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Proposed guidelines for skin-to-skin care and rooming-in should be more inclusive

Journal of Perinatology volume 38, pages 1277–1278 (2018)Cite this article

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Dear Editor,

We read with interest the recent commentary “The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. A critical review of the literature” published in the Journal of Perinatology [1]. Table 2, created by Gomez-Pomar and Blubaugh, provides a potential order set for “safe skin-to-skin care,” reportedly based on recommendations provided by the AAP [2] and Davanzo [3]. However, the guidance provided is unnecessarily restrictive and is inconsistent with recommendations endorsed by the American Heart Association/American Academy of Pediatrics/International Liaison Committee on Resuscitation (AHA/AAP/ILCOR) neonatal resuscitative guidelines [4]. There is no evidence that near-term newborns (37–38 weeks gestation), or those with no prenatal care, maternal fever, history of drug exposure, prolonged rupture of membranes, non-life-threatening congenital anomalies, infants <2500 g, or suspicion of chorioamnionitis require stabilization on a warmer bed. These newborns may be stabilized and assessed on the mother while in skin-to-skin care (SSC). Infants with meconium staining with normal respiratory effort, good tone, and heart rate >100 may also be placed immediately in SSC. Furthermore, late preterm newborns (≥35 weeks gestation) may have SSC if stable, with good tone, normal heart rate, respiratory effort, and Apgar score of ≥7 at 5 min. In the event of positive pressure ventilation, SSC should be postponed until the infant is stabilized, but is not precluded [5].

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References

  1. Gomez-Pomar E, Blubaugh R. The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. A critical review of the literature. J Perinatol. 2018. https://doi.org/10.1038/s41372-018-0068-0.

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Authors and Affiliations

  1. Department of Pediatrics, Cooper University Health Care, Camden, NJ, USA

    Lori Feldman-Winter

  2. Department of Pediatrics, York Hospital, WellSpan Health, York, PA, USA

    Michael H. Goodstein

  3. Department of Family Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

    Fern R. Hauck

  4. Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Robert A. Darnall

  5. Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

    Rachel Y. Moon

Authors
  1. Lori Feldman-Winter
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  2. Michael H. Goodstein
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  4. Robert A. Darnall
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  5. Rachel Y. Moon
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American Academy of Pediatrics Task Force on SIDS

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Correspondence to Lori Feldman-Winter.

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Feldman-Winter, L., Goodstein, M.H., Hauck, F.R. et al. Proposed guidelines for skin-to-skin care and rooming-in should be more inclusive. J Perinatol 38, 1277–1278 (2018). https://doi.org/10.1038/s41372-018-0175-y

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