): "Look at our baby in natural daylight. Is the baby's skin or the white part of their eyes yellow? Is the yellow color spreading down to the baby's tummy or legs?"
  • (Infection): "Does the baby have a fever, or does the body feel very hot or cold?"
  • (Infection): "Is there any redness or pus coming from the umbilical cord stump?"
  • (Sepsis): "Has the baby had any convulsions or fits?"

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