Skin‐to‐skin contact after birth: Developing a research and practice guideline

Acta Paediatrica, Journal Year: 2023, Volume and Issue: 112(8), P. 1633 - 1643

Published: May 11, 2023

Skin-to-skin contact immediately after birth is recognised as an evidence-based best practice and acknowledged contributor to improved short- long-term health outcomes including decreased infant mortality. However, the implementation definition of skin-to-skin inconsistent in both research studies. This project utilised World Health Organization guideline process clarify improve consistency application.The rigorous development combines a systematic review with acumen judgement experts wide range credentials experience.The developed received strong recommendation from Expert Panel. The result concluded that there was high level confidence evidence not resource intensive. Research gaps were identified areas for continued work delineated.The reached conclusion immediate, continuous, uninterrupted should be standard care all mothers babies (from 1000 g experienced staff if assistance needed), modes birth. Delaying non-essential routine favour has been shown safe allows progression newborns through their instinctive behaviours.

Language: Английский

Thermoregulation for very preterm infants in the delivery room: a narrative review

Pediatric Research, Journal Year: 2024, Volume and Issue: 95(6), P. 1448 - 1454

Published: Jan. 22, 2024

Abnormal temperature in preterm infants is associated with increased morbidity and mortality. Infants born prematurely are at risk of abnormal immediately after birth the delivery room (DR). The World Health Organization (WHO) recommends that newly maintained between 36.5-37.5

Language: Английский

Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe

International Breastfeeding Journal, Journal Year: 2025, Volume and Issue: 20(1)

Published: Jan. 2, 2025

Abstract Background Emerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in intensive units (NICUs) scarce. Therefore, aim was describe supporting practices Method Through Delphi rounds, a questionnaire developed comprising questions usage and occurrence of A multinational online survey distributed September October 2023 NICUs Europe using snowball sampling. Practices such as practice skin-to-skin contact (SSC), restrictions breastfeeding, providing information parents, observing responding infants’ cues were explored. Results The completed by 105 across 15 European countries. Less than half (46%) had no upon placing infant SSC with parents. Approximately (49%) stated that infants within first hour after birth. Many (68%) some restriction One week birth, 48% encouraged at 33 postmenstrual age whenever showed cues, regardless scheduled tube feeding time. This percentage increased 59% 33–35 gestational age. (47%) they necessary tools/instruments support transition from There variations milk intake assessed, weighing before or estimating time spent sucking. Infants 50% be fed exclusively orally discharge. (65%) provided specific enabled discharge fed. Conclusion employ practices, SSC, early initiation provide Staff plays significant role fostering preterm infant-mother dyads. still exist To understand impact different strategies there evaluations parents testing implementation care.

Language: Английский

Immediate skin‐to‐skin contact after birth ensures stable thermoregulation in very preterm infants in high‐resource settings

Acta Paediatrica, Journal Year: 2022, Volume and Issue: 112(5), P. 934 - 941

Published: Nov. 5, 2022

To investigate the impact of immediate skin-to-skin contact with a parent after birth on thermal regulation in very preterm infants.This clinical trial was conducted three neonatal intensive care units Scandinavia from 2018 to 2021. Infants born between 28 + 0 and 32 6 weeks days gestation were randomised or conventional an incubator during first postnatal hours. We report secondary outcome: serial measurements axillary temperature.Ninety-one infants care. Mean (range) gestational ages 31 2 (28 6, 5) 4, 6) days, mean weights 1572 (702, 2352) 1495 (555, 2440) grams, respectively. (95%CI, p-value) temperatures within normal range both groups, 0.2°C (-0.29, -0.14, p < 0.001) lower group. The group had relative risk developing events hyperthermia, RR = 0.70 (0.50, 0.99, 0.04).Very infants, irrespective stability, do not develop hypothermia birth. Immediate did protect against hyperthermia. Concerns about should limit implementation high-resource settings.

Language: Английский

Skin-to-skin contact in the delivery room for very preterm infants: a randomised clinical trial

BMJ Paediatrics Open, Journal Year: 2023, Volume and Issue: 7(1), P. e001831 - e001831

Published: March 1, 2023

Objective Evaluating safety, feasibility and effects on physiological parameters of skin-to-skin contact (SSC) from birth between mothers very preterm infants in a high-income setting. Design Open-label randomised controlled trial. Setting Three Norwegian neonatal units. Patients Preterm at gestational age (GA) 28 0 –31 6 weeks weight >1000g delivered vaginally or by caesarean section (C-section). Intervention Two hours early SSC the mother infant compared to standard care (SC) where is separated transferred unit an incubator. Results 108 (63% male, 57% C-section, mean (SD) GA 30.3 (1.3) 1437 g (260)) were included. Median (IQR) randomisation was 23 min (17–30). During first 2 after randomisation, 4% (2 51) 7% (4 57) hypothermic (<36.0°C) SC group, respectively (p=0.68, OR 0.5, 95% CI 0.1 3.1). Significantly fewer group had hyperthermia (>37.5°C) (26% (13 vs 47% (27 51), respectively, p=0.02, 0.4, 0.2 0.9). No needed mechanical ventilation within hours. duration 120 (80–120) intervention group. There no difference heart rate, respiratory rate oxygen saturation groups during 24 Conclusion This study setting confirmed that for safe feasible. Physiological not affected intervention. The long-term neurodevelopment, maternal–infant bonding maternal mental health will be collected. Trial registration number NCT02024854 .

Language: Английский

New policies on skin-to-skin contact warrant an oxytocin-based perspective on perinatal health care

Frontiers in Psychology, Journal Year: 2024, Volume and Issue: 15

Published: July 9, 2024

In 2023, the World Health Organization (WHO) published a Global Position Paper on Kangaroo Mother Care (KMC), which is applicable to all countries worldwide: from moment of birth, every "small and sick" newborn should remain with mother in immediate continuous skin-to-skin contact (SSC), receiving required clinical care that place. This was prompted by startling results randomized controlled trial 2021: 1,609 infants SSC were compared 1,602 controls separated their mothers but otherwise received identical conventional state-of-the-art care. The intervention showed 25% reduction mortality after 28 days.

Language: Английский

Mother-newborn couplet care: Nordic country experiences of organization, models and practice

Journal of Perinatology, Journal Year: 2023, Volume and Issue: 43(S1), P. 17 - 25

Published: Dec. 1, 2023

Abstract Mother-Newborn Couplet Care is a concept and defined as the provision of care for sick or preterm newborn in close proximity to coupled with mother from birth infant long needs hospital care. This requires system change both obstetrics pediatrics terms planning organization care, equipment design units. Accordingly, strong leadership setting clear goals emphasizing culture cohesive supported by targeted education training crucial ensure high-quality all mother-newborn dyads without separation. We describe various organizational models used Sweden Finland implementation processes. envision future where newborns mothers are always together, irrespective medical needs, form an inseparable center around which healthcare services providers organized.

Language: Английский

Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations

Research and Reports in Tropical Medicine, Journal Year: 2023, Volume and Issue: Volume 14, P. 121 - 134

Published: Dec. 1, 2023

Abstract: Neonatal sepsis causes significant global morbidity and mortality, with the highest burden in resource-limited settings where 99% of neonatal deaths occur. There are multiple challenges to achieving successful treatment neonates this setting. Firstly, reliable low-cost strategies for risk identification urgently needed facilitate as early possible. Improved laboratory capacity allow causative organisms would support antimicrobial stewardship. Antibiotic is still hampered by availability, but also increasingly resistance – making surveillance judicious antibiotic use a priority. Finally, supportive care key management neonate has been underrecognized priority settings. This includes fluid balance nutritional acute phase, follow-up order mitigate complications optimise long-term outcomes. much more work be done identifying holistic needs their families provide effective family-integrated interventions complete package Keywords: neonate, low- middle-income countries, resistance, outcomes,

Language: Английский

Skin-to-Skin Contact at Birth for Very Preterm Infants and Mother-Infant Interaction Quality at 4 Months

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(11), P. e2344469 - e2344469

Published: Nov. 30, 2023

Good-quality parent-infant interactions have protective effects on infant socio-emotional and behavioral development. These are especially critical for very preterm infants at risk of vulnerabilities related to immaturity. Skin-to-skin contact (SSC) has been found improve mother-preterm interaction behaviors, but few studies exist regarding its benefits when initiated immediately after birth.To determine the effect immediate SSC birth mother-infant quality 4 months corrected age.This secondary analysis used data from Immediate Parent-Infant Skin-to-Skin Study (IPISTOSS), a randomized clinical trial conducted between April 1, 2018, June 30, 2021, 3 neonatal units in Sweden Norway. Participants included (28-33 gestational weeks age) their parents. Four-month follow-up was concluded December 2021. Data analyses were performed March 16 September 18, 2023.Infants allocated standard incubator care or with either parent continued throughout first 6 hours birth.The primary outcome as measured Parent-Child Early Relational Assessment (PCERA), based video recordings 5-minute free-play situation dyads age. A multilevel regression performed.This 71 (31 twins [44%]) 56 mothers. Infants had mean (SD) age 31 (1.3) days, more than half male (42 [59%]); mothers 32 (4.9) years. There 37 34 birth. During birth, fathers provided mothers, median (IQR) 3.25 (2.25-4.5) 0.75 (0-2.5) hours, respectively. statistically significant difference 1 5 PCERA subscales (subscale 3: positive affect, communicative social skills) observed, higher-quality group (Cohen d = 0.67 [95% CI, 0.17 1.17]; P .01). This remained adjusting primiparity, child sex, observation setting.In this study beneficial relationship. findings suggest that should be supported setting.ClinicalTrials.gov Identifier: NCT03521310.

Language: Английский

The Skincubator: A novel incubator for Skin to Skin Care (SSC) of premature neonates, enables SSC within humidified environment and may improve thermoregulation during SSC.

American Journal of Perinatology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 31, 2025

This study aimed to assess thermoregulation and humidity within the Skincubator-a novel, wearable skin-to-skin incubator designed attach caregiver. Preterm neonates (PN; born between 24 33 weeks gestational age [GA]) received care (SSC) either via Skincubator or traditional SSC (t-SSC) with continuous axillary temperature monitoring. Twenty PN were enrolled in treated Skincubator. One couple who consented during delivery subsequently revoked their consent baby was excluded from further analysis. Fifty-four paired sessions of t-SCC performed compared for 19 babies. The average GA 29 (range: 26-32), weight -1,296 ± 271 g, day life 5 2. drop after transfer smaller than t-SSC (0.2°C [0.2-0.3] vs. 0.4°C [0.3-0.6]; Wilcoxon's signed rank test [WSRT], p < 0.001). hypothermia time per session a median (25th-75th%) 8.2 minutes (0-9) Skincubator, 27.8 (0-56) t-SSC, respectively (WSRT, = 0.002). No had moderate (35.5-35.9°C) as eight babies experienced (Fisher's exact 0.003). 85 7% above 70% 93% time. superior maintaining while also an optimally humidified environment. may promote early very extremely PN. (Trial registration number MOH_2021-12-13_010470 date 24/10/21.) KEY POINTS: · Early prolonged improves preterm infants' outcomes but be challenging perform.. To mitigate several barriers we invented SSC.. We have shown that reduces transient at initiation.. Average time..

Language: Английский