Impact of Skin-to-Skin Contact
Globally, approximately three million infants die within the first 28 days of life. Almost 99 percent of such deaths are reported in low- and middle-income countries (Houweling et al., 2019). Scientific evidence supports the use of skin-to-skin contact (SSC) within the first hours of birth for the benefit of both the mother and the baby (Singh et al., 2017). The data has led organizations such as the World Health Organization, Academy of Breastfeeding Medicine and the Neonatal Resuscitation Program, and the American Academy of Pediatrics to recommend SSC in clinical practice. SSC requires placing a naked infant on the mother’s chest as opposed to drying and wrapping an infant with a towel after birth. The exposed side of the baby can be covered with a blanket. The process helps regulate the infant’s heart rate, breathing, temperature, and stimulates the excretion of hormones to hasten breast milk (Nissen et al., 2019). Singh et al. (2017) note that in many low- and middle-income countries, only a small percentage incorporate SSC in practice. Many families lose their babies within the first weeks of birth. Implementation of SSC has the potential to change the statistics on neonatal mortality and give families comfort. It is essential to provide evidence on SSC and its impact on neonatal mortality and hypothermia.
PICOT Question: Among healthy newborn infants in low- and middle-income countries, does early skin-to-skin contact of the baby with the mother in the first hour of life compared with drying and wrapping have an impact on neonatal mortality and hypothermia?
Safari, K., Saeed, A. A., Hasan, S. S., & Moghaddam-Banaem, L. (2018). The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor. International breastfeeding journal, 13(1), 32.
The authors in this article argue that maternal and neonatal death is excessively high in Iraq. SSC is underutilized in the country’s healthcare facilities despite the high maternal and newborn mortality. The authors conducted a quasi-experimental study to evaluate the impact of early SSC on the instigation of breastfeeding, infant temperature, and length of third stage labor. The results of the study indicate that when SSC is used, newborns initiate breastfeeding within two minutes of birth compared to those without SSC that start breastfeeding at five minutes. Also, 98 percent of infants in the SSC group reported normal temperature, with only 2 percent showing signs of hypothermia compared to 42 percent of newborns in standard routine care. The mothers who applied SSC also showed shorter third stage labor compared to those without the intervention. The article recommends incorporating early SSC in Iraq health care facilities because it is straightforward and cost-effective.
The study’s strength is that the authors conducted a quasi-experimental study to observe and measure the outcomes. Using a scientific research design gives the article credibility necessary to make an appropriate conclusion. The other strength of the study is that it uses multiple sources from previous research to strengthen the findings. The authors also ensured the references are current to provide the most relevant results on the subject matter. The only weakness of the study is that it did not use random sampling. This increases the risk of bias in the analysis of the data collected.
The article will be useful to the EBP project because it provides strong evidence in favor of SSC. Given that the study was conducted in Iraq, it offers viable data on the use of SSC in low- and middle-income countries. The information matches the EBP project because it focuses on how SSC can be used effectively in developing countries. Using the article will ensure that credible data is available for completing the EBP project.
Nissen, E., Svensson, K., Mbalinda, S., Brimdyr, K., Waiswa, P., Odongkara, B. M., & Hjelmstedt, A. (2019). A low-cost intervention to promote immediate skin-to-skin contact and improve temperature regulation in Northern Uganda. African Journal of Midwifery and Women’s Health, 13(3), 1-12.
In this article, the authors assert that SSC is supported by evidence to avoid hypothermia in newborns. They conducted a quasi-experimental design to investigate whether a low-cost intervention in hospitals in Uganda can increase SSC and determine if SSC contributes to stable temperature in newborns. The research findings showed that implementing an SSC intervention led to an increase of 54.8 percent incorporation of the technique by mothers compared to previous zero percent. The length of SSC also increased to at least one hour of continuous contact. In terms of temperature, the use of SSC showed higher body temperature within five minutes of birth and at 60 minutes. Also, the mother’s breast temperature increased, showing positive outcomes for both the mother and infant.
The study’s strength lies in the fact that an experimental study was conducted in a low-income country. The researcher conducted the study in Northern Uganda to find credible data that informs the benefits of SSC in clinical practice. Another strength includes the precise organization of the article. The authors used rich and ordered subheadings that make the flow of the material accurate and readable. Also, the report incorporated updated sources to back up its conclusions. Using current sources increases the credibility of the article. The article’s weakness is that the researchers did not indicate how the intervention would be sustained in Uganda. Without a clear path, the intervention may not be continually executed in Uganda’s health care facilities after the research study.
The article will be beneficial in the EBP project because it helps expound on the need for SSC in health care facilities. It explains the limitations leading to poor application of SSC, a fact that would be useful in the EBP project. Also, the article helps recognize the challenges in developing countries like Uganda and the techniques that can help mothers incorporate SSC to reduce infant mortality rates. Such data will be incorporated into the EBP project to reinforce the arguments.
Karimi, F. Z., Sadeghi, R., Maleki-Saghooni, N., & Khadivzadeh, T. (2019). The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: A systematic review and meta-analysis. Taiwanese Journal of Obstetrics and Gynecology, 58(1), 1-9.
Karimi et al. ‘s article explore the impact of mother-infant SSC on the success and duration of initial breastfeeding. The authors analyzed randomized controlled trials from databases of PubMed, SID, Scopus, Google Scholar, and Magiran. The study came up with a total of nine trials to analyze. Conclusions from all the studies indicated that SSC contributes to significant stress reduction in infants because a substantial drop in salivary cortisol levels was noted. The study further showed that stress in infants occurs when separated from the mother. Further, a higher initial breastfeeding success was identified among infants who underwent SSC. A 95 percent difference was noted in breastfeeding interval between infants receiving SSC compared to those who did not. The study concluded that SSC was recommended as a significant clinical procedure that can improve newborn outcomes by promoting better breastfeeding for optimal health.
The strength of the study includes the credibility of the authors. The authors of the article are researchers from the Mashhad University of Medical Sciences who have completed many other publications in the pediatric and midwifery field. A note at the end of the article also states that the researchers reported they did not have a conflict of interest. Another strength of the report is that the study incorporated multiple peer-reviews materials as sources. The use of peer-reviews sources enhanced the credibility of the findings. The references are also recent, providing reliable conclusions relevant to the current clinical field. The article’s weakness is that the authors did not conduct a study to measure the findings from the trial. Any limitations of bias in the previous studies are carried down to the current study.
The article will be suitable for the EBP project because it provides additional information in support of SSC. While the study is not actually conducted in a low-income country, the findings are still significant. The data obtained can be applied in developing countries as a strategy to help families and lower incidents of child mortality.
Weldearegay, H. G., Medhanyie, A. A., Abrha, M. W., Tadesse, L., Tekle, E., Yakob, B., … & Arsenault, C. (2019). Quality of Kangaroo Mother Care services in Ethiopia: Implications for policy and practice. PloS one, 14(11).
The article argues that the provision of excellence kangaroo mother care (KMC), also often known as skin-to-skin contact, contributes to improved health outcomes for premature babies. However, in Ethiopia, data on KMC remains largely unavailable. The authors evaluated 2016 data from the Ethiopian Emergency Obstetric and Newborn care (EmONC). The EmONC included a cross-sectional study of data collected from all Ethiopian public hospitals and major private facilities providing maternal and newborn care within 12 months. The researchers found that the use of KMC services was poor in Ethiopia. Out of the 768 low birth weight infants included in the study, only 356 (approximately 46.4 percent) received some form of KMC. The data further shows that 66.7 percent of infants that received KMC survived compared to 12.9 percent that died. However, a lot of data, such as discharge reports, were missing in the majority of many other cases.
The study’s main strength is that it assesses the use of SSC in a low-and middle-income country. The data provided in the article follows the routine procedures and processes used when dealing with babies with low birth weight in the developing world. Through the study, a clear picture of the use of SSC in the developing world emerges. The authors use data from the Ethiopian maternal and newborn departments making it authentic to examine the state of SSC in the country. The other strength lies in the fact that the authors used sources from different parts of Ethiopia. The authors compare data from Tigray, Amhara, and Addis Ababa to ensure that a clear picture of the use of SSC in Ethiopia could be mapped out. The only weakness in the study is that the study does not have previous studies in Ethiopia that could be used for comparisons. The study is as good as the data used to create it.
The article will prove beneficial in the EBP project because it provides guidelines on why SSC use is limited in a low-income country. It is clear that the data can provide guidelines on how SSC programs can be implemented to benefit babies with low birth weight. The article will guide research on understanding the implication of use or lack of SSC within clinical settings using data from a low- and middle-income economy.
Singh, K., Khan, S. M., Carvajal–Aguirre, L., Brodish, P., Amouzou, A., & Moran, A. (2017). The importance of skin–to–skin contact for early initiation of breastfeeding in Nigeria and Bangladesh. Journal of global health, 7(2).
Signh et al. research investigate the rate in the use of SSC and its connection to the early initiation of breastfeeding in Bangladesh and Nigeria. The authors used Demographic and Health Survey (DHS) data collected in 2013 in Nigeria and 2014 in Bangladesh. Findings indicate the use of SSC among newborns in Nigeria and Bangladesh remains significantly low, with 10 percent in Nigeria and 26 percent in Bangladesh. In both countries, SSC was linked to an early start in breastfeeding and better quality of life. Also, the data showed that infants born through cesarean section had a 67 percent decreased likelihood of initiating breastfeeding. Children born in a health facility had a 30 percent lower rate of using SSC compared to those born in a non-facility environment. SSC in Nigeria often occurred in urban areas and among wealthy or privileged groups.
One strength of the article is that it incorporated data from two developing countries. The reader can see the incidents and application of SSC in low-income countries and its associated implication. The other strength of the article is that the authors used many sources to strengthen their arguments. Many of the sources are current, making it evident that the data can be replicated and used to implement better SSC strategies in the developing world. The weakness of the article is that the data is limited in these two countries. More data from other low- and middle-income countries should be collected to strengthen the authors’ arguments.
The article will provide valuable information on the EBP project. It provides comprehensive data on the use of SSC and the reasons SSC is not used to the maximum in developing countries. The information will help determine suitable recommendations for the implementation of SSC in low-income countries.
Conclusion
Skin-to-skin contact has gained significant attention over the recent past. However, its application, especially in low-and middle-income countries still remains weak. Many incidents of infant mortality in poorer countries have led researchers to try and understand how the situation can be remedied. The information will not only help governments and those in power implement reliable measures but also give families hope.