Skin-to-skin contact and delivery room practices: a longitudinal survey conducted in Piedmont and the Aosta Valley

Sudden Unexpected Postnatal Collapse: Review and Management

Sudden unexpected postnatal collapse (SUPC) of healthy newborns is a catastrophic event caused by cardiorespiratory collapse in a healthy newborn. The most common cause of SUPC is poor positioning of the newborn during skin-to-skin contact or breastfeeding when the newborn is not being observed by a health professional, attentive parent, or caretaker. Maternal/newborn health care professionals need to know about the essential information, definitions, incidence, risk factors, clinical presentation, outcomes, and prevention and management strategies to minimize the occurrence and impact of SUPC. A sample SUPC hospital policy is included in the manuscript.

Working dilemmas in care for breastfed newborns: An exploratory study in a single center in Taiwan

BACKGROUND

Clinical medical staff should be aware of and examine the correlation between breastfeeding and neonatal hospitalization. Additional attention should be paid to work dilemmas experienced by the nursing staff caring for newborns to avoid exposing newborns to hospitalization risk.

OBJECTIVE

The present study investigated the working dilemmas by neonatal nurses caring for breastfed newborns and risk of newborn hospitalization.

METHODS

This hospital-based study in Taiwan surveyed 84 neonatal nurses using a structured questionnaire entitled "Working Dilemmas in Clinical Care for Breastfed Newborns."

RESULTS

Collected data were analyzed statistically (descriptive analysis, chi-square test, and t test) using Statistical Package for the Social Sciences (SPSS) software. Neonatal intensive care unit (NICU) staff noted that breastfed newborns showed a high risk of hospitalization and nursery staff highlighted a lack of manpower and time. NICU staff experienced more working dilemmas (117.460±12.260) than nursery staff (87.410±15.820) when caring for breastfed newborns (t = 1.080, P <  0.001). NICU staff reported a higher risk of hospitalization in breastfed newborns and experienced more working dilemmas caring for these patients compared with nursery staff, who reported a lack of manpower and time.

CONCLUSION

Our findings highlight the working dilemmas by neonatal nurses and can serve as a foundation for further critical studies.

Amamentação na primeira hora de vida em município do interior do Rio de Janeiro: fatores associados

Resumo Objetivo analisar a amamentação na primeira hora de vida e os fatores associados em um município do interior do Rio de Janeiro. Método estudo online transversal, realizado entre maio de 2021 e agosto de 2022, com 97 parturientes do município de Rio das Ostras. Na associação entre variáveis, adotaram-se o Teste Qui-Quadrado e regressão logística. Resultados entre as participantes, 77,3% pariram na maternidade pública e 22,7% na maternidade privada. A prevalência da amamentação na primeira hora de vida na sala de parto e no alojamento conjunto foi, respectivamente, de 21,6% e 58,3%, com diferenças significativas entre as maternidades. Puérperas da maternidade pública tiveram mais chances de não amamentar na primeira hora de vida. Ter ensino básico aumentou as chances de o bebê não ser amamentado na sala de parto e não realizar contato pele a pele precoce, além de não ser amamentado no alojamento conjunto. Conclusão e implicações para a prática a amamentação na primeira hora de vida não atingiu níveis preconizados, e distintos fatores associados à sua ocorrência foram identificados, como nível de instrução, local do parto e contato pele a pele. Recomenda-se que maternidades implementem as práticas humanizadas no cuidado ao recém-nascido, para elevar as taxas da amamentação na primeira hora de vida.

Breastfeeding in the first hour of life in a city in the countryside of Rio de Janeiro: associated factors

Abstract Objective to analyze breastfeeding in the first hour of life and associated factors in a city in the countryside of Rio de Janeiro. Method a cross-sectional online study, carried out between May 2021 and August 2022, with 97 parturient women in the municipality of Rio das Ostras. In the association between variables, the chi-square test and logistic regression were used. Results among the participants, 77.3% gave birth in the public maternity hospital and 22.7% in the private maternity hospital. The prevalence of breastfeeding in the first hour of life in the delivery room and in rooming-in was, respectively, 21.6% and 58.3%, with significant differences between maternity hospitals. Postpartum women from the public maternity hospital were more likely to not breastfeed in the first hour of life. Having basic education increased the chances of the baby not being breastfed in the delivery room and not having early skin-to-skin contact and not breastfeeding breastfed in rooming-in. Conclusion and implications for practice breastfeeding in the first hour of life did not reach recommended levels and different factors associated with its occurrence were identified, such as education level, place of childbirth and skin-to-skin contact. It is recommended that maternity hospitals implement humanized practices in newborn care to increase breastfeeding rates in the first hour of life.

Survey of Skin-to-Skin Contact with Obstetrics and Pediatric Nurses

Skin-to-skin, or chest-to-chest, contact (SSC) between newborns and their mothers is known as kangaroo mother care. The physiological and psychological benefits of SSC for infants and mothers are well established. The World Health Organization (WHO) recommends practicing SSC for term and preterm newborns. However, in Saudi Arabia, SSC is not practiced as widely as recommended. There is insufficient evidence of the nurses' knowledge and attitudes regarding SSC in Saudi Arabia. The aims of this study were to describe and determine relationships between knowledge, education, beliefs/attitudes, and the implementation of SSC in Jeddah, Saudi Arabia. Thank You for Your Time and Kind Suggestion Methods: Cross-sectional descriptive data were collected from 40 nurses using an English-language version of a knowledge, beliefs/attitudes, education, and implementation questionnaire used by others. Results: The mean age of the nurses was 42.4 years (SD = 3.2), with a mean experience of 12 years (SD = 2.1). The mean total score of SSC knowledge was 13.6 (SD = 2.3), the mean of total score of attitudes/beliefs was 12.3 (SD = 3.1), the SSC education mean score was 17.1 (SD = 3.4), and the SSC implementation mean score was 17.0 (SD = 4.1). In total, 55% of the nurses were not sure of the impact of SSC on brain development in neonates, 45% could not interpret infants' responses during SSC; 67% disagreed that it was the nurses' responsibility to facilitate SSC, 37.5% were not aware of SSC guidelines, and 47% of the nurses had not received any continuing education on SSC in their units. Pearson correlations revealed a significant association between SSC implementation and nurses' knowledge level (r = 0.297, p = 0.031), education (r = 0.85, p = 0.015), and beliefs (r = 0.31, p = 0.024). Conclusions: Once nurses have improved their knowledge, education, and beliefs/attitudes, SSC implementation may concomitantly increase. A continuing education program and clear guidelines are needed to promote SSC adoption in practice.

Maternal and Neonatal Prognostic Factors for Cardiorespiratory Events in Healthy Term Neonates During Early Skin-to-Skin Contact

BACKGROUND

During early skin-to-skin contact (ESSC), alterations in peripheral oxygen saturation (SpO₂) and heart rate (HR) have been frequently observed.

OBJECTIVES

This study aimed to determine the incidence of cardiorespiratory events (CREs) during ESSC in healthy term newborns (HTNs) and estimate the association of maternal and neonatal prognostic factors with the risk of CREs.

METHODS

A pooled analysis of the cohort from a clinical trial involving healthy mother-child dyads during ESSC was performed. Pulse oximetry was employed to continuously monitor SpO₂ and HR within 2 h after birth. The individual and combined prognostic relevance of the demographic and clinical characteristics of dyads for the occurrence of a CRE (SpO₂ <91% or HR <111 or >180 bpm) was analyzed through logistic regression models.

RESULTS

Of the 254 children assessed, 169 [66.5%; 95% confidence interval (95% CI), 60.5-72.5%] had at least one CRE. The characteristics that increased the risk of CRE were maternal age ≥35 years (odds ratio, 2.21; 95% CI, 1.19-4.09), primiparity (1.96; 1.03-3.72), gestational body mass index (BMI) >25 kg/m² (1.92; 1.05-3.53), and birth time between 09:00 p.m. and 08:59 a.m. (2.47; 1.02-5.97).

CONCLUSION

CREs were more frequent in HTNs born during nighttime and in HTNs born to first-time mothers, mothers ≥35 years, and mothers with a gestational BMI >25 kg/m². These predictor variables can be determined during childbirth. Identification of neonates at higher risk of developing CREs would allow for closer surveillance during ESSC.

[Sudden unexpected postnatal collapse in a neonate]

A healthy full-term female neonate, aged 3 days and born by vaginal delivery (with a 1-minute Apgar score of 10 and a 5-minute Apgar score of 10), had unexpected cardiac and respiratory arrests in the early morning on day 3 after birth and recovered to spontaneous breathing and heartbeat after a 10-minute resuscitation. The child had poor response and convulsion after resuscitation. Blood gas analysis showed metabolic acidosis, and amplitude-integrated EEG showed a burst-suppression pattern. She was diagnosed with sudden unexpected postnatal collapse but improved after hypothermia and symptomatic/supportive treatment. This article reports the first case of sudden unexpected postnatal collapse in China and summarizes related risk factors, pathophysiological mechanisms, and preventive and treatment measures of this disorder.

Best practices, challenges and innovations in pediatrics in 2019

This paper runs through key progresses in epidemiology, pathomechanisms and therapy of various diseases in children that were issued in the Italian Journal of Pediatrics at the end of last year. Novel research and documents that explore areas such as allergy, critical care, endocrinology, gastroenterology, infectious diseases, neonatology, neurology, nutrition, and respiratory tract illnesses in children have been reported. These observations will help to control childhood illnesses.