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Implementing Skin to Skin Contact Routine Practice following Birth

Implementing Skin to Skin Contact Routine Practice following Birth. By Margaret O’Leary C.M.S. Lactation & Margaret Hynes C.M.S. Lactation. Baby Friendly Hospital Initiative (BFHI). Launched in 1991 by WHO/UNICEF Aim – to counteract worldwide decline in breastfeeding

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Implementing Skin to Skin Contact Routine Practice following Birth

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  1. Implementing Skin to Skin ContactRoutine Practice following Birth By Margaret O’Leary C.M.S. Lactation & Margaret Hynes C.M.S. Lactation

  2. Baby Friendly Hospital Initiative (BFHI) • Launched in 1991 by WHO/UNICEF • Aim – to counteract worldwide decline in breastfeeding • BFHI is • Mother / Baby Friendly • Global Initiative • Health Promoting

  3. Baby Friendly Hospital Initiative (B.F.H.I) • Cert of commitment - 1999 • 2001 • Full Award - 2004

  4. Common PracticePrior to B.F.H.I. • Baby dried & wrapped in blanket • Held by parents or • Put in incubator within mother’s view • Generally feeding established in postnatal ward

  5. Implementing Change • Change in practice and routine • Policies to ensure sustainability

  6. Why Skin to Skin ? • Reduces by 74% the production of stress hormones in baby which aids digestion & reduces incidence of hypoglycaemia. • Calms baby. • Regulates baby’s heart beat & breathing. • Maintains core body tempeture in baby. • Helps establish & sustain breastfeeding. • Promotes close mother/baby relationship.

  7. Practice/Routine • Staff education • Training • Video • Written information • Photographs • Parent education • Antenatal classes • Skills workshop • Private & public antenatal clinic • Written information

  8. Hospital Policies • Hospital Clinical Guideline on management of breastfeeding & lactation “Within half an hour of birth all mothers regardless of feeding choice will be given their baby to hold with skin to skin contact for at least 30 minutes” • Hospital policy for mothers • Hypoglycaemia policy • Regional Breastfeeding Policy

  9. Obstacles • Large number of staff • Turnover of patients in labour ward – “too busy” • Old habits die hard • Consistency in recording in maternity notes – incidence, duration and reason for discontinuing

  10. Overcoming Obstacles • Parentcraft team • Role of the Clinical Midwifery Specialist (CMS) • Additional education time at antenatal clinic • Informing mothers antenatally • Key people from each area in Hospital Baby Friendly Hospital Initiative Committee • Providing research based articles on importance of skin to skin

  11. Initial B.F.H.I assessment for full award was June 2004 • 78% of mothers met the criteria (Minimum requirement is 80%)

  12. What can we do to improve? • “Never give up” • Recommence on postnatal wards • Following infant’s first bath • Co-operation of postnatal & neonatal ward staff • Checking charts for documentation • Feeding back at ward report time • Care attendants

  13. What’s beneficial to achieve & maintain practice • Rooming in • No “well baby” nurseries • Supportive staff in all areas • Safety rails on beds in postnatal wards • Infant bathing at bedside • Feedback to staff of positive comments from mothers

  14. Baby Friendly Award Audit of Practice February 2005 Questionnaires • To 120 women (+ 36 weeks gestation) • To 100 mothers (Day 2 Postnatal)

  15. Results Antenatal Questionnaire • 84% returned What is skin to skin contact? • 93% knew Others • Thoughts linked with breastfeeding and childbirth – more vague

  16. Mother’s perception When will skin to skin contact be initiated? • 94% immediately or shortly after birth Others • Perceived it would happen with breastfeeding Why? • Bonding - 79% • Antibody/Immune system - 23% • Comfort/Safety - 9% • Breastfeeding - 6% • Temperature control - 4% • Heart rate - 4%

  17. Postnatal Questionnaires Results • 70 out of 100 replied • 68 of these received skin to skin contact • 100% - positive feedback from this group When? • 81% - immediately after birth • 22% - on admission to ward • 16% - following bath

  18. What did mothers say?- good for mother • 84% - Bonding/sense of comforting/liked baby next to them • 16% - Sense of relief! • Many individual positive comments

  19. What did mothers say?- good for baby • 56% - Relaxing, soothing, reassuring, security, happy, calm, comfort • 53% - Bonding, including smell, heart rate, sight of mother • 24% - Warmth ( temperature) • 2% - Sleep • 2% - Make baby alert

  20. Individual Comments “It reassured me baby was ok” “Made me feel like a mother” “ A complete high” “I found the experience very rejuvenating” “Just amazing, no words can describe it” “The feeling of bonding was very natural”

  21. Individual Comments “Made the arrival of the baby more real” “Breastfeeding started quicker” “ Calmed baby after birth” “Lovely to let him and I bond and be quiet together” “Reassurance that I was able to calm baby” “Very relaxing and great for bonding”

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