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Skin-to-Skin Contact and Physiological Adaptations in Newborns

Discuss About The Physiological Adaption In Healthy Newborns.

After birth whether through vaginal or caesarian section, a baby is dried and placed naked on the mother’s chest and covered with a blanket and head cap for warmth so as to establish a bond between the child and the mother. More to that, after clinical birth procedures have been carried out, from weight measurements to pressure among other checks ups are completed, the baby is handed to the mother for breastfeeding. Skin to skin contact is promoted in order to improve on the baby’s cardiorespiratory stability, glucose levels and also control the babies rate of crying. While this method isn’t as common in the Western country as it is in other countries, it has long been existent before civilization and has been credited to promoting breastfeeding exclusivity and the bond between mother and child. The research takes a look into the effectiveness of the skin to skin contact (SSC) also known as the Kangaroo Mother Child (KMC) method in breastfeeding and physiological adaptations of the newborns to the environment (Baley, 2015).

Overtime, there have been reports of newborn babies especially those that are prematurely dying from lack of adaptability to the environmental factors with the highest cost being that of death among new born babies, due to hypothermia and infections. Due to the western countries nature of placing babies in the incubators after birth, the child mother bond has been affected throughout the child’s progression as the baby is less sensitive to touch and feel and also there is less identification between mother and child. According to mammalian neuroscience, the contact between mother and child has the ability to evoke neuro sensory behaviors that ensures that a baby is able to fully meet all basic biological needs. The period is important in shaping the child’s future physiological state and behaviors. Therefore, it’s important to understand the effects of breastfeeding on physiological adaptations of the child and behaviors in healthy mother newborn dyads (Boo, 2007).

There has been need to establish ways into which child mother relationships can be promoted in order for a baby to realize a full healthy upbringing from birth to adulthood. This came about due to recent complications that rise from environmental influenced factors among them temperature and lack of proper and sufficient amount of nutrition. This lead to early postpartum hemorrhage and neo natal deaths, due to insufficient feeding among newborn babies. If not addressed properly, the conditions have and will lead to syndrome and unhealthy states for the baby from malnutrition, metal slowness with ultimate deadly results due to infection and hypothermia. The research establishes ethical manners or ways into which such factors can be analyzed and addressed among babies using methods that have long existed over time and seek lasting measures in handling the child physiological behaviors (Hake-Brooks, 2008).

Promoting Child-Mother Relationships and Newborn Growth

Its uncommon to find the skin to skin contact (SSC) routine being practiced on fully developed babies especially after caesarian section births. This is due to the fact that the baby is put under risk of developing hypothermia. The main focus of the project is to analyze if the SSC provided during breastfeeding is able to contribute positively towards newborns while in the hospital. It’s important to maintain a baby’s temperature after birth as a baby is yet to adapt to developing body warmth on their own, as they lack the shivering mechanism. This causes a rapid decrease in temperature for babies. This is why a baby is put in a warmer after birth and thus separated from the mother so as to keep the baby’s temperature at optimum levels. In order to promote bond between mother and child and also to regulate the baby’s temperature, the nurse applies the SSC method. The baby’s skin to skin contact to the mother especially touching of breasts while feeding increases the secretion of oxytocin which increases the breast milk yield and also increases temperature around the breast area. Feeding the milk to the baby is able to activate the baby’s sensory nerves, the baby becomes more comfortable around the mother and the sympathetic nerves reduce, causing dilation of skin vessels that results in increase of the baby’s temperature (Hake-Brooks, 2008).

The SSC is well common among natural deliveries but not to the caesarian section deliveries as the baby is at a risk of contracting hypothermia due to the low temperatures that are usually in the operating room, spread of the mother’s body heat to the environment and low temperatures experienced in operating rooms. With recent increase in caesarian section, the need to understand the physiological effects of SSC with both pre-term and full-term newborn babies has been established. SSC has for long been the key terms of friendliness between mother and child after and during breastfeeding sections. Most people in America have been seen to shorten breastfeeding moments while in the hospital opting for the baby being laid under a warmer, which leads to lose of contact between the mother and child and affects the growth of a baby (Gathwala, 2008).

The project seeks to find methodologies used in researching on the effectiveness of the SSC method in promoting newborn baby’s health and growth so as to create awareness on need of more mothers using the method as well by proving its effectiveness in breastfeeding and influencing of physiological behaviors.

The Effectiveness of Skin-to-Skin Contact in Breastfeeding and Physiological Behaviors

The research will confirm the necessity to promote skin to skin contact between mother and child so as to improve the child’s physiological behaviors and shape his or her future adaptability capability.

A study is to be conducted around a group of 6 women who are due to give birth in the same period of time by caesarian section and normal vaginal deliveries at 38-42 weeks gestational period, and between the age of 18-40. This means that cases of sever bleeding uterine inertia, gestational diabetes, hypertension and heart illnesses amongst others are not to be considered as optimum conditions of deliveries are set for accurate results. Infant babies suffering from high risk illnesses and abnormalities like syndromes are to excluded as well as they affect the results of the works.

Mothers were passed through a questionnaire series to determine their age, height, weight, head and chest circumference as well as women with past pregnancy complications like miscarriages. Their temperatures and that of the baby was recorded and a breastfeeding assessment tool set as sub-scales for sucking rooting, readiness and latching. Successful candidates’ information was registered and analyzed.  Mothers had their temperatures recorded before and during the birth and that of the baby was recorded after cutting of the umbilical cord. After the babies were taken to the nursey, their temperatures were taken and recorded as well. The babies would later be delivered to their mothers in suitable warm clothing and while breastfeeding their temperature was recorded. The process was repeated for delivery of the babies back to their cribs and temperatures taken in between 30 minutes period. The IBAT (Infant Breastfeeding Assessment Tool) was used in the assessment process. All variables kept constant, the results showed no major differences between SSSC during natural and delivery via caesarian. At the same time, there wasn’t much of a big difference between the SSC method and keeping a baby in a warmer.

In the case study where, newborn babies were placed into incubators after early deliveries, there was a note that the babies were healthy as their mothers were. The babies were put under the SSC group and others were put under the conventional method care (CMC). The weight of the babies was recorded during breastfeeding while keeping some factors constant. This would include the babies gestational age to 28 weeks, newborns breastfed or provided nutrition in alternative manners, new born who received vasodilator, newborn with stage 3 and 4 intra ventricular hemorrhage.  The babies’ details were recorded during period of stay in hospital. The SSC was provided for every 30 minutes between intervals (Heidarzadeh, 2013).

Study Methodology

The study results showed that the mothers practicing skin to skin contact or the kangaroo mother child had exclusive breastfeeding by time of discharge. Conventional care babies and babies breastfeeding using the SSC tool showed no significant change in terms of physical changes. However, there was an increase in sucking rates due to good and moderate method, Kangaroo mother child method (KMC). The method otherwise known as SSC is an effective method in breastfeeding due to the increase of milk during feeding. It offers a safer, effective, and feasible method of care for children. For this purpose, the method best serves newly born undeveloped babies who lack an incubator and also are separated from their mothers after birth. SSC feeding offers exclusive feeding to the baby. Its safety option lies within the positioning of the bay while feeding. Nutrition on the other hand depends of the mother’s dietary needs and the ability to meet the needs on time. This makes the medication phase more bearable for the little one as her or his health improves. SSC regulates an in-infant’s heart beat and also leads to breast milk provocation. Nutrition from the breast milk improves a baby’s immune system to the surrounding environment.  If a baby is sick, then the process is delayed to allow the baby to get better from medication. Then the process is incorporated within the routine for a few hours (Kirsten, 2001).

  • The process is more cost-effective.
  • The process is advantageous for both mother and child as it improves their bonding time.
  • The baby is able to digest milk that is full of all expected benefits for humans.
  • It decreases a baby’s crying rate and frequency.
  • Food is able to be quickly absorbed by the baby when calm due to the SSC.
  • The SSC is able to stabilize a baby much faster than an incubator can.
  • SSC improves a baby’s sensory nerves to touch and feel through feeling the mother’s heart beat and also touch.
  • A baby’s visual is also able to improve from constant look at the mother during breastfeed as well as smell by identifying the mother’s odor(Hake-Brooks, 2008).
  • Continuous SSC promotes spread of maternal flora from mother to child.
  • This includes condition like respiratory viruses and tuberculosis (TB). However, some diseases spread on their own due to proximity between different patients while others like pneumonia are influenced by the environment.
  • Its also important to ensure that the mother isn’t infected from the outside or inside her body before the start of SSC method to reduce risk.
  • The baby also needs to be positioned properly in the right direction with support of a nurse as wrong positioning can lead to death(Lamy, 2008).

The national statement on ethical conduct in human research that was set in 2007 allows for human research only under guidelines and principles for ethical conduct research involving human participants. The guidelines for ethical conduct in aboriginal and Torres Strait Islander Health Research provides guidance to the researchers and Human Research Ethics Committee (HRECs) on necessary but complex considerations in researches.  HREC seeks to provide support to researchers in understanding and also complying with National Statements, ethics and values of a responsible research.  Thus, it enables researches to be funded by the government.

There can be high risk values in the vent that the mothers due to deliver don’t attend the study due to personal reasons or complications in the delivery process. For one, a mother may opt out of the study for fear of exposure and thus causing the whole research program to be affected. Secondly, the delivery may develop complications that aren’t accounted or considered for in the research affecting the entire project.

Study Results

The pull out of volunteers due to exposure can be covered by having back-up volunteers who are ready at the same time as the previous candidates and thus meaning information of the volunteers had to be prerecorded beforehand. At the same time, should complications arise during delivery, they should be recorded and sighted for unavailability of some data. This keeps the research on course (Heidarzadeh, 2013).

The research enables future health institutions and other researchers to adapt to the new method of involving SSC method in the baby feeding process. Similarly, it contributes more reference information to similar research into the SSC or KMC method. This provides more awareness and trust in the process when it proves the hypothesis true.

The research is acceptable if the rights to confidentiality dictated in the ethical guidelines for volunteers are adhered to. At the same time, the research is also accepted when true record of information is kept and all procedures followed are detailed according the assessment tool provided for the SSC method. More to that, all measures, assumptions and contingency measures taken for rising issues need to be recorded to provide more ground to authenticity of the research project and thus make it adaptable for future researches and viable for funding from the institution of research and more so the government funds (Ludington-Hoe, 2009).

A legal and binding confidentiality agreement between the research team and the volunteers is established and signed upon between both parties. The research team also ensures that all involved parties also sign a confidentiality agreement to protect the institution and volunteers from exposure.

Extra information is stored in blindfolders to ensure that no information is lost from scrap work to the final assembled reports which include questionnaires and data sheets taken during the project. A back up is established in terms of soft data stored in the computer hard disk to portable storage devices like flash diskettes. Similarly, an online backup that is password protected and encrypted is required as one can never be too safe (The Univeristy of Melbourne, 2017).

Recording the project work in subtitles and titles enables the work to be easily disseminatable. Also, storing the information by order of date and issue attended or addressed makes the dissemination process more easier and enables accessibility.

References

Almeida, H. V. (2010). The impact of kangaroo care on exclusive breastfeeding in low birth weight newborns. J Pediatr, 250-253.

Conclusion

Baley, J. (2015). American Academy of Pediatrics and Journals, 136(3), 1-20.

Beiranvand, S. V. (2014). The Effects of Skin-to-Skin Contact on Temperature and Breastfeeding Successfulness in Full-Term Newborns after Cesarean Delivery. International Journal of Paediatrics, 7.

Boo, N. J. (2007). Short duration of skin-to-skin contact: effects on growth and breastfeeding. J Paediatr Child Health, 831-836. doi: 10.1111/j.1440-1754.2007.01198.x

Brimdyr, K. C. (2017). An implementation algorithm to improve skin?to?skin practice in the first hour after birth. International Paediatric Journal, 5. doi:10.1111/mcn.12571

Dodd, V. (2005). Implications of kangaroo care for growth and development in preterm infants. PubMed: J Obstet Gynecol Neonatal Nurs, 218-232.

Erlandsson, K. D. (2007). Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior. PubMed: Birth, 105-114.

Gathwala, G. S. (2008). KMC facilitates mother baby attachment in low birth weight infants. PubMed: Indian J Pediatr, 43-47.

Hake-Brooks, S. A. (2008). Kangaroo care and breastfeeding of mother-preterm infant dyads 0-18 months: a randomized, controlled trial. Neonatal Netw, 151-159.

Heidarzadeh, M. H. (2013). The Effect of Kangaroo Mother Care (KMC) on Breast Feeding at the Time of NICU Discharge. Iranian Red Crescent Medical Journal, 302-306. doi:10.5812/ircmj.2160

KBL781. (2016). National Statement on Ethical Conduct in Human Research (2007). Australian National Health and Medical Research Council, 1.

Kirsten, G. B. (2001). Kangaroo mother care in the nursery. Pediatr Clin North, 443-452.

Lamy, F. F. (2008). Evaluation of the neonatal outcomes of the kangaroo mother method in Brazil. J Pediatr, 428-435.

Last Name, F. M. (Year). Article Title. Journal Title, Pages From - To.

Last Name, F. M. (Year). Book Title. City Name: Publisher Name.

Ludington-Hoe, S. (2009). The best you can do to help your preterm infant . Tehran, 1.

Moore, R. E. (2012). Early skin-to-skin contact for mothers and their healthy newborn infants. Europe PubMed Central, 7. doi:10.1002/14651858.CD003519.pub3

Nagai, S. A. (2010). Earlier versus later continuous Kangaroo Mother Care (KMC) for stable low-birth-weight infants: a randomized controlled trial. Acta Paediatr, 827-835.

Porter, R. (2004). The biological significance of skin-to-skin contact and maternal odours. Acta Paediatr, 1560-1562.

Ramanathan, K. P. (2001). Kangaroo Mother Care in very low birth weight infants. Indian J Pediatr, 1019-1023.

Suman, R. U. (2008). Kangaroo mother care for low birth weight infants: a randomized controlled trial. Indian Pediatr, 17-23.

Suzuki, S. (2013). Effect of early skin-to-skin contact on breast-feeding. Taylor and Francis Online, 695-696. doi:10.3109/01443615.2013.819843

Tessier, R. C.-P. (2009). Kangaroo Mother Care, home environment and father involvement in the first year of life: a randomized controlled study. Acta Paediatr, 1440-1450.

The Univeristy of Melbourne. (2017). Links to guidelines, university polices, and national guidelines for human research ethics. The Univeristy of Melbourne, 1.

Thukral, A. C. (2008). Kangaroo mother care--an alternative to conventional care. Indian J Pediatr, 497-503.

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