Implementing Skin-to-Skin Care in a Baby-Friendly Community Hospital
Version of Record online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, page S41, June 2012
How to Cite
Reeg, J. L. and Lott, T. (2012), Implementing Skin-to-Skin Care in a Baby-Friendly Community Hospital. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S41. doi: 10.1111/j.1552-6909.2012.01360_17.x
- Issue online: 14 JUN 2012
- Version of Record online: 14 JUN 2012
- skin-to-skin care;
- kangaroo care;
Purpose for the Program
To improve mother–infant attachment and breastfeeding.
To implement skin-to-skin care in a baby friendly community hospital.
Implementation, Outcomes, and Evaluation
Health First, Inc. Cape Canaveral Hospital, a Baby-Friendly facility since June 2000, launched a skin-to-skin initiative in 2009. An evidence-based practice protocol for placing newborns skin-to-skin at birth and in the immediate postpartum period was incorporated into our labor, delivery, recovery, and postpartum (LDRP) unit, and encouraged during the entirety of the postpartum stay. Staff nurses were educated in appropriate skin-to-skin techniques and patient instruction, first in a small group interactive setting and later followed with a video and discussion format. Patient education pamphlets were distributed to women in labor and Kangaroo care shirts were loaned to new mothers during their hospital stay. Families were encouraged to attempt to keep their newborn skin-to-skin for up to 6 hours a day for the first week of life and a minimum of 2 hours a day for the second week through fourth week. Mothers were assured that anyone, e.g., fathers and grandmothers, can engage in the skin-to-skin care with the infant. Studies have reported benefits of skin-to-skin care of the newborn to include reduced crying, improved mother–infant interaction, warmer babies, and greater breastfeeding success. Additional positive effects on neonatal self-regulation during the transition from intrauterine to extrauterine life include increased sleep, decreased apnea and bradycardia, improved respiration and oxygen saturation, accelerated weight gain, and, for the mother, increased milk production. The staff at Cape Canaveral Hospital has observed anecdotal evidence of these benefits.
The nursing and lactation staff at Cape Canaveral Hospital strive to achieve skin-to-skin care with every new mother–baby couplet, making allowance for individual circumstances and infant condition. A chart audit was conducted from 2010 to 2011 for evidence of skin-to-skin care attempted and encouraged immediately after birth and within the first hour of life, and of documentation of mother education on benefits of skin-to-skin care. Results show a 90% success rate, indicative of a positive trend in the number of mother–baby couplets opting for this practice and verbalizing their intent to continue skin-to-skin care at home. Mothers seen one-on-one in the lactation clinic after discharge are further encouraged to continue skin-to-skin care in the first weeks.
Implications for Nursing Practice
The practice of skin-to-skin care as a component of our baby friendly philosophy contributes positively to neonatal transition, enhances attachment, and promises long-term benefit to new families. We at Cape Canaveral Hospital are committed to continuing promotion of skin-to-skin care as part of best practice.