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Providing Safe Skin-to-skin Care

March 2020

As we continue to look at the evidence and recommendations for the Baby-friendly Hospital Initiative, this post will discuss safety concerns with immediate and early skin-to-skin contact (SSC). Revisions to the Ten Step document have been released for the United States and are currently being completed for the remaining global community. You will find the link to the full document below.

baby skin

“There is a concern about cases of sudden infant collapse, most commonly reported among infants of primiparous mothers who are unobserved by healthcare personnel during a period of skin-to-skin contact with the infant prone or on the side of the mother’s chest. Sudden unexpected postnatal collapse of an apparently healthy infant occurring within the first two hours after birth have been estimated to occur in between 1.6 and 5 cases per 100,000 live birth, with death rates of 0-1.1 per 100,000 live births,” ¹.

The reviews of literature for this step included Australia, Colombia, Egypt, Italy, Palestine, Russia, Sweden, the United Kingdom of Great Britain and Northern Ireland, and the United States of America, and can be found in Annex 4 of the document linked below.

What are some of the factors that make safety an issue?
• Inadequate time for staff to observe and support mothers during SSC
• Limited staff capacity which reduces quality time staff can spend with the new dyad
• Lack of staff knowledge regarding breastfeeding and safe SSC

Recommendation 1 states, “Early and uninterrupted skin-to-skin contact between mothers and infants should be facilitated and encouraged as soon as possible after birth,” and is backed by moderate-quality evidence. Providing quality staff education and training can help to decrease and even prevent sudden neonatal collapse in the early postpartum period. Would you like to read more on this topic? Links have been provided below.

Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC

Professional Development Educator

 

Reference

1. Protecting, promoting and supporting Breastfeeding in Facilities providing maternity and newborn services. (2017). World Health Organization https://www.who.int/nutrition/publications/guidelines/breastfeeding-facilities-maternity-newborn/en/

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Last Updated: September 2018