Delivery room cuddles for extremely preterm babies and parents: concept, practice, safety, parental feedback

Abstract

Aim Following extreme preterm birth, there has traditionally been felt an imperative to rush baby to the neonatal unit for ongoing intensive care. Immediate needs of parents to bond with their babies through direct early physical contact have often been overlooked; many weeks can pass before parents get to hold their babies for the first time. Recognition of the importance of early contact is growing. We aimed to review the safety and value of routinely practising delivery room cuddles for extremely preterm babies. Methods We reviewed delivery room cuddles in babies born <27 weeks’ gestation in our centre between 2006 and 2017 via case‐control. We also conducted a questionnaire survey of mothers who experienced a delivery room cuddle to gain their feedback and perspectives. Results We found no difference in age or temperatures on neonatal unit admission. There was no case of inadvertent extubation associated with cuddles. Parental feedback was very positive. Conclusion With appropriate safeguards, delivery room cuddles are feasible and achievable for extremely preterm babies irrespective of birth gestation. Facilitation of the cuddle is an early and very important family‐centred care practice which seems much appreciated by parents and which may improve bonding, lactation, and maternal mental health.

Parental Narratives of Bonding and Relational Experiences with Preterm Infants Born at 23 to 24 Weeks—A Qualitative Descriptive Study

“…Earlier literature shows that an educationalbehavioural intervention program to enhance mothers' participation improved motherinfant interactions scores [35]. Recent literature has reported very positive and meaningful parental experiences related to immediate physical parent-infant closeness among parents of very preterm infants [36][37][38][39]. In addition, immediate skin-to-skin contact was associated with less impaired bonding in a randomised controlled trial including infants born between 25 and 32 weeks of gestation [40].…”

Cuddling very and extremely preterm babies in the delivery room is a positive and normal experience for mothers after the birth

“…To date, one other study in the UK has explored parent experience associated with delivery room cuddles. Clarke et al, using a parent questionnaire design, also reported parental associated feelings including relief, reassurance, pride and love, fear and anxiety 26 …”

“…Clarke et al, using a parent questionnaire design, also reported parental associated feelings including relief, reassurance, pride and love, fear and anxiety. 26 The qualitative design approach used in this project has enabled us to deepen our understanding of the emotional touchpoints associated with the delivery room cuddle and also captures the continuum of emotions that are imbued in the delivery of a high-risk infant.…”

Mother-newborn couplet care: Nordic country experiences of organization, models and practice

“…A RCT in Germany reported less impaired bonding and improved motor and vocal development of the infant, as well as reduced expression in studied stress-related genes in the group receiving immediate skin-to-skin contact, compared to conventional care after a very preterm birth [ 16 , 17 ]. The feasibility, safety and positive parental experiences of “delivery room cuddle”, in which the mother holds her extremely preterm or sick infant for a brief period of time prior to the admission to the neonatal intensive care unit (neonatal unit), have been reported by different study groups in the United Kingdom [ 18 – 20 ]. Non-separation can be attained, and it is preferred by parents, also during the resuscitation of the infant if the stabilization procedure is performed near the mother in the labor ward/operating room [ 21 – 23 ].…”