An implementation algorithm to improve skin-to-skin practice in the first hour after birth

Area of Science:

• Neonatal care
• Maternal-infant bonding
• Public health interventions

Background:

• Skin-to-skin contact (SSC) and early breastfeeding are recommended for maternal and infant well-being.
• The WHO/UNICEF 'Ten Steps to Successful Breastfeeding' emphasize immediate, uninterrupted SSC.
• Previous reviews noted inconsistencies and inadequate evidence regarding optimal SSC timing and duration.

Purpose of the Study:

• To introduce a novel algorithm for analyzing the implementation of SSC in the first hour postpartum.
• To identify challenges and opportunities for improving SSC practices.
• To assess SSC based on maternal Robson criteria, experience, and infant instinctive stages.

Main Methods:

• Development of a new algorithm to analyze SSC in the first hour after birth.
• Utilization of two datasets: vaginal births in Japan and caesarean births in Australia.
• Integration of maternal Robson criteria, SSC experience, and Widström's 9 Stages into the analysis.

Main Results:

• The algorithm provides a novel way to analyze SSC data, highlighting implementation challenges.
• The analysis illuminates successes, barriers, and areas for improvement in achieving optimal SSC standards.
• Data from diverse birth settings (vaginal and caesarean) were used to test the algorithm's utility.

Conclusions:

• The developed algorithm offers a valuable tool for evaluating and improving early skin-to-skin care practices.
• Further application of the algorithm in diverse facilities and with varied Robson classifications is recommended.
• This approach can help standardize and enhance the quality of immediate postpartum SSC.