Training boosts skin-to-skin contact between parents and newborns

Targeted training interventions for both health professionals and parents significantly increase the amount of skin-to-skin contact between newborns and their parents in the first 48 hours after birth. The proportion of babies who received nearly 24 hours of skin contact over the first 24 hours increased from 33 per cent to 58 per cent. This is shown in a new study from Uppsala University.

Skin-to-skin contact helps the baby adjust to life outside the womb, which is perhaps the biggest change a human being goes through. Suddenly, the child has to manage parts of both circulation and nutrition on its own. Skin-to-skin contact facilitates this transition. Body contact is also important to improve the chances of mothers successfully breastfeeding, as well as to facilitate the attachment and bonding between child and parents," says Docent Eva-Lotta Funkquist, a midwife and pediatric nurse and a senior lecturer at Uppsala University, who led the study.

It is well recognised that skin-to-skin contact between parents and newborn babies has significant health benefits for both baby and parent. The 24-hour period immediately after childbirth is particularly important. Yet before the implementation of the programme, only one in three newborns received more than 20 hours of skin contact during the first 24 hours. In healthcare, there has been a need to know how to facilitate this contact. How can healthcare staff be trained to encourage physical contact between children and parents beyond the first crucial hour?

Follow-up after two months

In a new study, researchers have introduced and examined the effects of a special training programme, in which both health professionals and new parents received targeted information on breastfeeding and skin-to-skin contact. The study was carried out at two clinics, in Visby and Uppsala. Parents were recruited in connection with the child's birth and a total of 211 parents participated: 104 parents in a baseline measurement and 107 after the programme was introduced. Parental participation involved recording, on a paper chart developed for the study, how long their child was in skin-to-skin contact with one or other of the parents during the first 48 hours. When the child was two months old, the parents were asked to answer a questionnaire about how the child was cared for.

The results show a clear improvement in the extent of skin-to-skin contact at the beginning of the child's life and support the researchers' thesis: A structured training intervention can improve the care of newborns and their parents during this critical first period of life.

After the targeted training interventions:

• The average time in skin-to-skin contact with the mother increased from 12.9 hours to 14.6 hours during the first 24 hours (p=0.009).
• The proportion of newborns receiving almost constant contact (>20 hours) with one or other of the parents during the first 24 hours increased from 33 per cent to 58 per cent (p=0.001).
• The study showed that children who had more skin-to-skin contact over the first few days were also carried by parents more often after two months, compared with other children.

Parents' arms a key to secure attachment

The researchers behind the study suggest that improved skin-to-skin contact practices can benefit not only the health of the child, but the wellbeing of the whole family. Improved care routines can also influence how parents care for their child later on. Young children are very dependent on their parents and being in their parents' arms is one of the keys to secure attachment.

Poor care practices have meant that instead of making things easier for the child, we have made things more difficult. Women's clinics need to work actively on this issue all the time and our training programme can help improve care."

Docent Eva-Lotta Funkquist, midwife and pediatric nurse and a senior lecturer at Uppsala University