PQCNC HM Well Baby Skin to Skin

8/7/2019 PQCNC HM Well Baby Skin to Skin

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Skin-to-Skin Care

Perinatal Quality Collaborative of North Carolina


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The Ten Steps Maintain a written breastfeeding

policy that is routinelycommunicated to all health carestaff.

Train all health care staff in skillsnecessary to implement thispolicy.

Inform all pregnant women aboutthe benefits and management ofbreastfeeding.

Help mothers initiate

breastfeeding within onehour of birth. Show mothers how to breastfeed

and how to maintain lactation,even if they are separated fromtheir infants.

Give infants no food or drinkother than breastmilk, unlessmedically indicated.

Practice rooming in-- allowmothers and infants to remaintogether 24 hours a day.

Encourage unrestrictedbreastfeeding.

Give no pacifiers or artificialnipples to breastfeeding infants.

Foster the establishment of

breastfeeding support groups andrefer mothers to them ondischarge from the hospital orclinic.


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All major health professional organizationsrecommend:

Healthy infants should be placed andremain in direct skin-to-skin contact with

their mothers immediately after deliveryuntil the first feeding is accomplished.

(AAP, Guidelines 2005)


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LetDown

Latch

MovingMilk

Three factors of Breastfeeding Success:Let Down


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Skin to skin and starting the first feed

Medianminutes afterbirth

6 Opening the eyes

11 Massage-like hand movement on mothers breast12 Hand-to-mouth movement

21 Rooting movement

25 Hand to nipple movement27 Licking

80 Sucking

Matthiesen A-S, et al. Postpartum Maternal Oxytocin Release by Newborns:Effects of Infant Hand Massage and Sucking. Birth. 2001;28(1):13-19.


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Skinto

skin

Routine

Breastfeedingat discharge

Breastfeedingat 1-4 months

Breastfeedingat 12 months

Successfulfirst feed

Bottom line: Mothers who held their infants skin-to-skin breastfed43 days longer than mothers who did not.

Anderson GC, et al. Early skin-to-skin contact for mothers and their healthy newborn infants.Cochrane Database of Systematic Reviews. 2007;3.


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Homeostasis

Physiology in the firsthours of life


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Babies need Mothers

Randomized trial of50 healthy term

infants Skin to skin at

delivery, then cotvs. skin to skin for

90 minutes

STS Cot

HR 136.6 6.9 140.7 9.0

RR* 44.3 7.9 49.8 10.2

Glucose* 3.17 0.7 2.56 0.71

Changein baseexcess*

3.4 2.7 1.8 2.6

Christensseon et al. Temperature, metabolic adaptation and crying in healthy full-termnewborns cared for skin-to-skin or in a cot. Acta Paediatr 81: 488-93, 1992.


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Axillary Temperature

37.1

36.8

36.6

36.5


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Number of infants crying


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Cumulative proportions of

neonates that reached 3650C

Christensson et al. Randomised study of skin-to-skin versus incubator care for

rewarming low-risk hypothermic neonates. The Lancet. 1998;352(9134):1115


13/18Co ri ht 2000 American Academ of Pediatrics

Gray, L. et al. Pediatrics 2000;105:e14

Helping babies handle stress


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Keeping calm

Co ri ht 2000 American Academ of Pediatrics

Gray, L. et al. Pediatrics 2000;105:e14



Morelius, E. et al. Pediatrics 2005;116:1105-1113

Salivary cortisol, VAS score, total mood scale score, and heart rate for mothers

before, during, and after the first and fourth SSCs


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Homeostasis

Birth separates mother and infant for thefirst time

Skin-to-skin contact is associated withphysiologic changes in mother and baby

Mothers need babies, and babies need

mothers.


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Take home messages

Skin-to-skin is a simple, free, evidence-basedpractice thats good for mothers and babies

The experiences women and infants have aroundpregnancy and birth influence them for alifetime.

What we all do matters very, very much

Documents

PQCNC HM Well Baby Skin to Skin