I recently learned of two infant deaths in the first 24 hours post-delivery, with both occurring while the infants were in skin-to-skin care with their mothers. Many of those involved and within the various hospital systems wanted to immediately blame it on the skin-to-skin. However, both cases involved high-risk factors which most likely played a part in the fatalities. Maternal obesity, use of magnesium sulfate before and after delivery, use of narcotic medications during labor, and infrequent checks on the dyads while in skin-to-skin care.
So here are some factors to look at in the provision of SAFE skin-to-skin care:
1. Protect the infant's airway. Can you see both nares clearly? Is the chin horizontal to the body, avoiding hypo or hyper-extension of the neck?
2. Infant positioning. Flexion, upright, not nestled down into the maternal cleavage.
3. Infant temperature. Don't overheat the new infant, keep him/her clad in diaper only (or nothing at all), against mother's bare chest. Add hat and heated blanket. Check the temperature and add additional blankets as needed.
4. Monitor the dyad closely. Depending on your policies for skin-to-skin care, check on them frequently. Educate the parents on signs of problems. And remind them that safety if your first concern.
To learn more than you ever wanted to know about skin-to-skin care, this link with take you to the site with Drs. Susan Luddington, Nils Bergman, and Gene Anderson. References and information is extensive, and it can help with policy and procedure writing for your staff. http://www.skintoskincontact.com/home.aspx
Coming in future posts...additional information on skin-to-skin care, infant sleep positions, and much more!
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