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<html lang="en" class="hexml-course s2e"><!--[if lt IE 8]> <html class="oldie"> <![endif]--><!--Generated at Wed, 12 Oct 2022 23:23:13 +0000--><head><meta name="author" content='["Carole Dobrich"]'><meta name="course" content="MA03"><meta name="topic" content="3.3"><meta http-equiv="content-type" content="text/html; charset=utf-8"><meta name="copyright" content="2022 Health e-Learning"><meta name="robots" content="NONE,NOARCHIVE"><meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=0"><link rel="stylesheet" href="//static.health-e-learning.com/jigsaw/design/hexml.pack.css?v=1665616993" type="text/css"><script type="text/javascript" charset="utf-8" src="//static.health-e-learning.com/jigsaw/design/hexml.pack.js?v=1665616993"></script><title>MA03: Addressing barriers to skin-to-skin</title></head><body class="loading"><div class="ajax-modal Fixed"></div><div class="watermark"><span>Health e-Learning</span></div><div id="access"><a href="#access" accesskey="a">Access Keys</a><a href="#menu" accesskey="m">Skip to Menu</a><a href="#content" accesskey="c">Skip to Content</a><a href="#footer" accesskey="f">Skip to Footer</a></div><div id="nav"><span class="nav-menu">Maintaining BFHI Education for Nurses and Midwives - Series 2</span><a id="hamburger" href="#"><span class="hamburger hamburger--collapse"><span class="hamburger-box"><span class="hamburger-inner"></span></span></span></a><div class="progress-container"><div id="myBar" class="progress-bar"></div></div></div><nav id="menu"><ol><li><a href="topic_1-0.html"><span class="menu-item-icon">1.0 </span><span class="menu-item-title">Introduction</span></a></li><li><a href="topic_2-0.html"><span class="menu-item-icon">2.0 </span><span class="menu-item-title">Protection of Breastfeeding [Domain 1]</span></a><ol><li><a href="topic_2-1.html"><span class="menu-item-icon">2.1 </span><span class="menu-item-title">A Code History Timeline</span></a></li><li><a href="topic_2-2.html"><span class="menu-item-icon">2.2 </span><span class="menu-item-title">Marketing - the role of the International Code</span></a></li></ol></li><li><a href="topic_3-0.html"><span class="menu-item-icon">3.0 </span><span class="menu-item-title">Understanding the importance of skin-to-skin</span></a><ol><li><a href="topic_3-1.html"><span class="menu-item-icon">3.1 </span><span class="menu-item-title">Infant innate behaviours</span></a></li><li><a href="topic_3-2.html"><span class="menu-item-icon">3.2 </span><span class="menu-item-title">Skin-to-skin and the role of the Health Worker</span></a></li><li class="current mm-selected"><a href="topic_3-3.html"><span class="menu-item-icon">3.3 <i class="fa fa-caret-right" aria-hidden="true"></i></span><span class="menu-item-title">Addressing barriers to skin-to-skin</span></a></li><li><a href="topic_3-4.html"><span class="menu-item-icon">3.4 </span><span class="menu-item-title">The loving relationship</span></a></li></ol></li><li><a href="topic_4-0.html"><span class="menu-item-icon">4.0 </span><span class="menu-item-title">Postnatal Interventions</span></a><ol><li><a href="topic_4-1.html"><span class="menu-item-icon">4.1 </span><span class="menu-item-title">The chemistry of feeding</span></a></li></ol></li><li><a href="topic_5-0.html"><span class="menu-item-icon">5.0 </span><span class="menu-item-title">Special needs and infant challenges [Domain 6]</span></a><ol><li><a href="topic_5-1.html"><span class="menu-item-icon">5.1 </span><span class="menu-item-title">The 'late preterm' 'early term' baby</span></a></li><li><a href="topic_5-2.html"><span class="menu-item-icon">5.2 </span><span class="menu-item-title">Ankyloglossia</span></a></li></ol></li><li><a href="topic_6-0.html"><span class="menu-item-icon">6.0 </span><span class="menu-item-title">Managing common difficulties</span></a><ol><li><a href="topic_6-1.html"><span class="menu-item-icon">6.1 </span><span class="menu-item-title">Engorgement</span></a></li><li><a href="topic_6-2.html"><span class="menu-item-icon">6.2 </span><span class="menu-item-title">Hyperlactation</span></a></li></ol></li><li><a href="topic_7-0.html"><span class="menu-item-icon">7.0 </span><span class="menu-item-title">Supplementation</span></a><ol><li><a href="topic_7-1.html"><span class="menu-item-icon">7.1 </span><span class="menu-item-title">Feeding-line device at the breast or chest</span></a></li><li><a href="topic_7-2.html"><span class="menu-item-icon">7.2 </span><span class="menu-item-title">Cup feeding</span></a></li><li><a href="topic_7-3.html"><span class="menu-item-icon">7.3 </span><span class="menu-item-title">Finger Feeding</span></a></li></ol></li><li><a href="topic_8-0.html"><span class="menu-item-icon">8.0 </span><span class="menu-item-title">Closing session</span></a><hr></li><li class="appendix"><a href="references.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-book i-topic"></i></span><span class="menu-item-title">List of references</span></a></li><li class="appendix"><a href="contents.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-file-text-o i-topic"></i></span><span class="menu-item-title">Course contents</span></a></li><li class="appendix"><a href="full.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-print i-topic"></i></span><span class="menu-item-title">Print version</span></a></li></ol></nav><div id="content"><h1 id="top">3.3 Addressing barriers to skin-to-skin</h1><section class="section" id="Barriers_to_skin-to-skin"><h2>Barriers to skin-to-skin</h2> <blockquote> <div class="content-node"> <p>The major barriers to skin-to-skin care (SSC) at birth are lack of personnel, time constraints, and safety concerns. Training, designated health personnel for SSC, and teamwork are the key interventions likely to improve SSC at birth.</p> </div> </blockquote> <div class="content-node"> <p> <strong>Concern that the newborn will get cold. </strong> </p> <ul> <li>Place newborn's abdomen directly on the mother/birthing parent's chest, without drying</li> <li>Skin-to-skin is immediate (directly from the mother/birthing parent)</li> <li>Newborn is extended as much as possible, so as much skin contact as possible (oxytocin)</li> <li>Newborn is dried, especially back and head</li> <li>Newborn is then covered with a dry blanket</li> <li>Skin-to-skin re-warms cold babies better than in an incubator or warmer (hypothermia = 36.3 C)</li> </ul> <p></p> <p> <strong>Newborn needs to be examined.</strong> </p> <ul> <li>Most examinations can be conducted with a newborn on the mother's/birthing parent's chest.</li> <li>There is no need to move the newborn to monitor vital signs.</li> <li>Weighing can be delayed.</li> </ul> <p></p> <p> <strong>Mother/birthing parent needs suturing.</strong> </p> <ul> <li>Newborn can stay on the mother's/birthing parent's abdomen while an episiotomy is sutured.</li> <li>Newborn can stay on the mother's/birthing parent's chest while suturing a cesarean section wound16.</li> </ul> <p></p> <p> <strong>Newborn needs to be bathed.</strong> </p> <ul> <li>Delaying the first bath provides better thermoregulation and allows the vernix to remain on the skin.</li> <li>Gently wipe the newborn dry after birth, preserving the vernix.</li> <li>Vernix retention is associated with significantly higher skin hydration, a lower skin pH, and significantly less erythema.</li> <li>Early bathing is associated with a significant fall in temperature. </li> </ul> <p></p> <p> <strong>Delivery/birthing room is busy.</strong> </p> <ul> <li>Mother/birthing parent and newborn can be transferred to the postnatal ward while in skin-to-skin contact.</li> </ul> <p></p> <p> <strong>Insufficient staff to remain with the mother/birthing parent.</strong> </p> <ul> <li>A responsible family member can stay with the mother/birthing parent and newborn.</li> <li>Discuss routine precautions with the family member to ensure their safety.</li> <li>Monitoring of maternal and newborn infant vital signs by staff should continue as per hospital standards.</li> </ul> <p></p> <p> <strong>Newborn is not alert.</strong> </p> <ul> <li>If a newborn is sleepy due to maternal medications it is even more important that the newborn has contact as he/she needs extra support to bond and feed.</li> </ul> <p></p> <p> <strong>Mother/Birthing parent is tired.</strong> </p> <ul> <li>A mother/birthing parent is rarely so tired that they do not want to hold their infant.</li> <li>Contact with her infant can help the birthing parent to relax.</li> <li>Review labor practices such as withholding fluid and foods, and practices that may increase the length of labor.</li> <li>Skin-to-skin care and breastfeeding is best when the birthing parent is in a semi-reclined position; a good position for resting.</li> </ul> <p></p> <p> <strong>Lack of knowledge in the health professional wishing to move the infant</strong> </p> <ul> <li>This first step following birthing has far-reaching effects on the birthing parent, infant, and breastfeeding.</li> <li>Train all birthing room staff in the effects of immediate and undisturbed skin-to-skin contact. </li> <li>Refer all staff to the hospital policy which they must follow. Hospital breastfeeding policies will reflect the 10 Steps to Successful Breastfeeding, including Step 4.</li> </ul> </div> <section class="section" id="https://www.llli.org/skin-to-skin-is-as-easy-as-1-2-3/"><h3>Resources</h3> <div class="captionBox"><img width="1587" height="2245" data-src="images/Copy-of-123-Skin-to-Skin-Contact-1.png" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt="Skin-to-skin Contact"><p>Skin-to-skin Contact. <br>&copy; Developed by Magdalena Whoolery and Carole Dobrich. Illustrations by Angela Eastgate. May (2020)</p></div> <div class="content-node"> <p>This poster is available in multiple languages on the<img alt="External" src="//static.health-e-learning.com/jigsaw/design/external.gif"><a href="https://www.llli.org/skin-to-skin-is-as-easy-as-1-2-3/" title="External link" target="_blank"> LLLI website</a>.</p> </div> </section> </section><div id="footer"><a href="topic_3-2.html" rel="prev" class="prev">&laquo; Prev</a><a href="topic_3-4.html" rel="next" class="next">Next &raquo;</a><br style="clear: both"><div class="floating-menu"><button class="theme-toggle" title="Toggle colors (dark or light)"><i class="fa fa-moon-o"></i></button><button class="gotoTop" title="Back to top"><i class="fa fa-chevron-up"></i></button></div><a href="javascript:%20window.print()" id="printLink">Print this page</a><span class="noPrint"> | </span>&copy; 2022 Health e-Learning<p class="printOnly">COPYRIGHT: You are permitted to print ONE (1) copy for your personal use only. No graphics, tables, quizzes, videos, etc, may be used in any form without express written consent. Author: ["Carole Dobrich"]</p><p class="dateUpdated">Updated on Wed, 12 Oct 2022 23:23:13 +0000</p></div></div></body></html>
