Guidelines
Updated: 3/24/2010 &4/12/2014
______ 2006 Australian J Nurs
Skin to skin contact should be promoted and KC encouraged in the first
24 hours after birth. This is a grade A recommendation on pg. 32
Aboudiab et al. 2007
FT, case studies of Birth KC altes and gives guidelines that it is nurse’s
responsibility to watch closely for these events.
Academy BF Medicine, 2002-06 FT Protocol on BF, recommends birth KC to help initiate breastfeeding
(pulled up protocol after reading Chantry, 2005 below)
Academy of BF Medicine, 2010
PT & FT, use KC as second best pain reduction intervention
Amer Acad Fam Physicians 2001 PT, FT Recommends KC to facilitate breastfeeding initiation
Amer Acad Pediatrics 2005
FT and PT, recommends birth KC until infant has completed first feed
for fullterms and says that KC should be encouraged as soon as poss
ible for preterm and risk infants.
Amer Acad Peds 2012
FT, Direct skin to skin contact with mother immediately after delivery
until first feed is accomplished and encouraged throughout postpartum
period (6 weeks).
Amer Acad Ped 2011or 2012
FT, recommends that KC be continued postpartally and through 3
months?
Amer Acad ped & AHA 2000
PT & FT. recommends KC for keeping baby warm in NRP steps
Amer Acad Ped & AHA 2006
FT recommends birth KC for initial steps of resuscitation and
thermoregulation of healthy term infants on page 1-18. NRP
recommends Birth KC
Amer Acad Ped & AHA 2011
PT, FT, continues to recommend birth kc if infant does not need
resuscitation. Specific statements are under Kattwinkel et al. 2010
Amer Acad Ped , Can Ped 2006
PT, FT, Neonatal. Use KC to decrease pain.
ACOG 2000
FT, recommends birth KC
ACOG 2007
FT, recommends birth KC
Anand et al., 2006
Neonatal Pain Group recommends KC for procedural pain in term and
preterm infants
Andres et al., 2007
FT 6 case studies of ALTEs and deaths with Birth KC and BF in first
two hrs postbirth. Gives guidelines for nurses vigilant observation of
primp moms and babies and has list of contraindications to birthkc.
AWHONN 2000,2008
FT, recommends birth KC for breastfeeding
Batton et al., 2006`
Becher et al., 2011
FT, PT. Review that says now CPS and AAP recommend KC to reduce pain
FT, SUPC guidelines (60% of cases cause is known after postmortem which should
be done on all dead babies. Lists the tests to do while baby is still alive and in postmortem
Becher et al., 2012
FT, ALTEs and deaths with birth KC and BF, but both should continue
with nurses being more vigilant and parents assessing airway, breathing
and color of infant. Other guidelines are primip, prone positioning, etc.
Bergh et al. 2012
PT, her implementation scoring system has monitoring items that could be
used as standards for accreditation
Black 2012
PT, Says KC is one of the first steps in initiating breastfeeding (pg. 13)
Bogota Declaration
PT, FT
Branger et al. 2007
FT, Altes and deaths in BirthKC. provides CONTRAINDICATION
guidelines for BirthKC
Canadian Ped Society 2012
PT Position Statement. See Jefferies et al., 2012 below and this refers
to many published guidelines by Ludington-Hoe, DiMenna, etc. See
also Jefferies, 2013 which is same article.
Cattaneo, D &T, 1998
CDC (2005)
FT. On page 1 of chapter?? It states “ skin-to-skin
contact should be given to improve breastfeeding outcomes.” Also in
Shealy
CDC 2005
FT, page 1 says KC should be done to promote breastfeeding – also
CDCP 2007
CDC 2008
CDC, 2011
Chalmers 1999
Chalmers 2000
Chalmers 2009
Chandry 2005
Charpak, FC, R, 2000
Charpak, R& F, 2000
Charpak et al., 2005. 25 yrs .
.
Children’s Hosp Philly 2007
Chitty et al., 2013
Chiu et al., 2005
Clarke, 2009
Cleary et al., 1997
Crenshaw 2007
Dageville et al., 2008
Davanzo, 1993
Davanzo et al., 2013
Davanzo & Cattaneo, 1995
Demott et al., 200 6
Di Menna, 2006
Drosten-Brooks, 1993
Espagne et al., 2004
European Commission 2006
Franck, Bernal, & Gale, 2002
Galligan 2006
Henderson 2011
Int Lactation Assoc 1999
under Shealy et al.,
FT, national survey of USA hospitals practice of birth KC to promote
breastfeeding.
FT, national survey results of 2700 birth centers shows poor Birth KC
practice and poor support for breastfeeding in hospitals. Long way to
go to achieve Healthy People objective
PT, FT, BF success recommendations for hospitals to follow
FT. Academy of Breastfeeding Medicine guidelines say it is NOT
appropriate to separate mom and infant immediately after birth and that
KC immediately after birth is recommended routine to promote
breastfeeding and to prevent hypoglycemia
PT, protocol and procedure for transfer of ventilated infants into KC
and protocol/policy for KC with preterm infants..
PT, review that KC has sufficient evidence for it to be used
meticulously in all health care settings as much as any other
thermoregulatory intervention like hats, radiant warmers, etc.
FT. guidelines for KCBF and KC immediately after birth on page 120.
Review of KMC for meeting Millenium Dev. Goals, and recommends
KMC for rich and poor and advantaged and disadvantaged sources of
childhealth care. Says rich nations should learn from poor in relation to
KMC.
Presents Lamaza International’s recommendation for Birth KC and
continuous KC throughout postpartum and that all treatments be done
in mom’s room.
FT. Over one year in 22 hospitals 2 BirthKC ALTEs and one was okay
and other has CP. Provides guidelines for watching : primip, 1 st two
hours, watch soft bedding,etc.
PT, lack of policy for KMC use in NICU hinders KMC use so they
provided a sample policy based on INK recommendations
FT, UK guidelines for breastfeeding with many sections on Birth KC and
need to feed with KC within 30-70 minutes of birth.
PT. Provides evidence-based guidelines for Neonatal unit KC and
ventilated KC.
FT, ALTEs with Birth KC and may have some guidelines
FT, PT, guidelines for breastfeeding and all feeding practices from
antenatal period through one year of life. Many citations about use of
Birth KC to facilitate initiation of BF.
Review Of hospitals that have practices, how many of each
FT, Evidence based guidelines (hat, position, check at 15,30, 60 mins
post start of KC, etc) for rewarming fullterms for milk hypothermia
with KC rather than warmers
FT, Review of breastcrawl events and quotes USBC and AAP
guidelines. UNICEF recommends the breast crawl as the “preferred
method for initiating breastfeeding.”
FT, recommends non-separation and birth KC for breastfeeding.
Int Lact Assoc,2007
FT and some PT, Trifold about how to support BF with Birth KC and
recognize signs of readiness for BF.
Jefferies et al. 2012
PT., Position statement of Canadian Paediatric Society that supports
KC with preterm infants and says it should encouraged in nurseries that
care for preterm infants >26 wks GA
Jefferies & CPA,2013
PT, Review article that is same as Canadian Paediatric Society 2012
and Jefferies et al., 2012. Says in abstract that “
Kattwinkel et al., 2010
FT, new NRP guidelines that say term infant who spontaneously
breathes or cries and has good muscle tone should not be separated
from mother and should be placed in skin-to-skin contact with the
mother with both of them covered with dry linen and that infants may
continue to be observed for breathing, activity, and color while in
contact with the mother. (See Lewis 2012 too)
Kenner et al., 20??
Pt, The Comprehensive Neonatal Nursing text has a sample protocol on
page 1121.
Klaus, 2009
FT, recommends birth KC because there is critical period for
establishing maternal-infant interaction (Bystrova et al., 2009)
Lago et al., 2009
Italian Pediatric Society recommendations for pain management
include KC for “non-routine” heel sticks.
Lamp & Zadvinskin 2009
FT., guidelines for non-separation post birth for healthy term infants.
Lazarov 1994
FT, guidelines for implementing STEP FOUR of baby Friendly that
Speaks to Very Early KC within 30 minutes of birth for better BF.
Lewis, 2012
FT, Review of the Kattwinkel report of 2010 NRP GUIDELINES and
it says the same as the report: term infant who spontaneously breathes
or cries and has good muscle tone should not be separated from mother
and should be placed in skin-to-skin contact with the mother with both
of them covered with dry linen and that infants may continue to be
observed for breathing, activity, and color while in contact with the
mother
Ludington-Hoe & Swinth, 1993
PT
Ludington-Hoe et al 1994
PT -KC with stable prematures, relates head cap use, flexed prone
position, containment, insulation, head/neck issues, maternal legs
elevated, etc.
Ludington-Hoe et al., 2003 (JOGNN, vol. 32 #5) KC with ventilated infants.
Ludington-Hoe et al. 2008
PT, has step by step procedure for ventilated KC
NANN 2009
PT, step by step poster showing transfer into and out of ventilated KC
National Collaborating Ctr 2006 FT. This is national UK policy for postnatal care for women and their
babies that includes KC
MacDonald, 2005
FT, PT, review of European blueprint for BF that says health workers
should have commitment to best practices and Ludington adds that
Birth KC is a best practice. Good general guidelines for a country to
follow to get BF moving.
Martinez 2007
Recommends KC to all pediatricians, Great succinct review
Moran et al. 2013
PT, FT, USAID and Save the Children are considering adding birth KC to their list
of evaluative criteria for good perinatal care for all infants (the Mat Newborn Child
Health evaluation criteria) See also Stanton 2013.
Munson et al. 2012
PT, late preterm care guidelines and it recommends Birth KC,
postpartum KC, home KC and continuous KC as much as possible plus
surrogate KC to minimize late preterm infant problems.
NANN Brd Directors, 2009
Position Statement on Breastfeeding that says that KC is an important
component of transitioning the infant from tube feedings to direct
feedings at the breast.
NANN Brd Director 2012
Position statement on BF and it says that KC really helps and tells how
to use it to this end.
Nyqvist, 2004
PT. Includes the policy and BF guidelines for KMC in Sweden
PT. Provides guidelines on page 40 of article that they don’t do KMC
in first week of life for infants <1000 to prevent hypothermia and not
for ventilated infants who are unstable with transfer, and after these, no
frequency or duration of KMC restrictions.
Nyqvist etal., 2008
PT, moms recommended new steps for Baby Friendly Hosp. Initiative
and KC constitutes step 5on page 257.
Nyqvist 2009
PT, FT in NICU, international guidelines for KMC in neonatal
intensive care to be adopted by WHO for adding to their Practical
Guidelines book.
Nyqvist et al., 2009
PT, FT. Recommendations (extensive) from Swedish Meeting of KMC
network in 2008.
Nyqvist et al. 2010
PT /FT. HAS MANY RECOMMENDATIONS FROM INK
Nyqvist et al., 2010 (State of Art) PT/FT, has many recommendations from INK and guidelines for
ventilated KC
Nyqvist & Heinemann, 2011
PT, Review Ideally KMC is initiated and continues uninterrupted in
infants born at ≥ 32 weeks, also after cesarean and this is also possible
at 28-31 wks gestational age. For infants <27 weeks Gestation,
intermittent KMC can be introduced during the first week of life based
on individual assessment.
NYqvist et al., 2012
PT, guidelines for expanding baby friendly into NICU. Three principles
were added to Baby Friendly to guide NICU Baby Friendly: 1)staff
attitude is focused on mother, not staff 2) family friendly environment
must be supported, 3) health system provides continuity of care.
Quasem et al., 2003
PT/FT. Simple criteria for choosing KMC babies in community care
Safe Motherhood 2004
FT, newsletter about how the WHO 1996 guidelines for normal term
birth are being followed. Be sure to see also SAndin-Bojo articles on
same topic.
Sandin-Bojo, 2004-2011
FT, skin-to-skin within 30 minutes after delivery is considered
QUALITY care given by midwives. They developed a tool to measure
QUALITY Care, something like the Bologna scale and others. Great
Delphi technique
Save the Children
US AID funded agency to made KC part of essential care of the
newborn worldwide for all newborns, term and preterm.
Shealy et al., 2006
CDC BF guidelines say keep infant in KC to promote BF
Shetty 2007
Review, but provides some guidelines
Stanton et al., 2013
PT, FT, Kc is considered a high impact measure of peripartum care
and should be included in the MNCH (Maternal , Newborn, child
Health) parameters to be measured . This was qualitative study of
mothers in Mozambique and they thought KC was important and
authors say it should be added to the evaluative criteria.
Stevens et al.,2014
FT review of KC and C/S articles and says that WHO and UN
recommend birth KC as soon as mom alert and responding AFTER c/S
and that it has many benefits to mom and baby
Terhar & Starr 2007
Recommends KC to Pediatricians
Thompson & Hartsock 1979
Recommends KC for Breastfeeding
UK BFHI (from Henderson 2011) Recommends: bed sharing is encouraged because it increases duration of
breastfeeding and UNICEF/BABY FRIENDLY says when baby is in bed
with mother and mother is sleeping, “it’s only necessary to provide
intermittent observation to monitor for any immediate environmental
dangers and promote a safe sleep environment (UNICEF UK BFHI 2004).
Do not permit sleeping on couch or recliner, only on firm mattress with
light blankets, well-fitting sheet and no bulky objects around baby. No
smoking, no ETOH use, no substance use (alters response or sensitivity to
newborn). She gives guidance for prevention of falls, i.e. low bed,, head
of bed <45 degrees, tucking in linens, no sleeping between parents,
mother sleeping on side to enclose baby and let baby roll onto back after
Nyqvist 2005
UNICEF 1998
UNICEF/WHO 2009
Vanderbilt Univ. Med Ctr 2007
WHO 2003
WHO/UNICEF 1989
WHO/UNICEF 1992
WHO/UNICEF 1992
WHO/UNICEF/Wellstart 2009
WHO 2003
WHO, 1996
Winberg 2006
Zaichkin, 2011
feeding. (pg. 305).
FT. Guidelines for implementation of BirthKC and VEKC.
FT. New Baby Friendly guideline that says “Place babies in skin to
skin contact with their mothers immediately following birth for at least
an hour. And the criteria are that 90% will have met this requirement.
PT. Guidelines/hospital policy/protocol for KC in NICU.
PT the book called Practical Guidelines. On page 2 it says: “Almost
two decades of implementation and research have made it clear that
KMC is more than alternative to incubator care. It has been shown to
be effective for thermal control, breastfeeding and bonding in all
newborn infants irrespective of setting, weight, gestational age, and
clinical condition.”
FT – states KC should begin within 30 min of birth for NSVD and
Within 30 minutes of mom being able to respond for C/S deliveries
FT - states KC should begin within 30 min of birth for NSVD and
Within 30 minutes of mom being able to respond for C/S deliveries and
Says that these are GLOBAL criteria.
FT. guidelines for hospital implementation of Baby Friendly conditions
FT & PT, baby friendly guidelines now include specific birth KC
references
FT and PT. Practical guidelines for implementing KC with fullterm
And preterm infants in all environments (advantaged and
Disadvantaged, but focuses on disadvantaged.
FT guidelines for normal term birth and in the category for “after the
baby is born” the first one is “the baby was placed skin-to-skin within
30 minutes of delivery” See all of the Sandin-Bojo articles because they
measured this in Sweden
Rev of early mutual caregiving and how we are similar to mammals.
Relates physiologic mechanisms of mutual regulation and states that
Mother’s body is playground for newborn. Recommends close skin-to
Skin contact.
PT, a one page guideline of benefits and how to position preterm infant
for skin to skin care that appears on AAP’s Bright Futures website and
also at www.healthychildren.org’s website.