Aim Current care of very preterm infants in an incubator implies separation of the mother‐infant dyad. The aim of this study was to determine whether skin‐to‐skin contact (SSC) between parent and very preterm infant from birth and during the first postnatal hour is feasible. Methods Infants born in 2014‐16 in Stockholm at gestational age 28 + 0‐33 + 6 weeks were randomised to care provided in SSC with a parent or on a resuscitaire and later in an incubator or bed during the first postnatal hour. Infant body temperature was measured on admission to the neonatal unit and at one postnatal hour. Data on respiratory support and breastfeeding were prospectively collected. Results We studied 55 infants at 32 + 0 ± 1.4 weeks (range 28 + 2‐33 + 6), with birthweight 1760 g ± 449 g (range 885‐2822). 60% were boys. Mean body temperature in the SSC group was 0.3°C lower 1 hour after birth, 36.3°C ± 0.52 (range 34.4‐37.2) vs 36.6°C ± 0.42 (range 36.0‐37.4, P = .03). No differences between groups were seen in respiratory support or breastfeeding. Conclusion Stabilisation of very preterm infants can be performed while in SSC with a parent, but caution needs to be paid to maintain normothermia.

Aim Our aim was to investigate what effect immediate skin‐to‐skin contact with a parent had on the cardiorespiratory stabilisation of very preterm infants. Methods This randomised clinical trial was conducted during 2018–2021 at two university hospitals with three neonatal intensive care units in Norway and Sweden. Infants born from 28+0 to 32+6 weeks of gestation were randomised to immediate skin‐to‐skin contact with a parent for the first six postnatal hours or standard incubator care. The outcome was a composite cardiorespiratory stability score, based on serial measures of heart and respiratory rate, respiratory support, fraction of inspired oxygen and oxygen saturation. Results We recruited 91 newborn infants with a mean gestational age of 31+1 (range 28+4–32+6) weeks and mean birth weight of 1534 (range 555–2440) g: 46 received immediate skin‐to‐skin contact and 45 received incubator care. The group who received skin‐to‐skin contact had an adjusted mean score of 0.52 higher (95% confidence interval 0.38–0.67, p < 0.001) on a scale from zero to six when compared to the control group. Conclusion Immediate skin‐to‐skin contact for the first six postnatal hours had beneficial effects on the cardiorespiratory stabilisation of very preterm infants.

Compared with T-piece systems, the new system had a marked reduction in iWOB in bench tests. The feasibility trial did not reveal problems with usability or safety.

IntroductionIn Scandinavia, 6% of infants are born preterm, before 37 gestational weeks. Instead of continuing in the in-utero environment, maturation needs to occur in a neonatal unit with support of vital functions, separated from the mother’s warmth, nutrition and other benefits. Preterm infants face health and neurodevelopment challenges that may also affect the family and society at large. There is evidence of benefit from immediate and continued skin-to-skin contact (SSC) for term and moderately preterm infants and their parents but there is a knowledge gap on its effect on unstable very preterm infants when initiated immediately after birth.Methods and analysisIn this ongoing randomised controlled trial from Stavanger, Norway and Stockholm, Sweden, we are studying 150 infants born at 28+0 to 32+6 gestational weeks, randomised to receive care immediately after birth in SSC with a parent or conventionally in an incubator. The primary outcome is cardiorespiratory stability according to the stability of the cardiorespiratory system in the preterm score. Secondary outcomes are autonomic stability, thermal control, infection control, SSC time, breastfeeding and growth, epigenetic profile, microbiome profile, infant behaviour, stress resilience, sleep integrity, cortical maturation, neurodevelopment, mother-infant attachment and attunement, and parent experience and mental health.Ethics and disseminationThe study has ethical approval from the Swedish Ethical Review Authority (2017/1135-31/3, 2019–03361) and the Norwegian Regional Ethical Committee (2015/889). The study is conducted according to good clinical practice and the Helsinki declaration. The results of the study will increase the knowledge about the mechanisms behind the effects of SSC for very preterm infants by dissemination to the scientific community through articles and at conferences, and to the society through parenting classes and magazines.Study statusRecruiting since April 2018. Expected trial termination June 2021.Trial registration numberNCT03521310 (ClinicalTrials.gov).

With an increasing awareness of the importance of nurturing care and within a framework of Infant‐ and Family‐Centred Developmental Care (IFCDC), zero separation, keeping parent and infant in continuous close physical and psychological proximity to each other, is key. In modern neonatology, high technological and pharmaceutical treatments are consistently integrated with caregiving considerations. Mother‐Newborn Couplet Care is a concept of care where the dyad of the ill or prematurely born infant and the mother, needing medical care of her own, are cared for together, from the birth of the baby to its discharge. Mother‐Newborn Couplet Care requires systems changes in both obstetrics and paediatrics considering planning and organisation of care, equipment and design of units. Accordingly, strong leadership setting clear goals and changing the professional mindset by providing targeted education and training is crucial to ensure the warranted high quality of care of all mother‐baby dyads.