Mother‐Newborn Couplet Care from theory to practice to ensure zero separation for all newborns

Klemming, Stina; Lilliesköld, Siri; Westrup, Björn

doi:10.1111/apa.15997

Cited by 32 publications

(30 citation statements)

References 18 publications

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“…Obstetricians took daily rounds for mothers and attended immediately to their urgent needs. We learnt from experience of mother-newborn couplet care in Sweden [17,18]. A strong co-operation, co-ordination, and collaboration between pediatricians and obstetricians is the cornerstone of MNCU.…”

Section: Care For the Mother In Mncumentioning

confidence: 99%

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

et al. 2022

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While a Cochrane review (2016) showed that kangaroo mother care (KMC) initiated after clinical stabilization reduces mortality by 40%, evidence of the effect of initiating KMC immediately after birth without waiting for babies to become stable was unavailable until recently. This research gap was addressed by a multicountry, randomized, controlled trial co-ordinated by WHO. This trial was conducted in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania. Implementation of this trial led to development of the “mother–newborn care unit (MNCU).” Mother–newborn care unit or mother–newborn intensive care unit (M–NICU) is a facility where sick and small newborns are cared with their mothers 24 × 7 with all facilities of level II newborn care and provision for postnatal care to mothers. The mother is not a mere visitor, but she has her bed inside the special newborn care unit (SNCU)/newborn intensive care unit (NICU) and as a resident of MNCU, becomes an active caregiver and is involved in continuum of neonatal care. The study results show that intervention babies in MNCU had 25% less mortality at 28 d of life, 35% less incidence of hypothermia, and 18% less suspected sepsis as compared to control babies cared in conventional NICU. World Health Organization is in the process of reviewing the current recommendations on care of preterm or LBW newborns considering new evidence that has become available. However, it would require national policy change to permit mother and surrogate in SNCU/NICU 24 × 7, making the concept of zero-separation a reality.

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Section: Care For the Mother In Mncumentioning

confidence: 99%

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

et al. 2022

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“…In a study from two Scandinavian neonatal intensive care units (NICU), infants with a median gestational age (GA) of 32 weeks had a median time to first SSC of 6 h 10 . Reasons for not practicing SSC in the early postpartum period have included logistic challenges 11 …”

Section: Introductionmentioning

confidence: 99%

Immediate skin‐to‐skin contact may have beneficial effects on the cardiorespiratory stabilisation in very preterm infants

et al. 2022

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Aim Our aim was to investigate what effect immediate skin‐to‐skin contact with a parent had on the cardiorespiratory stabilisation of very preterm infants. Methods This randomised clinical trial was conducted during 2018–2021 at two university hospitals with three neonatal intensive care units in Norway and Sweden. Infants born from 28+0 to 32+6 weeks of gestation were randomised to immediate skin‐to‐skin contact with a parent for the first six postnatal hours or standard incubator care. The outcome was a composite cardiorespiratory stability score, based on serial measures of heart and respiratory rate, respiratory support, fraction of inspired oxygen and oxygen saturation. Results We recruited 91 newborn infants with a mean gestational age of 31+1 (range 28+4–32+6) weeks and mean birth weight of 1534 (range 555–2440) g: 46 received immediate skin‐to‐skin contact and 45 received incubator care. The group who received skin‐to‐skin contact had an adjusted mean score of 0.52 higher (95% confidence interval 0.38–0.67, p < 0.001) on a scale from zero to six when compared to the control group. Conclusion Immediate skin‐to‐skin contact for the first six postnatal hours had beneficial effects on the cardiorespiratory stabilisation of very preterm infants.

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“…The NICU has 19 beds, with 9 single-family rooms (two rooms are twins) and 8 beds in an open bay and family-centered and developmentally supportive care are implemented in it. Parents are invited to participate and be part of their childcare, as is indicated by the evidence [ 28 ]. From the admission, parents work together with staff.…”

Section: Methodsmentioning

confidence: 99%

Lateral Kangaroo Care in Hemodynamic Stability of Extremely Preterm Infants: Protocol Study for a Non-Inferiority Randomized Controlled Trial CANGULAT

Collados-Gómez

Esteban‐Gonzalo

López-López

et al. 2021

IJERPH

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Introduction: This study aims to assess the efficacy of the modified kangaroo care lateral position on the thermal stability of preterm neonates versus conventional kangaroo care prone position. Material and methods: A non-inferiority randomized parallel clinical trial. Kangaroo care will be performed in a lateral position for the experimental group and in a prone position for the control group preterm. The study will take place at the neonatal intensive care unit (NICU) of a University Hospital. The participants will be extremely premature infants (under 28 weeks of gestational age) along the first five days of life, hemodynamically stable, with mother or father willing to do kangaroo care and give their written consent to participate in the study. The sample size calculated was 35 participants in each group. When the premature infant is hemodynamically stable and one of the parents stays in the NICU, the patient will be randomized into two groups: an experimental group or a control group. The primary outcome is premature infant axillary temperature. Neonatal pain level and intraventricular hemorrhage are secondary outcomes. Discussion: There is no scientific evidence on modified kangaroo care lateral position. Furthermore, there is little evidence of increased intraventricular hemorrhage association with the lateral head position necessary in conventional or prone kangaroo care in extremely premature newborns. Kangaroo care is a priority intervention in neonatal units increasing the time of use more and more, making postural changes necessary to optimize comfort and minimize risks with kangaroo care lateral position as an alternative to conventional prone position kangaroo care. Meanwhile, it is essential to ensure that the conventional kangaroo care prone position, which requires the head to lay sideways, is a safe position in terms of preventing intraventricular hemorrhage in the first five days of life of children under 28 weeks of gestational age. Trial registration at clinicaltrials.gov: NCT03990116.

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Mother‐Newborn Couplet Care from theory to practice to ensure zero separation for all newborns

Cited by 32 publications

References 18 publications

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

Immediate skin‐to‐skin contact may have beneficial effects on the cardiorespiratory stabilisation in very preterm infants

Lateral Kangaroo Care in Hemodynamic Stability of Extremely Preterm Infants: Protocol Study for a Non-Inferiority Randomized Controlled Trial CANGULAT

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