Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns

Feldman-Winter, Lori; Goldsmith, Jay P.

doi:10.1542/peds.2016-1889

Cited by 157 publications

(113 citation statements)

References 71 publications

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“…This also gives a clear role to the companion and provides both motivation to remain with the mother and newborn infant, and an additional opportunity for the baby's safety. Parents thereby have this additional knowledge and can prioritise focus on the newborn infant rather than distractive actions such as phone calls , posting on the Internet, talking to friends or family in the room, which are behaviours that are best postponed until after this unique time.…”

Section: Resultsmentioning

confidence: 99%

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Brimdyr²,

et al. 2019

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Aim This paper integrates clinical expertise to earlier research about the behaviours of the healthy, alert, full‐term infant placed skin‐to‐skin with the mother during the first hour after birth following a noninstrumental vaginal birth. Method This state‐of‐the‐art article forms a link within the knowledge‐to‐action cycle, integrating clinical observations and practice with evidence‐based findings to guide clinicians in their work to implement safe uninterrupted skin‐to‐skin contact the first hours after birth. Results Strong scientific research exists about the importance of skin‐to‐skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short‐ and long‐term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant's instinctive behaviour and maternal responses while in skin‐to‐skin contact. Conclusion The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.

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Section: Resultsmentioning

confidence: 99%

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Brimdyr²,

et al. 2019

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“…This report provided recommendations on safer implementation of these practices, such as use of risk assessment tools, to make the practices of skin-to-skin care and rooming-in safer. 16 …”

Section: | Discussionmentioning

confidence: 99%

“…15 Furthermore, rooming-in promotes family-centered care as the infant is not taken away for pediatric rounds and other routine procedures. 16 …”

Section: | Introductionmentioning

confidence: 99%

Trends in rooming‐in practices among hospitals in the United States, 2007‐2015

Barrera

Boundy

Perrine

2018

Birth

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Background Rooming-in, or keeping mothers and infants together throughout the birth hospitalization, increases breastfeeding initiation and duration, and is one of the Ten Steps to Successful Breastfeeding. Methods The Centers for Disease Control and Prevention’s (CDC) Maternity Practices in Infant Nutrition and Care (mPINC) survey is a biennial census of all birth facilities in the United States and its territories. Data from the 2007–2015 mPINC surveys were used to assess trends in the prevalence of hospitals with most (≥90%) infants rooming-in more than 23 hours per day (ideal practice). Hospital practices among breastfed infants not rooming-in at night and reasons why hospitals without ideal rooming-in practices removed healthy, full-term, breastfed infants from their mothers’ rooms were also analyzed. Results The percentage of hospitals with ideal practice increased from 27.8% in 2007 to 51.4% in 2015. Most breastfed infants who were not rooming-in were brought to their mothers at night for feedings (91.8% in 2015). Among hospitals without ideal rooming-in practices, the percentage removing 50% or more of infants from their mothers’ rooms at any point during the hospitalization decreased for all reasons surveyed during 2007–2015; however, in 2015, hospitals still reported regularly removing infants for hearing tests (73.2%), heel sticks (65.5%), infant baths (40.2%), pediatric rounds (35.5%), and infant photos (25.4%). Conclusions Hospital implementation of rooming-in increased 23.6 percentage points during 2007–2015. Continued efforts are needed to ensure that all mothers who choose to breastfeed receive optimal lactation support during the first days after giving birth.

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“…These assumptions are reflected in the fact that the AAP issues separate guidelines for breastfeeding and for infant sleep. The AAP has recently acknowledged that proximity to mother matters for health (Feldman‐Winter, Goldsmith, Committee, & Newborn, & Task Force On Sudden Infant Death, ; Task Force On Sudden Infant Death S, ) and that breastfeeding matters for health (American Academy of Pediatrics and Section on Breastfeeding, ), but they are each discussed only as risk reduction strategies in guidance on reducing childhood morbidity and mortality. If breastsleeping were treated as the norm, these guidelines would be integrated, and instead, we would be asking about the risks of separation from mother, not solely the risks of sleeping with one's infant.…”

Section: Introductionmentioning

confidence: 99%

Babies in boxes and the missing links on safe sleep: Human evolution and cultural revolution

Bartick

Tomori

Ball

2017

Maternal & Child Nutrition

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Concerns about bedsharing as a risk for sudden infant death syndrome and other forms of sleep-associated infant death have gained prominence as a public health issue. Cardboard "baby boxes" are increasingly promoted to prevent infant death through separate sleep, despite no proof of efficacy. However, baby boxes disrupt "breastsleeping" (breastfeeding with co-sleeping) and may undermine breastfeeding. Recommendations enforcing separate sleep are based on 20th century Euro-American social norms for solitary infant sleep and scheduled feedings via bottles of cow's milk-based formula, in contrast to breastsleeping, an evolutionary adaptation facilitating the survival of mammalian infants for millennia. Interventions that aim to prevent bedsharing, such as the cardboard baby box, fail to consider the implications of evolutionary biology or of ethnocentrism in sleep guidance. Moreover, the focus on bedsharing neglects more potent risks such as smoking, drugs, alcohol, formula feeding, and poverty. Distribution of baby boxes may divert resources and attention away from addressing these other risk factors and lead to a false sense of security wherein we overlook that sudden unexplained infant deaths also occur in solitary sleep environments. Recognizing breastsleeping as the evolutionary and cross-cultural norm entails re-evaluating our research and policy priorities, such as providing greater structural support for families, supporting breastfeeding and safe co-sleeping, investigating ways to safely minimize separation for formula-fed infants, and mitigating the potential harms of mother-infant separation when breastsleeping is disrupted. Resources would be better spent addressing such questions rather than on a feel-good solution such as the baby box.

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Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns

Cited by 157 publications

References 71 publications

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Trends in rooming‐in practices among hospitals in the United States, 2007‐2015

Babies in boxes and the missing links on safe sleep: Human evolution and cultural revolution

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