Skin to skin contact

Published

Specializes in OB, Post Partum, Home Health.

I have started putting all babes skin to skin with mom and I've even convinced almost all of the docs that I work with to let the cord stop pulsating before clamping. I take the bag and mask to the mom's bed and hook it up, I've even given PPV on the mom's abdomen with the cord still attached. I have read lots of studies about the benefits of skin to skin and delayed cord clamping and I must say-my experience has supported it, babe's temps are rarely under 98.0, they breastfeed better and we give far fewer IV's to babes just to give a fluid bolus. Most mom's also love it-now of course I do have the occasional mom that is "grossed out" by having the babe touch her before being wrapped up, and I will honor her requests.

Just wondering if any one else would like to share their success stories.

Up Vote Up Vote ×
Specializes in student; help!.

My last two were born at home (in a tub) and I had them s2s right away. We tracked temps for 24h and saw the same thing, always nice and toasty. No IVs, of course, but DD2 nursed at 17m (after sucking on her paw for a few minutes :heartbeat).

Then again, DD1 was a hospital baby, suctioned for mec, dried, and wrapped before I really got to spend too much time with her, and we had no problems. But given a choice, I go with option A.

Good for you for doing what's best for baby and mama instead of what's convenient for the docs. :yeah:

Up Vote Up Vote ×

My daughter was born 10 weeks early by emergency caesarian due to severe preeclampsia so I didn't get to touch her at all until 2 days after she was born. The NICU nurses strongly suggested skin-to-skin contact (they called it kangaroo care). I tried it and I will say my daughter's VS did improve and she did take my breastmilk much better when we did the kangaroo care. If we do decide to try for another and I make it to term without any problems, I will definitely have them place the baby on me and wait for the cord to stop pulsating. That was what I wanted the first time before the pre-e came into play...

Up Vote Up Vote ×
Specializes in L&D and NICU.

We have had excelled results with skin to skin contact both during the immediate postpartum period for well babies and throughout the NICU stay for NICU babies. some studies show the benefits of delayed cord clamping as a 'mini transfusion' but I have heard a lot of pediatricians complain about polycythemia and increased biliruin levels when there is delayed cord clamping. One pediatrician actually asked a dr to stop delaying cord clamping while she dried the baby because that OBs deliviers had a significantly higher rate of extremely high bilirubin levels. Delayed cord clamping serves a purpose but Its a trade off, an extra boost of blood can likely lead to jaundice which upsets some parents a lot. If the baby is expected to need blood work, etc it helps in building a reserve for this expected blood loss. I think delaying cord clamping should be left up to the discretion of the attending pediatricians in the facility.

Up Vote Up Vote ×
Specializes in L&D and NICU.

And I dont mean the pediatrician determines it for each case, but there would be a standard set by the peds of the facility as when and when to delay cord clamping or which peds like clamping and which do not.

Up Vote Up Vote ×
Specializes in Pediatrics.

JessiD,

Thanks for mentioning about the jaundice! I have started to see (this is anecdotally) in the office that the babies with the delayed cord clamp seem to have worse jaundice in the follow up than those that don't. Especially if they are breastfed too (compared to breastfed and no delay in the clamping).

Since this is becoming a new Thing to Do, I hope someone does some research in the delay-jaundice area. I haven't run across anything in my journals yet.

Up Vote Up Vote ×

This is the article I refer to when people ask me about delayed cord clamping. I believe in the benefits of it, however, our nursery staff seem unable to evaluate babies anywhere except the warmer, so I have been pressured to cut the cord earlier so that the baby can go to the warmer faster :( Sometimes, delayed cord clamping is the only way I can keep a mom and baby together in the first few minutes after birth.

My understanding is there is even more benefit shown in premature babies. I don't have any articles on that at the moment.

http://jama.ama-assn.org/cgi/content/full/297/11/1241

Up Vote Up Vote ×
Specializes in LDRP.

Many of our docs are coming around and are willing to put the baby up on the belly. Most will, if you ask them to. Some do it without asking first-they just assume thats what mom wants. One doc, when presenting the option to a patient, said something like "I can put the baby up on your belly, but its slimy and wet, and we can get it cleaned up first if you'd like" so you could tell he didn't really like the idea.

One mom didn't want the baby on her belly (I offer it to everyone when they are in labor). Nursery came in for delivery and brought a blanket right over to the mom, b/c she was assuming baby would go on belly. Same nurse will do apgars and listen to heart/lungs while baby on mom, help them latch on to mom before ever bringing them to warmer.

I would have LOVED skin to skin with my baby, but he came out kind of bluish, with a 1min apgar of 2. (lt meconium, shoulder dystocia, 4700+grams).

I think all of the docs around here don't do delayed cord clamping. Had a lady who delivered 3mins after getting to hospital. I caught the baby, put him up on her abdomen and was drying him off. Didn't do squat to the cord. 1 or 2mins later, the doc shows up. says "did you do anything to the cord?" i said no! the cord is fine! lol.

Up Vote Up Vote ×

Hi!

I work in a medium-size hospital in Quebec, Canada. In here, it is routine to put babies skin-2-skin with mommy right after birth. We ALWAYS do APGAR scoring on mommy's tummy, and we put babies on warmer ONLY if they need to have neonatal ressuscitation (Only few babies go on the warmer, if they only need oxygen, we even give it directly on the mother). We delay baby care (Vit. K and Illoticyn) after the first feeding, sometimes up to 3 hours! We never bathe our babies in the first twelve hours, and rarely put IV's. Even our c/s moms get to have skin to skin contact with their babies once they're back in the recovery room! I really like the way we practice L&D in my hospital, and I am surprised not every hospital (except acute care ones) don't do the same!

Up Vote Up Vote ×
Specializes in OB, House Sup, ER, Med Surg.

We practice pretty much the same as zyna15 at our small rural hospital. We have really pushed in the past year to get all babies s2s, and delay eyes and thighs until after first feeding. We do bathe babies when we get back to pp, but not until mom and dad are ready for us to. We have recently started recovering C/S babes with mom, and the patients love it. I have seen improved bf continuation rates also.

Up Vote Up Vote ×
Specializes in OB, Post Partum, Home Health.
We have had excelled results with skin to skin contact both during the immediate postpartum period for well babies and throughout the NICU stay for NICU babies. some studies show the benefits of delayed cord clamping as a 'mini transfusion' but I have heard a lot of pediatricians complain about polycythemia and increased biliruin levels when there is delayed cord clamping. One pediatrician actually asked a dr to stop delaying cord clamping while she dried the baby because that OBs deliviers had a significantly higher rate of extremely high bilirubin levels. Delayed cord clamping serves a purpose but Its a trade off, an extra boost of blood can likely lead to jaundice which upsets some parents a lot. If the baby is expected to need blood work, etc it helps in building a reserve for this expected blood loss. I think delaying cord clamping should be left up to the discretion of the attending pediatricians in the facility.

Have you found any studies that support higher bilirubin levels? I did a project on delayed cord clamping and I was unable to find any studies that supported the idea that delayed cord clamping leads to higher bilirubin levels. I found many, many studies that supported the benefits and most of the those studies included checking bilirubin levels-all studies found that bilirubin levels were similar in delayed cord clamping and immediate cord clamping. Based on my research I believe the higher idea of higher bilirubin is a myth.

Up Vote Up Vote ×
+ Join the Discussion