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 for responsive care.
• The postnatal care Guideline Development Group noted the following based on the original guideline.
• Responsive caregiving incorporates anticipatory guidance for safety, education, development and the establishment of a caring and understanding relationship with one’s child. Parenting is not limited to biological parents but extends to guardians or caregivers providing consistent care for the child.
• To provide responsive care for a newborn, parents and caregivers need to be aware of the newborn’s signals, such as readiness for a feed, pain or stress, and be able to respond to these signals appropriately.
• Interventions to support responsive caregiving during the postnatal period should focus on promoting positive caregiver–infant interactions and strengthening the parent–infant relationship. An emphasis should be placed on responsiveness between caregivers and the infant, and should target the caregiver–infant dyad rather than the caregivers or the child alone.
• Health workers should encourage and support responsiveness (care that is prompt, consistent, contingent and appropriate to the child’s cues, signals, behaviours and needs). Interventions that improve parents and caregivers’ abilities to incorporate the child’s signals and perspective can be undertaken in the context of, but not limited to, play, communication and feeding. For the newborn, they include, but are not limited to, facilitating the caregiver to be aware of, receptive and appropriately responsive to the baby’s needs and wants, such as exclusive breastfeeding on demand.