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Early Skin-to-Skin After Cesarean to Improve Breastfeeding

Hung, Kristina J. MS, RN, CNS; Berg, Ocean MSN, RN, CNS

MCN, American Journal of Maternal Child Nursing: September/October 2011 - Volume 36 - Issue 5 - p 318–324
doi: 10.1097/NMC.0b013e3182266314
FEATURE ARTICLE: CE Connection

This article describes a quality improvement project in which early skin-to-skin (STS) contact, in the operating room (OR) and during recovery, was used as an intervention to increase the success of breastfeeding initiation among healthy infants after cesarean, at a large, urban, acute care teaching hospital. The nursing role is key for the intervention, but the program involves the entire perinatal team, including the obstetricians, pediatricians, and anesthesiologists. During the first 3 months of our intervention, the rate of early STS among healthy babies born by cesarean increased from 20% to 68%. The rate of infants who did not get STS contact within 4 hours of birth decreased from 40% to 9%. Nine months after the initiation of the intervention, 60% of healthy cesarean births utilized STS in the OR, and 70% involved STS within 90 minutes of birth. Healthy infants born by cesarean who experienced STS in the OR had lower rates of formula supplementation in the hospital (33%), compared to infants who experienced STS within 90 minutes but not in the OR (42%), and those who did not experience STS in the first 90 minutes of life (74%). We concluded that STS contact was feasible after cesarean and could be provided for healthy mothers and infants immediately after cesarean birth. Perinatal and neonatal nurses should be leaders in changing practice to incorporate early STS contact into routine care after cesarean birth.

Nurses have been in the forefront of studying family-centered methods of newborn care which not only promote attachment, but also improve health markers. In this QI project, nurses show how skin-to-skin care improves rates of one more important marker: breastfeeding after cesarean birth.

Kristina J. Hung is a perinatal nurse at San Francisco General Hospital and Trauma Center. She can be reached via e-mail at kristinahung@gmail.com

Ocean Berg is a Perinatal Clinical Nurse Specialist at San Francisco General Hospital and Trauma Center.

The authors have disclosed that there are no financial relationships related to this article.

For 121 additional continuing nursing education articles on neonatal topics, go to nursingcenter.com/ce

© 2011 Lippincott Williams & Wilkins, Inc.