**7.3 Thermal care**

Community health structures can be organized to VHTs and CHWs to support women through postnatal home visits to establish adequate thermal care for their preterm neonates. Every neonate needs thermal care by simple actions such as drying and wrapping, warming up the room the neonates are in, covering the head with a cap, delaying the first bath, and using warm water for bathing [23]. Preterm babies will require kangaroo mother care which involves placing the preterm neonate on the chest of the mother or other attendant for a direct, continuous skin-to-skin contact to provide stable warmth and encouraging exclusive breast feeding. These techniques can be taught to mothers and other family members and reinforced through regular supervision and monitoring by VHTs/CHWs.

### **7.4 Early breast feeding**

Breast milk is particularly important for preterm neonates not just for nutrition but for their immunological and neurological development. Preterm neonates have ineffective suckling reflex that leads poor breast feeding; they need support with expressed breast milk fed using a cup or a spoon. Again, community health structures established through VHTs/CHWs can support mothers to establish early and effective breast feeding for preterm neonates through education, supervision, and monitoring.
