Skin‐to‐skin contact after birth: Developing a research and practice guideline

Brimdyr, Kajsa; Stevens, Jeni; Svensson, Kristin; Blair, Anna; Turner‐Maffei, Cindy; Grady, Julie; Bastarache, Louise; al Alfy, Abla; Crenshaw, Jeannette T.; Giugliani, Elsa Regina Justo; Ewald, Uwe; Haider, Rukhsana; Jonas, Wibke; Kagawa, Mike; Lilliesköld, Siri; Maastrup, Ragnhild; Sinclair, Ravae; Swift, Emma; Takahashi, Yuki; Cadwell, Karin

doi:10.1111/apa.16842

Cited by 22 publications

(6 citation statements)

References 81 publications

(203 reference statements)

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“…Skin-to-skin contact is one of the four components of kangaroo care and has become a worldwide standard of care due to its positive effects on infant global health, including the stabilization of neonatal physiological parameters, better state of sleep, weight gain, reduction in the length of hospital stay, breastfeeding and bonding optimization, and increase in cortical activity [26][27][28][29][30]. A guideline developed based on the World Health Organization's guideline development process has recommended that, irrespective of the mode of birth, immediate, continuous, and uninterrupted skin-to-skin contact should be the standard of care for all mothers and newborns [31].…”

Section: Rationale For the Interventionmentioning

confidence: 99%

Randomized Controlled Trial Protocol on the Effects of a Sensory Motor Intervention Associated with Kangaroo Skin-to-Skin Contact in Preterm Newborns

Reco,

Soares-Marangoni

2024

IJERPH

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There is still very limited evidence on the effects of neonatal interventions on infant neurodevelopmental outcomes, including general movements (GMs). This research will primarily assess the effects of a sensory motor physical therapy intervention combined with kangaroo skin-to-skin contact on the GMs of hospitalized preterm newborns. Secondary outcomes include body weight, posture and muscle tone, behavioral state, length of hospital stay, and breastfeeding. This study protocol details a two-arm parallel clinical trial methodology, involving participants with a postmenstrual age of 34–35 weeks admitted to a Neonatal Intermediate Care Unit (NInCU) with poor repertoire GMs. Thirty-four participants will be randomly assigned to either the experimental group, receiving a 10-day sensory motor physical therapy associated with kangaroo skin-to-skin contact, or the control group, which will only receive kangaroo skin-to-skin contact. The study will measure GMs (primary outcome), and body weight, posture and muscle tone, behavioral state, length of hospital stay, and breastfeeding (secondary outcomes). Data collection occurs in the NInCU before and after the intervention, with follow-up measurements post discharge at 2–4 weeks and 12–15 weeks post-term. SPSS will be used for data analyses. The results will provide novel information on how sensory motor experiences may affect early neurodevelopment and clinical variables in preterm newborns.

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Section: Rationale For the Interventionmentioning

confidence: 99%

Randomized Controlled Trial Protocol on the Effects of a Sensory Motor Intervention Associated with Kangaroo Skin-to-Skin Contact in Preterm Newborns

Reco,

Soares-Marangoni

2024

IJERPH

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“…However, the implementation and definition of skin‐to‐skin contact has been inconsistent in both research studies and clinical practice. Brimdyr et al used the World Health Organization's guideline development process to produce skin‐to‐skin guidance for the first hour after birth, including clear step‐by‐step instructions 1 . In his Editorial, Whitelaw states that because skin‐to‐skin contact for newborn infants and their mothers seems such a natural activity, many readers may not know how recent it is, how it was established and how it has been tested 2 …”

Section: Research and Practice Guideline On Skin‐to‐skin Contact Afte...mentioning

confidence: 99%

Issue highlights

Lagercrantz¹,

Käll²

2023

Acta Paediatrica

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“…The SSC method is routinely practiced intermittently for preterm infants in the neonatal unit. Because of its multiple benefits, SSC between newborn infants and mothers provided in the immediate period after birth is considered the standard of care . For infants born preterm, the timing of SSC initiation can vary greatly .…”

Section: Introductionmentioning

confidence: 99%

“…Because of its multiple benefits, SSC between newborn infants and mothers provided in the immediate period after birth is considered the standard of care. [1][2][3][4] For infants born preterm, the timing of SSC initiation can vary greatly. 5,6 In a Swedish population-based register study, only a minority of infants born before gestational week 32 received SSC within their first day of life.…”

Section: Introductionmentioning

confidence: 99%

Skin-to-Skin Contact at Birth for Very Preterm Infants and Mother-Infant Interaction Quality at 4 Months

Lilliesköld,

Lode-Kolz,

Rettedal

et al. 2023

JAMA Netw Open

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ImportanceGood-quality parent-infant interactions have protective effects on infant socio-emotional and behavioral development. These interactions are especially critical for very preterm infants at risk of vulnerabilities related to immaturity. Skin-to-skin contact (SSC) has been found to improve mother–preterm infant interaction behaviors, but few studies exist regarding its benefits when initiated immediately after birth.ObjectiveTo determine the effect of immediate SSC at birth for very preterm infants on mother-infant interaction quality at 4 months of corrected age.Design, Setting, and ParticipantsThis secondary analysis used data from the Immediate Parent-Infant Skin-to-Skin Study (IPISTOSS), a randomized clinical trial conducted between April 1, 2018, and June 30, 2021, at 3 neonatal units in Sweden and Norway. Participants included very preterm infants (28-33 gestational weeks of age) and their parents. Four-month follow-up was concluded in December 2021. Data analyses were performed on March 16 and September 18, 2023.InterventionInfants were allocated to standard incubator care or SSC with either parent initiated at birth and continued throughout the first 6 hours after birth.Main Outcomes and MeasuresThe primary outcome was mother-infant interaction quality as measured with the Parent–Child Early Relational Assessment (PCERA), based on video recordings of a 5-minute free-play situation with mother-infant dyads at 4 months of corrected age. A multilevel regression analysis was performed.ResultsThis analysis included 71 infants (31 twins [44%]) and 56 mothers. Infants had a mean (SD) gestational age of 31 weeks 3 (1.3) days, and more than half were male (42 [59%]); mothers had a mean (SD) age of 32 (4.9) years. There were 37 infants allocated to standard care and 34 to SSC with either parent after birth. During the first 6 hours after birth, fathers provided more SSC than mothers, with a median (IQR) of 3.25 (2.25-4.5) and 0.75 (0-2.5) hours, respectively. A statistically significant difference in 1 of 5 PCERA subscales (subscale 3: infant positive affect, communicative and social skills) was observed, with higher-quality mother-infant interaction in the SSC group at 4 months (Cohen d = 0.67 [95% CI, 0.17 to 1.17]; P = .01). This effect remained significant when adjusting for primiparity, child sex, and observation setting.Conclusions and RelevanceIn this study of the effect of immediate parent-infant SSC after very preterm birth, SSC was beneficial for the mother-infant relationship. These findings suggest that immediate SSC should be supported in the clinical setting.Trial RegistrationClinicalTrials.gov Identifier: NCT03521310

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Skin‐to‐skin contact after birth: Developing a research and practice guideline

Cited by 22 publications

References 81 publications

Randomized Controlled Trial Protocol on the Effects of a Sensory Motor Intervention Associated with Kangaroo Skin-to-Skin Contact in Preterm Newborns

Randomized Controlled Trial Protocol on the Effects of a Sensory Motor Intervention Associated with Kangaroo Skin-to-Skin Contact in Preterm Newborns

Issue highlights

Skin-to-Skin Contact at Birth for Very Preterm Infants and Mother-Infant Interaction Quality at 4 Months

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