What would you tell your nurses if you were a newborn in a birthing hospital? Interesting question, isn't it? The abstract for a recent article in the Journal of Perinatal Nursing states, "Separation of mothers and infants after birth is standard practice for many hospitals, yet not evidence-based. Nonseparation clearly has numerous benefits. However, newborns lack a voice to make choices to direct their course of care. The evidence supports nonseparation strategies for mother and infants that promote attachment, physiologic regulation, nutrition, sleep, communication and management of stress/pain. Moreover, the evidence is compelling that nonseparation is essential,” (p. 80).
The Codes of Ethics for nursing organizations around the globe often promote the treatment of ALL patients with dignity, respect for their distinct and individual qualities, and for their individual rights to be advocated for and protected. "However, newborn care is often influenced by cultural and hospital norms, socially accepted parenting practices, and the competing needs of the mother. The gap in knowledge and appreciation of some of the newborn's needs during the postpartum hospitalization combined with a task-oriented approach to nursing care contribute to non-evidence-based practice,” (p. 80). Think about the long list of chores, so to speak, that are done with and to newborns following delivery and prior to their discharge at 1-3 days: pediatric rounds, vital signs checks, photography, heel sticks, phototherapy, hearing tests, change of shifts, bathing, and more. It was long thought that having those infants in a separate nursery would make it easier for staff and physicians to complete these things during the short stay of the mother-infant dyad. What would the infant say to the nursery experience?
"Evidence strongly suggests that the physiologic, emotional, and social needs of the newly born infant are best met when mothers and infants are cared for together during the postpartum hospitalization. It is time for newborn care strategies to change to the basis of our seeing the care through the newborn's eyes,” (p. 82). Study after study has demonstrated the benefits of prolonged skin-to-skin care which promotes regulation of physiologic processes for both infant and mother, the bonding and attachment that occur from the first moment of skin-to-skin, and other systems' (nutrition, immune response, sleep, communication, stress and pain responses, social regulation) regulation.
I'd suggest you get a copy of this article; you will find a wealth of information to begin the paradigm shift in your birthing facility. Table 1 (pp. 86-87) gives 17 strategies to promote optimal infant care with references for research-based care. You'll have good resources to have your Quality Improvement team "Think Like A Baby”!
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA
Professional Development Educator
Francis, K. and Pugsley, L. (2018). Care through the Newborn's Eyes. J Peri & Neonatal Nursing; 32(1): 80-90.
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