SAINT LOUIS UNIVERSITY SCHOOL OF NURSING BAGUIO CITY

SUBMITTED BY: ALYSSA AMOR B. ALMAIN BSNIV-J2

SUBMITTED TO: SIR SHEERWEEN E. CACANANDO CLINICAL INSTRUCTOR

SUMMARY This article entitled Early skin to skin after cesarean to improve breastfeeding describes a quality improvement project in which early skin-to-skin contact in the operating room and during recovery was used as an intervention to increase the success of breastfeeding initiation among healthy infants after cesarean, at a large, urban, acute care teaching hospital.The nursing role is key for the intervention, but the program involves the entire perinatal team, including the obstetricians, pediatricians, and anesthesiologists. During the first 3 months of their intervention, the rate of early STS among healthy babies born by cesarean increased from 20% to 68%. The rate of infants who did not get STS contact within 4 hours of birth decreased from 40% to 9%. Nine months after the initiation of the intervention, 60% of healthy cesarean births utilized STS in the OR, and 70% involved STS within 90 minutes of birth. Healthy infants born by cesarean who experienced STS in the OR had lower rates of formula supplementation in the hospital (33%), compared to infants who experienced STS within 90 minutes but not in the OR (42%), and those who did not experience STS in the first 90minutes of life (74%).The study had concluded that STS contact was feasible after cesarean and could be provided for healthy mothers and infants immediately after cesarean birth. The study also shows that Immediate STS contact has considerable benefits because it requires minimal financial resources, is not associated with adverse effects among healthy infants, shows an overall positive effect on breastfeeding, and appears to improve newborn stabilization during transition.

REACTION In this journal it was been proven that skin to skin contact after cesarean improves breastfeeding after a cesarean birth, where in fact now a days mother and baby are monitored postoperatively for several hours, often in separate rooms and without the opportunity to

breastfeed and bond immediately after the operation. wherein the newborn babies were not immediately fed in that they needed to be to prevent hypoglycemia. It is good that this study shows a lot of improvements regarding this practice since it was already proven to be safe and beneficial to both the baby and the mother, Effective communication is essential to the success of this intervention. Communication regarding STS should begin preoperatively between the nurses, the patient, and the medical team, so that the entire team is aware of the possibility of STS in the OR to prevent repetition of interventions, thus preventing more errors to occur. The experience of cesarean birth can be frightening or stressful to a mother who is strapped to the

operating table, and is unable to watch her baby enter the world (WHO &UNICEF, 2009). It is true since mothers usually worry if their baby would not be with them after delivery, they might thought of having their baby dead or in trouble thus, Providing her with the opportunity to hold her infant in STS contact soon after birth can provide a sense of control and empowerment to the mother. With early STS contact, the nurse does not instruct the mother how to feed her infant or grab the mothers breast and put it into the infants mouth. Instead the focus is on the mothers ability to provide the perfect environment and stimulation for the infants reflexes and self-regulation to come into play, which in turn leads to successful breastfeeding initiation (Radzyminski,2005). Yes its true since during this time, mother might not be psychologically nor physically ready for the teachings necessary to her and her baby, so maybe it would be taught to her in the later part. Parenting skills are strengthened as the mother provides appropriate care giving by merely holding the infant, and in turn, the neurobehavioral development of the infant is promoted (Ludington-Hoe & Swinth, 1996). Thus this statement itself agreed to this journal that early STS really matters and beneficial to both baby and mother. Early STS

maternalinfant contact has become the standard after vaginal birth, and there is no evidence that suggests that it should not be extended to cesareans. And according to the research findings there are no harmful effects of doing STS after cesarean instead giving more benefits .During the study they have included other health care professionals in doing STS which is good since not all the time nurses are available to do all of these also it will improve the nurses and other health professionals to be connected and more open to each other removing any unnecessary barriers that would further decrease the quality of care to be given to the patient we both handle thus promoting quality care our patients deserve. But then it is always necessary for all nurses to be knowledgeable and always be updated in all necessary nursing interventions that would highly benefit their patients. Thus this research must influence all health care professionals to practice STS, but then it would also depend on the different hospital policies. SO it must be suggested or be communicated to the different hospitals regarding this research and its effectively must be emphasized. Further researchers must also conduct researches with the improvement or further implementation of this practice for better acceptance. Finally this research study must be adopted to all since it was already proven to be effective to all without any complications and any burden to the health care professionals since it was not a complicated one but an easy and faster way on how to improve a better life, promoting quality care to every deserving patient.