Top

Published in:

Open Access 01-12-2019 | Research

Skin-to-skin contact and delivery room practices: a longitudinal survey conducted in Piedmont and the Aosta Valley

Authors: Michelangelo Barbaglia, Enrico Finale, Silvia Noce, Alessandro Vigo, Cesare Arioni, Raffaella Visentin, Elisabetta Scurati-Manzoni, Andrea Guala, SUPC Piedmont and Aosta Valley study group

Published in: Italian Journal of Pediatrics | Issue 1/2019

Abstract

Background

Sudden unexpected postnatal collapse of presumably healthy neonates during early skin-to-skin contact is a rare, yet recognized occurrence, associated with a high risk of mortality and morbidity. A survey was conducted in 2012 in 30 delivery wards throughout Piedmont and the Aosta Valley to evaluate the environmental and logistical aspects that could be linked to SUPC. The survey was again conducted in 2016 in 28 delivery wards in Piedmont and the Aosta Valley in order to evaluate organizational improvements introduced after ministerial indications and recommendations by the Italian Society of Neonatology were published in 2014, in light of new findings regarding the phenomenon.

Methods

A questionnaire specifically asking about the organization of delivery wards, and surveillance or supervision during early skin-to-skin contact, was sent to all of the hospitals taking part in the survey in both 2012 and 2016. The collected data were elaborated anonymously and the statistical analysis was performed by using the two by two table.

Results

In 2012, 28 out of 30 delivery wards in Piedmont and Aosta, with a total of 31,074 newborns out of 35,435, were evaluated in all of the environmental and logistical aspects that might be cause for SUPC to occur. An identical survey was taken again in 2016; 26 out of 28 wards participated with a total of 27,484 newborns out of 30,339. In 2012, early skin-to-skin contact took place immediately in all the delivery rooms in 27 wards, and soon after in the post-partum room in one; in 11 out of 28 wards there was early skin-to-skin contact in the operating theater itself, following caesarean sections (11/26 in 2016). Routine newborn care was given after 3 h in 8 delivery wards (7/26 in 2016); after 2 h in 12 (7/26 in 2016); after 1 h in 2 (4/26 in 2016); after 30 min in 3 (2/26 in 2016); after 10 min in 1 (0/26 in 2016); after 1 or 2 min in 1 (0/26 in 2016) and at any time in one ward (6/26 in 2016).

Conclusion

Periodic surveys of delivery wards are useful for the assessment of all the aspects and risk factors that need to be changed in order to implement safe early skin-to-skin contact.

Available only for authorised users

Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #7. Model hospital policy. Revision 2010. Breastfeed Med. 2010;5:173–7.CrossRef

American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–41.CrossRef

American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and Committee on Obstetric Practice. Special report from ACOG. Breastfeeding: maternal and infant aspects. ACOG Clin Rev. 2007;12:1S–16S.

Andres V, Garcia P, Rimet Y, Nicaise C, Simeoni U. Apparent life-threatening events in presumably healthy newborns during early skin-to-skin contact. Pediatrics. 2011;127:1073–6.CrossRef

Becher JC, Bhushan SS, Lyon AJ. Unexpected collapse in apparently healthy newborns-a prospective national study of a missing cohort of neonatal deaths and near-death events. Arch Dis Child Fetal Neonatal Ed. 2012;97:F30–4.CrossRef

Centers for Disease Control and Prevention, Division of nutrition, physical activity, and obesity: improving hospitals’ support for breastfeeding. 2011.

Dageville C, Pignol J, De Smet S. Very early neonatal apparent life-threatening events and sudden unexpected deaths: incidence and risk factors. Acta Paediatr. 2008;97:866–9.CrossRef

Davanzo R. Best practices ostetrico-neonatologiche per migliorare la sicurezza postnatale del neonato a termine, sano. Protocollo di prevenzione della SUPC. Milano: IRCCS Burlo Garofolo-Dipartimento Materno Neonatale; 2014.

Davanzo R, De Cunto A, Paviotti G, Travan L, Inglese S, Brovedani P, et al. Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding. J Hum Lact. 2015;31:47–52.CrossRef

10.

Feldman-Winter L, Goldsmith JP, Committee on fetus and newborn; task force on sudden infant death syndrome. Safe sleep and skin-to-skin care in the neonatal period for healthy term newborns. Pediatrics. 2016;138(3):e20161889. https://doi.org/10.1542/peds.2016-1889 Epub 2016 Aug 22.CrossRefPubMed

11.

Ferrarello D, Carmichael T. Sudden unexpected postnatal collapse of the newborn. Nurs Womens Health. 2016;20:268–75.CrossRef

12.

Fleming PJ. Unexpected collapse of apparently healthy newborn infants: the benefits and potential risks of skin-to-skin contact. Arch Dis Child Fetal Neonatal Ed. 2012;97:F2–3.CrossRef

13.

Friedman F Jr, Adrouche-Amrani L, Holzman IR. Breastfeeding and delivery room neonatal collapse. J Hum Lact. 2015;31:230–2.CrossRef

14.

Gnigler M, Ralser E, Karall D, Reiter G, Kiechl-Kohlendorfer U. Early sudden unexpected death in infancy (ESUDI)--three case reports and review of the literature. Acta Paediatr. 2013;10:235–8.CrossRef

15.

Herlenius E, Kuhn P. Sudden unexpected postnatal collapse of newborn infants: a review of cases, definitions, risks, and preventive measures. Transl Stroke Res. 2013;4:236–47.CrossRef

16.

Ludington-Hoe SM, Morgan K. Infant assessment and reduction of sudden unexpected postnatal collapse risk during skin-to-skin contact. Newborn Infant Nurs Rev. 2014;1:28–33.CrossRef

17.

Ministero della Salute; Raccomandazioni per la prevenzione della morte o disabilità permanente in neonate sano di peso > 2500 grammi non correlate a malattia congenita, Raccomandazione n° 16. 2014.

18.

Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2012;5:CD003519.PubMedCentral

19.

Marin N, Valverde E, Cabañas F. Severe apparent life-threatening event during “skin-to-skin”: treatment with hypothermia. An Pediatr. 2013;79:253–6.CrossRef

20.

Pejovic NJ, Herlenius E. Unexpected collapse of healthy newborn infants: risk factors, supervision and hypothermia treatment. Acta Paediatr. 2013;102:680–8.CrossRef

21.

Peters C, Becher JC, Lyon AJ, Midgley PC. Who is blaming the baby? Arch Dis Child Fetal Neonatal Ed. 2009;94:F377–8.PubMed

22.

Poets A, Steinfeldt R, Poets CF. Sudden deaths and severe apparent life-threatening events in term infants within 24 hours of birth. Pediatrics. 2011;127:869–73.CrossRef

23.

Wellchild. Guidelines for the investigation of newborn infants who suffer a sudden and unexpected postnatal collapse in the first week of life: recommendations from a Professional Group on Sudden Unexpected Postnatal Collapse. London; 2011.

24.

UNICEF/WHO; Baby-friendly hospital initiative. The ten steps to successful breastfeeding. (revised 2018). https://www.who.int/nutrition/bfhi/ten-steps/en/

25.

Piumelli R, Davanzo R, Nassi N, Salvatore S, Arzilli C, Peruzzi M, et al. Apparent life-threatening events (ALTE): Italian guidelines. Ital J Pediatr. 2017;43:111.CrossRef

26.

Colson SD, Meek J, Hawdon JM. Optimal Positions triggering primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev. 2008;84(7):441–9.CrossRef

27.

Colson S. Does the mother’s posture have a protective role to play during skin to skin contact? Clin Lact. 2014;5:41.CrossRef

28.

Ilardi L, e Gruppo di Lavoro SUPC della Sezione Lombarda SIN. Raccomandazioni per la prevenzione del Sudden Unespected Postnatal Collapse. Milano: Biomedia Ed; 2018.

Title: Skin-to-skin contact and delivery room practices: a longitudinal survey conducted in Piedmont and the Aosta Valley
Authors: Michelangelo Barbaglia
Enrico Finale
Silvia Noce
Alessandro Vigo
Cesare Arioni
Raffaella Visentin
Elisabetta Scurati-Manzoni
Andrea Guala
SUPC Piedmont and Aosta Valley study group
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: Italian Journal of Pediatrics / Issue 1/2019
Electronic ISSN: 1824-7288
DOI: https://doi.org/10.1186/s13052-019-0688-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Skin-to-skin contact and delivery room practices: a longitudinal survey conducted in Piedmont and the Aosta Valley

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics

The association of prenatal and postnatal macrolide exposure with subsequent development of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis

Otogenic temporomandibular septic arthritis in a child: a case report and a review of the literature

SIADH versus adrenal insufficiency: a life-threatening misdiagnosis

Extreme thrombocytosis in systemic juvenile idiopathic arthritis. A case report

Effect of vitamin D3 seasonal supplementation with 1500 IU/day in north Italian children (DINOS study)