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Skin-to-Skin Care
Perinatal Quality Collaborative of North Carolina
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The Ten Steps Maintain a written breastfeeding
policy that is routinelycommunicated to all health carestaff.
Train all health care staff in skillsnecessary to implement thispolicy.
Inform all pregnant women aboutthe benefits and management ofbreastfeeding.
Help mothers initiate
breastfeeding within onehour of birth. Show mothers how to breastfeed
and how to maintain lactation,even if they are separated fromtheir infants.
Give infants no food or drinkother than breastmilk, unlessmedically indicated.
Practice rooming in-- allowmothers and infants to remaintogether 24 hours a day.
Encourage unrestrictedbreastfeeding.
Give no pacifiers or artificialnipples to breastfeeding infants.
Foster the establishment of
breastfeeding support groups andrefer mothers to them ondischarge from the hospital orclinic.
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All major health professional organizationsrecommend:
Healthy infants should be placed andremain in direct skin-to-skin contact with
their mothers immediately after deliveryuntil the first feeding is accomplished.
(AAP, Guidelines 2005)
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LetDown
Latch
MovingMilk
Three factors of Breastfeeding Success:Let Down
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Skin to skin and starting the first feed
Medianminutes afterbirth
6 Opening the eyes
11 Massage-like hand movement on mothers breast12 Hand-to-mouth movement
21 Rooting movement
25 Hand to nipple movement27 Licking
80 Sucking
Matthiesen A-S, et al. Postpartum Maternal Oxytocin Release by Newborns:Effects of Infant Hand Massage and Sucking. Birth. 2001;28(1):13-19.
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Skinto
skin
Routine
Breastfeedingat discharge
Breastfeedingat 1-4 months
Breastfeedingat 12 months
Successfulfirst feed
Bottom line: Mothers who held their infants skin-to-skin breastfed43 days longer than mothers who did not.
Anderson GC, et al. Early skin-to-skin contact for mothers and their healthy newborn infants.Cochrane Database of Systematic Reviews. 2007;3.
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Homeostasis
Physiology in the firsthours of life
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Babies need Mothers
Randomized trial of50 healthy term
infants Skin to skin at
delivery, then cotvs. skin to skin for
90 minutes
STS Cot
HR 136.6 6.9 140.7 9.0
RR* 44.3 7.9 49.8 10.2
Glucose* 3.17 0.7 2.56 0.71
Changein baseexcess*
3.4 2.7 1.8 2.6
Christensseon et al. Temperature, metabolic adaptation and crying in healthy full-termnewborns cared for skin-to-skin or in a cot. Acta Paediatr 81: 488-93, 1992.
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Axillary Temperature
37.1
36.8
36.6
36.5
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Number of infants crying
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Cumulative proportions of
neonates that reached 3650C
Christensson et al. Randomised study of skin-to-skin versus incubator care for
rewarming low-risk hypothermic neonates. The Lancet. 1998;352(9134):1115
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Gray, L. et al. Pediatrics 2000;105:e14
Helping babies handle stress
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Keeping calm
Co ri ht 2000 American Academ of Pediatrics
Gray, L. et al. Pediatrics 2000;105:e14
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Morelius, E. et al. Pediatrics 2005;116:1105-1113
Salivary cortisol, VAS score, total mood scale score, and heart rate for mothers
before, during, and after the first and fourth SSCs
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Morelius, E. et al. Pediatrics 2005;116:1105-1113
Salivary cortisol, VAS score, total mood scale score, and heart rate for mothers
before, during, and after the first and fourth SSCs
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Homeostasis
Birth separates mother and infant for thefirst time
Skin-to-skin contact is associated withphysiologic changes in mother and baby
Mothers need babies, and babies need
mothers.
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Take home messages
Skin-to-skin is a simple, free, evidence-basedpractice thats good for mothers and babies
The experiences women and infants have aroundpregnancy and birth influence them for alifetime.
What we all do matters very, very much
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