Remarks

• This recommendation has been adapted and integrated from the 2020 Improving early childhood development: WHO guideline (238), where it was considered a strong recommendation based on moderate-certainty evidence.
• The postnatal care Guideline Development Group noted the following based on the original guideline.
• Responsive feeding is a part of responsive caregiving and is essential to adequate nutrition. To thrive, nutrition interventions alone are not enough to improve child development, but they have an impact on young children’s development, particularly when combined with responsive caregiving and opportunities for early learning. For the newborn, exclusive breastfeeding on demand is a form of responsive feeding.
• Health workers should support mothers to exclusively breastfeed their infant on demand, while encouraging and supporting sensitivity and responsiveness (care that is prompt, consistent, contingent on, and appropriate to the child’s cues, signals, behaviours and needs) and secure attachment.
• In the postnatal period, interventions for optimal nutrition can be enhanced by including guidance on making eye contact, smiling, talking, singing and gentle massage of the newborn infant (see Recommendation 37 in this guideline), during feeding times and beyond.