Lactating Mothers and Newborns

The period immediately after birth, known as the postnatal period, is one of the most critical yet most neglected stages in the healthcare continuum. Both lactating mothers and newborns face elevated risks of infection, malnutrition, and complications that can be fatal without timely and appropriate care.

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In many of the remote communities Wandikweza serves, some women give birth at home or far from skilled providers. Without proper support, new mothers often lack the knowledge and resources needed to exclusively breastfeed, recognize danger signs, or care for themselves after delivery. This makes the first 1,000 days, from conception to a child’s second birthday, a vital window for intervening with life-saving, dignity-affirming care.

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​What We Do​

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Our Proactive Doorstep Care (PDC) model ensures that no mother or newborn is left behind regardless of where they live or how far they are from the nearest clinic.

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Postnatal Home Visits

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The period following childbirth is both fragile and formative, for the health of the newborn and the well-being of the mother. In Malawi’s rural and underserved communities, access to quality postnatal care is limited, and many mothers go without any follow-up after delivery. Our Postnatal Home Visit Program ensures that no mother or baby is left alone during this critical time.

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Our trained Community Health Workers (CHWs) and Nurses on Bikes (NoBs) conduct structured home visits beginning within the first 48 hours after delivery, followed by scheduled visits during the first six weeks postpartum, aligned with national and WHO guidelines.

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During these visits, our team provides comprehensive support through:

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• Newborn Health Assessments:
  CHWs and NoBs carefully examine the baby for signs of infection, fever, jaundice, breathing difficulty, poor feeding, or other danger signs. These early screenings are crucial for preventing neonatal complications and mortality.

• Maternal postpartum monitoring:
  Mothers are checked for postpartum bleeding, signs of sepsis, wound healing (especially after C-section or episiotomy), and anemia. Our teams also assess for breast engorgement, uterine involution, and general fatigue.

• Breastfeeding Support:
  Exclusive breastfeeding is encouraged from birth. CHWs offer practical, culturally sensitive guidance on latching, positioning, feeding frequency, and overcoming challenges like sore nipples or low milk supply. When needed, they facilitate referrals for lactation support or clinical evaluation.

• Mental and emotional well-being:
  Emotional health is prioritized, particularly for first-time mothers, adolescent mothers, or those who have experienced loss or trauma. NoBs offer psychosocial first aid, listen without judgment, and provide referrals accordingly for mental health support when signs of postpartum depression or anxiety are identified.

• Family involvement and education:
  We encourage the presence of spouses, grandmothers, or other caregivers during visits to strengthen shared understanding and responsibility for newborn care, hygiene, nutrition, and maternal support.

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These home visits build trust, continuity, and confidence for families navigating the postpartum period. They also create a safety net for early detection, referral, and follow-up, closing the gap between the home and the health system. We reach mothers and newborns where they are, at home, at their most vulnerable, to  transform postnatal care from a missed opportunity into a lifesaving intervention.

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Growth Monitoring and Early Stimulation

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We recognize that the first 1,000 days of life, from conception to a child’s second birthday are critical for healthy physical and cognitive development. Our CHWs and Nurses on Bikes play a vital role in monitoring newborn growth and promoting early stimulation during routine home visits.

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We track key growth indicators, including weight gain, length, and head circumference, using standardized tools and child health cards. These measurements allow us to detect early signs of growth faltering or undernutrition, which can be addressed through timely referrals and caregiver counseling. For mothers, this is more than a health check — it’s an opportunity to understand how their baby is progressing and what to look out for.

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Our team also promotes age-appropriate early stimulation, such as talking, singing, skin-to-skin contact, and eye-tracking exercises. These simple, no-cost activities support brain development, emotional bonding, and sensory-motor skills. We teach caregivers how to engage with their babies in nurturing ways that lay the foundation for future learning and social-emotional well-being.

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In addition, CHWs provide guidance on safe sleeping practices, proper holding techniques, and developmental milestones, helping caregivers recognize red flags such as delayed movement, poor response to sound, or lack of eye contact. When concerns arise, CHWs initiate referrals and support families in navigating the care pathway. We combine physical growth monitoring with stimulation and caregiver education, to ensure that newborns do not just survive, they thrive.

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WASH and Hygiene Education

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Good hygiene and sanitation practices are essential to safeguarding the health of both lactating mothers and newborns, especially in remote and underserved communities where access to clean water and proper sanitation is limited. Our CHWs integrate Water, Sanitation, and Hygiene (WASH) education into every postnatal and household visit to help families prevent infections and promote a clean, healthy start to life.

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We provide one-on-one counseling to mothers and caregivers on key hygiene practices, including:

• Hygienic cord care: CHWs demonstrate how to keep the umbilical cord clean and dry, avoiding harmful substances and unnecessary handling that can lead to life-threatening infections like neonatal sepsis or tetanus.

• Proper handwashing: Mothers are taught critical handwashing moments, before breastfeeding, after changing diapers, before preparing food, and after using the toilet, using soap and clean water or chlorine solutions where available.

• Safe water use and storage: CHWs educate families on how to treat drinking water using chlorine or boiling, how to store it safely, and how to prevent recontamination.

• Latrine use and waste disposal: We promote the consistent use of latrines and safe disposal of baby waste to prevent fecal contamination and diarrheal diseases, which are especially dangerous for newborns.

• Clean home environments: Guidance is given on maintaining a dust- and smoke-free environment, separating animals from living spaces, and ensuring clean bedding and clothing for mothers and infants.

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Our team also distributes chlorine for water treatment in high-risk areas and offers demonstrations on proper dilution and storage. All hygiene messages are tailored to the local context, culturally sensitive, and delivered in the local language to ensure full comprehension and practice.

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We equip mothers with the knowledge and tools to create a clean and safe environment, this helps reduce preventable infections, strengthen maternal confidence, and improve newborn survival during the most vulnerable stage of life.

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Nutrition Support

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Nutrition is a cornerstone of both maternal health and newborn survival. At Wandikweza, we recognize that well-nourished mothers are the foundation for well-nourished babies, especially during the critical first six months of life when exclusive breastfeeding is recommended and most beneficial.

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In the communities we serve, many lactating mothers face food insecurity, nutrient deficiencies, and poor access to nutrition education. These challenges often lead to low milk production, maternal fatigue, and poor infant weight gain. Our Community Health Workers (CHWs) and Nurses on Bikes (NoBs) are trained to conduct routine nutritional assessments during household visits and early postnatal care.

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Our Approach Includes:

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• Early identification of nutritional risk
  The Nurses on Bikes assess maternal dietary intake, energy levels, and breastfeeding patterns, while also tracking newborn weight and feeding behavior. Any signs of faltering growth or maternal undernutrition are flagged immediately.

• Timely referral and follow-up
  Mothers and infants identified with nutritional challenges are referred to our mobile clinics or partner health facilities for further assessment, counseling, and medical support. CHWs provide ongoing follow-up at the household level to ensure continuity of care.

• Breastfeeding support and counseling
  We offer one-on-one breastfeeding guidance on latching, positioning, and managing breastfeeding difficulties. Our teams reinforce the importance of exclusive breastfeeding for the first six months, help troubleshoot common issues, and support mothers in building confidence.

• Linkage to food assistance and supplementation
  Malnourished lactating women are linked to nutrition and food support programs through Wandikweza or local partners. These may include supplementary feeding programs, fortified foods, or community-based kitchen initiatives.

• Therapeutic feeding for older infants:
  While newborns rely exclusively on breastmilk, older infants and children identified with moderate or severe acute malnutrition are referred for treatment with Ready-to-Use Therapeutic Food (RUTF) or other therapeutic interventions. CHWs monitor adherence and recovery at home.

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Referral and Emergency Support

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Timely access to higher-level care can be the difference between life and death for newborns and lactating mothers facing complications. That is why Wandikweza has built a strong, coordinated referral and emergency response system that ensures no one is left behind in critical moments.

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Our Community Health Workers (CHWs) and Nurses on Bikes (NoBs) are trained to identify early warning signs during home visits, such as excessive postpartum bleeding, signs of infection, breastfeeding difficulties, neonatal jaundice, or respiratory distress in newborns. Once identified, they initiate an immediate referral to the nearest health facility equipped to manage complications.

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Wandikweza works in close partnership with local health facilities, health surveillance assistants (HSAs), and District Health Offices (DHOs) to ensure:

• Clear referral pathways are established and understood by CHWs

• Referral tools (referral slips/logbooks) are used consistently and documented

• Back-referrals (feedback from the facility to the CHW) are tracked to confirm treatment completion and continuity of care

In emergency cases, particularly in hard-to-reach areas, Nurses on Bikes act as the first responders. They are trained to provide stabilizing care, escort patients to health facilities, and ensure urgent communication with facility staff. When available, Wandikweza also coordinates with local transport providers or health centers for emergency transport arrangements, ensuring no mother or baby is stranded due to lack of mobility or resources.  CHWs conduct follow-up visits after referral to monitor recovery, support treatment adherence, and address any remaining concerns. This looped system of detection, referral, transport, and follow-up ensures that care is not only responsive but sustained.

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We embed referral and emergency support into our doorstep care model, to ensure that even in the most remote communities, families have a lifeline when complications arise, one that is fast, trusted, and built on strong health system linkages.