12
WHO RECOMMENDATIONS ON NEWBORN HEALTH
Administration of surfactant before the onset of respiratory distress syndrome (prophylactic
administration) in preterm newborns is not recommended. (Strong recommendation, low-
quality evidence). Source
In intubated preterm newborns with respiratory distress syndrome, surfactant should be
administered early (within the first 2 hours aer birth) rather than waiting for the symptoms
to worsen before giving rescue therapy. (Conditional recommendation, (only in health-care
facilities where intubation, ventilator care, blood gas analysis, newborn nursing care and
monitoring are available), low-quality evidence). Source
Feeding of Low-birth-weight (LBW) infants
LBW infants, including those with VLBW, should be fed mother’s own milk. (Strong
recommendation, moderate quality evidence). Source
LBW infants, including those with very low birth weight (VLBW), who cannot be fed mother’s
own milk should be fed donor human milk. (Strong situational recommendation relevant to
settings where safe and aordable milk-banking facilities are available or can be set up, high
quality evidence). Source
LBW infants, including those with VLBW, who cannot be fed mother’s own milk or donor
human milk should be fed standard infant formula. (Weak situational recommendation
relevant for resource-limited settings, low quality evidence). Source
VLBW infants who cannot be fed mother’s own milk or donor human milk should be given
preterm infant formula if they fail to gain weight despite adequate feeding with standard
infant formula. (Weak situational recommendation relevant for resource-limited settings,low
quality evidence). Source
LBW infants, including those with VLBW, who cannot be fed mother’s own milk or donor
human milk should be fed standard infant formula from the time of discharge until 6 months
of age. (Weak situational recommendation relevant for resource-limited settings, low quality
evidence). Source
VLBW infants who are fed mother’s own milk or donor human milk need not be given bovine
milk-based human-milk fortifier. VLBW infants who fail to gain weight despite adequate
breast-milk feeding should be given human-milk fortifiers, preferably those that are human
milk based. (Weak situational recommendation relevant to resource-limited settings, low to
very low quality evidence). Source
VLBW infants should be given vitamin D supplements at a dose ranging from 400 i.u. to 1000
i.u. per day until 6 months of age. (Weak recommendation, very low quality evidence). Source
VLBW infants who are fed mother’s own milk or donor human milk should be given daily
calcium (120–140 mg/kg per day) and phosphorus (60–90 mg/kg per day) supplementation
during the first months of life. (Weak recommendation, low quality evidence). Source
VLBW infants fed mother’s own milk or donor human milk should be given 2–4 mg/kg per day
iron supplementation starting at 2 weeks until 6 months of age. (Weak recommendation, low
quality evidence). Source
Daily oral vitamin A supplementation for LBW infants who are fed mother’s own milk or
donor human milk is not recommended at the present time because there is not enough
evidence of benefits to support such a recommendation. (Weak recommendation, low quality
evidence). Source