A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care

Brimdyr, Kajsa; Widström, Ann‐Marie; Cadwell, Karin; Svensson, Kristin; Turner‐Maffei, Cynthia

doi:10.1891/1058-1243.21.3.149

Cited by 27 publications

(27 citation statements)

References 22 publications

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“…The study was conducted at Loma Linda University Medical Center (LLUMC), a large teaching hospital in the Western part of the United States that has approximately 2,500 births per year. The staff previously had received in‐services and training in the provision of skin‐to‐skin care using the PRECESS method . The hospital routinely provides uninterrupted skin‐to‐skin contact for all healthy newborns immediately after all vaginal births for at least 1 hour.…”

Section: Methodssupporting

confidence: 90%

The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

Brimdyr

Cadwell

Widström

et al. 2015

Birth

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Background: Intrapartum drugs, including fentanyl administered via epidural and synthetic oxytocin, have been previously studied in relation to neonatal outcomes, especially breastfeeding, with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin-to-skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes. Method: Prospective comparative design. Sixty-three low-risk mothers self-selected to labor with intrapartum analgesia/anesthesia or not. Video recordings of infants during the first hour after birth while being held skin-to-skin with their mother were coded and analyzed to ascertain whether or not they achieved Stage 8 (suckling) of Widstr€ om's 9 Stages of newborn behavior during the first hour after birth. Results: A strong inverse correlation was found between the amount and duration of exposure to epidural fentanyl and the amount of synthetic oxytocin against the likelihood of achieving suckling during the first hour after a vaginal birth. Conclusions: Results suggest that intrapartum exposure to the drugs fentanyl and synthetic oxytocin significantly decreased the likelihood of the baby suckling while skinto-skin with its mother during the first hour after birth. (BIRTH 42:4 December 2015)

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Section: Methodssupporting

confidence: 90%

The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

Brimdyr

Cadwell

Widström

et al. 2015

Birth

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“…It expands the understanding of each of these through the lens of the authors' clinical expertise and research experience from direct observation of newborn infant behaviour. Expertise comes from experience as well as analysis of hundreds of hours of videotapes of newborn infants' developing feeding behaviour in skin-to-skin contact (12,17,18,21,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Additionally, the authors had the opportunity to improve skin-to-skin care after birth, both in vaginal and caesarean delivery at 10 hospitals in Egypt and the United States according to a 5-day video-ethnographic intervention.…”

Section: Methodsmentioning

confidence: 99%

“…(ii) practical application of the skin-to-skin procedure, with the American and Swedish team and staff working at the delivery ward together, to continue the educational process; (iii) videotaping the evolving process as the hospital staff work to implement the new procedures; (iv) conducting an interaction analysis workshop to review videotapes and discuss barriers and solutions; and (v) administering the continuing application of the procedure (12,28).…”

Section: Methodsmentioning

confidence: 99%

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Brimdyr²,

et al. 2019

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Aim This paper integrates clinical expertise to earlier research about the behaviours of the healthy, alert, full‐term infant placed skin‐to‐skin with the mother during the first hour after birth following a noninstrumental vaginal birth. Method This state‐of‐the‐art article forms a link within the knowledge‐to‐action cycle, integrating clinical observations and practice with evidence‐based findings to guide clinicians in their work to implement safe uninterrupted skin‐to‐skin contact the first hours after birth. Results Strong scientific research exists about the importance of skin‐to‐skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short‐ and long‐term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant's instinctive behaviour and maternal responses while in skin‐to‐skin contact. Conclusion The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.

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“…In light of our experience researching and implementing SSC Brimdyr, Widström, Cadwell, Svensson, & Turner-Maffei, 2012;Stevens, Schmied, Burns, & Dahlen, 2016;Takahashi et al, 2011) and in consideration of the findings of the Cochrane team (Moore et al, 2016), we present a novel algorithm, Healthy Children Project's Skin-to-Skin Implementation Algorithm (HCP-S2S-IA; Figure 1), which considers the mothers' condition as she begins the birthing experience according to Robson criteria (Table 2) and then, using the tool, plots the experience of each dyad in regard to immediate, continuous, and uninterrupted SSC after birth.…”

mentioning

confidence: 99%

An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth

Brimdyr¹,

Cadwell²,

Stevens

et al. 2017

Maternal & Child Nutrition

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Evidence supporting the practice of skin‐to‐skin contact and breastfeeding soon after birth points to physiologic, social, and psychological benefits for both mother and baby. The 2009 revision of Step 4 of the WHO/UNICEF “Ten Steps to Successful Breastfeeding” elaborated on the practice of skin‐to‐skin contact between the mother and her newly born baby indicating that the practice should be “immediate” and “without separation” unless documented medically justifiable reasons for delayed contact or interruption exist. While in immediate, continuous, uninterrupted skin‐to‐skin contact with mother in the first hour after birth, babies progress through 9 instinctive, complex, distinct, and observable stages including self‐attachment and suckling. However, the most recent Cochrane review of early skin‐to‐skin contact cites inconsistencies in the practice; the authors found “inadequate evidence with respect to details … such as timing of initiation and dose.” This paper introduces a novel algorithm to analyse the practice of skin to skin in the first hour using two data sets and suggests opportunities for practice improvement. The algorithm considers the mother's Robson criteria, skin‐to‐skin experience, and Widström's 9 Stages. Using data from vaginal births in Japan and caesarean births in Australia, the algorithm utilizes data in a new way to highlight challenges to best practice. The use of a tool to analyse the implementation of skin‐to‐skin care in the first hour after birth illuminates the successes, barriers, and opportunities for improvement to achieving the standard of care for babies. Future application should involve more diverse facilities and Robson's classifications.

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A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care

Cited by 27 publications

References 22 publications

The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth

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