Reducing mother-infant separation through early skin-to-skin care in a neonatal intensive care unit setting

In neonatal care, mother-infant separation is common even when infants are stable or require only short-term support. Early skin-to-skin (ESTS) care may reduce separation and improve stability, bonding and breastfeeding. We aimed at implementing the practice as a protective quality improvement project.

The study was conducted in a level-2 neonatal intensive care unit (NICU) in Denmark, embedded in routine practice. ESTS was offered whenever feasible to preterm infants, GA ≥ 30 weeks or term infants with low birth weight or respiratory symptoms. ESTS was initiated immediately after birth or when admission was indicated. A neonatal nurse stayed with the infant continuously, providing monitoring, continuous positive airway pressure (CPAP) if needed, and early feeding. Predefined safety and quality measures were recorded.

A total of 65 infants were included (37 preterm/low birth weight; 28 ≥ 35 weeks with respiratory symptoms). Among preterm/low birth weight infants, 32% received CPAP, none developed respiratory distress syndrome and all received ESTS for at least two hours. In the ≥ 35 weeks group, 71% received CPAP, and 36% avoided NICU transfer after short-term support. Overall, 87% were normothermic, 96% had normal glucose and no severe hypoglycaemia occurred. Latching within two hours succeeded in 29%.

In this real-world NICU setting, ESTS proved to be feasible and safe for selected infants. The approach reduced early separation and prevented some admissions without extra resources, supporting family-centred neonatal practice in high-income care.

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