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Skin-to-Skin Contact Improving Health Outcomes:

Skin-to-Skin Contact Improving Health Outcomes Jesse Herse, Justin Charbonneau, Jenna Radke, and Christine Prucha Creighton School of Nursing

Clinical Problem Significance:

Clinical Problem Significance Studies have shown many positive outcomes with skin to skin contact 1,2,3,4 “Neurological, immunological and cognitive outcomes” of breast milk in infants 1 Significantly lower rates of breast feeding with preterm infants 2 Risk for hypothermia with skin to skin contact after cesarean birth 3 “Tradition of separation of the mother and baby after birth” 4

Problem Statement:

Problem Statement There are many differences in clinical practices regarding skin to skin contact that could potentiate negative effects on health outcomes.

PICO question:

PICO question Do mother and newborn dyads that participate in skin-to-skin contact have more positive health outcomes than mother and newborn dyads that do not?

Synthesis Summary:

Synthesis Summary


Sample 18-40 year old mothers and newborn pairs Inpatient for delivery Geographic countries Sweden 1 , United States 2 , Italy 3 , Russia 4

Level of Evidence:

Level of Evidence Level IV moderate to strong 1 Level II strong 2,3,4

Quality of Research Evidence:

Quality of Research Evidence Internal and External Validity Moderate 3 Moderate to strong 1,4 Strong 2 Combined threat of validity: Moderate to strong

Synthesized Findings:

Synthesized Findings Skin to skin contact helps improve health outcomes Positive effects of breastfeeding Consistent with PICO statement

Recommendation for Practice:

Recommendation for Practice Health care providers should provide maximum effort to not separate mothers and infants in the first hours of the infants’ life. 1,2,3,4 Level IV-moderate to strong 1 Level II- strong 2,3,4 Strong consistency among the articles

Implications for Practice:

Implications for Practice Provide education based on EBP regarding skin to skin contact to mothers and families 1,4 Structure of NICU should be built to allow mothers to have constant access to infant 1 Hospital should establish NICU protocol regarding skin to skin contact 3

Cost, Clinical and Quality Outcomes of Recommendation:

Cost, Clinical and Quality Outcomes of Recommendation Cost: Shorter hospital stay Fewer hospitalizations Clinical: Positive effects on breast feeding 1,2,3 and bonding 4 Quality: Increased health outcomes 1,2,3 and bonding 4  Increased QOL

Further Recommendations for Research:

Further Recommendations for Research Closely examine the different hospitalization periods in which skin to skin contact was performed 2 Studies on multiple hospitals 3 Including different types of delivery methods 3 Researching various emotional benefits regarding skin to skin and breast feeding 1


References (1.) Flacking, R., Ewalk, U., & Wallin, L. (2011). Positive effect of kangaroo mother care on long-term breastfeeding in very preterm infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40, 190-197. (2.)Hake-Brooks, S.J., Anderson, G.C. (2008). Kangaroo care and breastfeeding of mother—Preterm infant dyads 0-18 months:A randomized, controlled trial. Neonatal Network, 27(3) 151-159. (3.) Gouchon, S., Gergori , D., Picotta , A., Patrucco , G., Nangeroni , M., & Giulio , P. (2010). Skin-to-skin contact after cesarean delivery:An experimental study. Nursing Research, 59(2), 78-84. (4). Bystrova, K., Ivanova , V., Edhborg , M., Matthiesen , A.S., Ransjo-Arvidson , A.B., Mukhamedrakhimov , R., Uvnas Moberg , K., & Widstrom , A.M. (2009). Early contact versus separation: Effects on mother-infant interaction one year later. Birth, 36(2), 97-109.

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