Preterm Perinatal Wellbeing Package (PPWP)

There are a number of well-established interventions which have been clearly shown to improve short and long-term outcomes in babies born prematurely. As well as a significant reduction in mortality, these interventions reduce important morbidities such as intraventricular haemorrhage, preterm lung disease, sepsis, necrotising enterocolitis in the short term, and reduced cerebral palsy and improved neurological outcomes in the long term. The package is designed for maternity and neonatal colleagues to work in collaboration on the seven process measures.


  1. The smallest and most preterm babies (< 27 weeks) should deliver in a centre with a Neonatal Intensive Care Unit (NICU) (level 3). 
  2. All mothers of infants born < 30 weeks should be given Magnesium Sulphate antenatally within 24 hours of delivery.
  3. All mothers of infants born < 34 weeks should be given antenatal steroids within 1 week of birth, and ideally greater than 24 hours before delivery.
  4. Optimal cord clamping (≥ 60 seconds) should be carried out for all infants unless specifically contraindicated, e.g. no signs of life, Twin to Twin Transfusion Syndrome, evidence of major placental separation.
  5. Babies should reach an admission temperature of 36.5-37.5 °C within 1 hour of birth (< 32 weeks gestation as per NNAP),
  6. All infants born < 30 weeks should receive at least one dose of caffeine within the first three days.
  7. Mothers own breast milk should be given to all infants < 32 weeks either as mouth care or enterally, within 24 hours of birth.