Cochrane Review on Skin to Skin
Some comments from different hospitals to this same issue.
We use active warming measures prior to scheduled C-sections:
Institute Active Warming Measures 30 minutes prior to surgery
Warmed IV and irridation fluids
Warm blankets. socks, limit skin exposure
Forced air warming system (paws or hugger)
We do skin to skin in the OR routinely, on well mothers and babies. We have never done triplets before, but we did today! 36+6 weeks! the babies self-attached in the OR, <quite a few of them do>, but these were triplets and all of them nursed on the table. We then go to the PACU skin to skin where all of them do nurse, if they haven't already!
We have not had a problem with cold babies after cesareans that I am aware of. We are starting a pilot project in January beginning skin-to skin in the OR. I will have more info after all of that data is gathered!
We pre-warm our surgical patients in Pre-op with a bair hugger and all IV fluids go through a fluid warmer pre-op and intra-op. This has significantly reduced our hypothermic moms in PACU.....so I bet it has done the same with babies.
I'm preparing for the pilot in January, we came across some techniques and terms that not all OB staff were familiar with. Some nurses bring the unwrapped baby over to the mother and place him on her chest and then cover them both with blankets. Depending on the distance of your mom from your baby warmer and your room temp, the baby could get cold in the transfer. The suggestion was to wrap the baby in a "hotdog" roll for transfer and skin-to-skin time. Basically a warmed bath blanket is folded over the baby like a hotdog bun. It can overlap for the transfer and then open up for the baby (hotdog) to go skin-to-skin with mom so the baby is never fully exposed to the cold air.
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Resources from Professional Organizations
AAFP - American Academy of Family Practitioners
AAP - American Academy of Pediatrics
ABM - Academy of Breastfeeding Medicine: Clinical Protocols
ACOG - American College of Obstetricians and Gynecologists Clinical Review: Breastfeeding: Maternal and Infant Aspects
AWHONN - Association of Women's Health, Obstetric, and Neonatal Nurses
Baby-Friendly Hospital Initiative (BFHI) at Boston Medical Center is a research-tested intervention designed to implement hospital practices that support breastfeeding.
Bottle Feeding Resources
CDC - Guide to Breastfeeding Intervention: http://www.cdc.gov/breastfeeding/
ILCA - International Lactation Consultants Association - www.ilca.org
The Joint Commission
Medications for Mother's Milk - http://www.infantrisk.com/
For information about safety of medications during lactation, contact the Texas Tech Infant Risk Center. Open to answer calls Monday-Friday 8am-5pm central time. (806)-352-2519.
For information about safety of medications during lactation, contact the Texas Tech Infant Risk Center.
Open to answer calls Monday-Friday 8am-5pm central time. (806)-352-2519.
Milk Banking Information
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Smoking and Breastfeeding US Breastfeeding Committee - www.usbreastfeeding.org
The Model Policy: Payer Coverage of Breastfeeding Counseling Services, Pumps, and Supplies was created by USBC to identify best practices for payers that appropriately meet the requirements of the Affordable Care Act and ensure adequate delivery of breastfeeding support, using the language, format, and terminology applicable for expedient, meaningful use by this audience. The Model Policy is intended to guide payers in determining insurance coverage. As such, it focuses on those health care professionals who are customarily credentialed by insurers3 to provide health care services in today’s insurance marketplace. This policy does not address community-based counseling and support options, offered by organizations and individuals in settings not currently covered by insurance. Model Policy Payer Coverage Breastfeeding Support 2013 Model Payer Policy Cover Letter
World Health Organization (WHO)
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