Aim: To evaluate how different delivery‐ward routines influence temperature in newborn infants. Methods: A total of 176 newborn mother‐infant pairs were included in a randomized study. The babies were kept skin‐to‐skin on the mother's chest (Skin‐to‐skin group), held in their mother's arms, being either swaddled or clothed (Mother's arms group), or kept in a cot in the nursery, being either swaddled or clothed (Nursery group). Temperature was measured in the axilla, on the thigh, back and foot at 15‐min intervals at from 30 to 120 min after birth. Results: During this time period the axilla, back and thigh temperatures rose significantly in all the treatment groups. The foot temperature displayed a significant fall in the babies in the Nursery group and this decrease was greatest in the swaddled babies. In contrast, foot temperature rose in the babies in the Mother's arms group and in particular in babies in the Skin‐to‐skin group. Foot temperature remained high in the Skin‐to‐skin group, whereas the low temperature observed in the Nursery group gradually increased and two days after birth the difference was no longer significant. Conclusion: The results show that delivery‐ward routines influence skin temperature in infants in the postnatal period. Allowing mother and baby the ward routine of skin‐to‐skin contact after birth may be a “natural way” of reversing stress‐related effects on circulation induced during labour.

The results show that delivery-ward routines influence skin temperature in infants in the postnatal period. Allowing mother and baby the ward routine of skin-to-skin contact after birth may be a "natural way" of reversing stress-related effects on circulation induced during labour.

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Study objectives-The main aim of the study was to discover if a midwife home visiting programme has a significant effect on the prevalence of health problems and breast feeding behaviour of mothers who delivered normally and their healthy fullterm newborn babies, during a period of 42 days after delivery. Another aim was to compare the mothers', the midwife's, and the doctor's findings of prevalence of health problems at the end of the puerperium period. Design-A randomised controlled trial was carried out. One group of mothers and their infants were randomly allocated to a home visiting group (Group A); the other group (Group B) was only visited at day 42. Setting-The study was carried out at the University Teaching Hospital (UTH) in Lusaka, the capital city of Zambia. Participants-A total of 408 mothers who had a normal delivery and gave birth to a healthy fullterm infant, as assessed by the attending midwife, were randomised to two groups. Group A consisted of 208 mother/infant dyads who were visited by a midwife in their homes at days 3, 7, 28, and 42 after delivery and Group B consisted of 200 mother/infant dyads who were only visited at day 42. Main results-At day 42 an equal proportion (30%) of mothers in both groups perceived that they had health problems. The prevalence of infant health problems in Group B was significantly higher (p<0.01) as perceived by mothers. There were more mothers in Group B (p<0.01) perceiving insuYcient milk production and giving supplementary feeding. At day 42, mothers in Group A (56%) took more actions than mothers in Group B (41%) to solve infant health problems ( p<0.03). In both groups the mothers' perceived own health problems, were significantly higher (p<0.01) than those observed by the obstetrician and those observed by the midwife. The midwife found more infant health problems in Group B (p< 0.01) than in Group A and more infants with health problems in both groups compared with the paediatrician's findings (p<0.01). Conclusions-There was a significant difference between the mothers' reported health problems and the health problems identified by the midwife and the doctors. The study shows that a midwife home visit and individual health education to mothers, reduce the prevalence of infant health problems, and enables the mother to more often take action when an infant health problem is identified. There is a need to re-evaluate the midwifery training curriculums with the intention to include more infant management care. (J Epidemiol Community Health 1998;52:385-391) The concept of high risk pregnancy has been extensively discussed in recent years 1 and programmes have been suggested to improve the coverage, content and quality of health service and support for the childbearing women. 2-5Less attention has been paid to describing the health and social situation of women as well as their concerns during the postpartum period. Information is limited on mother's self perceived health problems and self care actions for herself and her newborn child and the cor...