Table 1.

Local practices and potential benefits and harms to the newborn

Practice	Potential benefit	Potential harm
Wrapping newborns in heavy clothing and applying a hat	Thermal care	Unknown (rashes; hyperthermia)
Immediate bathing	Reduced risk of blood contamination if mother is HIV-infected	Reduced protection from vernix; higher risk of hypothermia
Delayed bathing for preterm infants	Benefit of vernix; reduced risk of hypothermia
Nighttime bathing in cold water		Increased risk of hypothermia, pneumonia
Substances applied to skin	Potential benefit of newborn massage with baby lotion, petroleum jelly	Unknown effect of use of “cooking” oil (higher potential risk with recycled oil); skin infection e.g. bullous impetigo (possibly from application of contaminated substances such as petroleum jelly from a communal jar)
Application of breast milk to umbilical stump	Unknown effect of breast milk application to stump	Potential risk of HIV transmission if mother is HIV-infected
Application of powders to umbilical stump		High risk of neonatal infection
Protection of fontanel	Protects newborn skull; caregiver sensitivity to sunken fontanel (symptom of dehydration)
Heated cloth for weak joints	Potential benefit for thermal care and massage
Variety of cord cutting practices	Use of new razor blades reduces risk of infection	Increased risk of infection from old razor blades
Delayed cord cutting if mother is HIV infected	Potential benefit of additional iron to newborn
Avoidance of cord blood if mother is HIV infected	Delayed cord clamping; reduced risk of HIV transmission to newborn
Prone sleep position		Increased risk of sudden infant death syndrome (SIDS)
Retained vernix for preterm or low birth weight infants	Benefit of thermal care and antibacterial benefit
Wrapping preterm/low birth weight infants in mabono leaves	Potential benefit of thermal care	Unknown effect of leaves on skin, especially if old or reused leaves