Skin-to-skin care is when a baby is placed directly against the mother’s bare chest wearing only a diaper and both are then covered with a blanket. Recently, nursing research has begun to explore the impact of this practice on full-term infants after birth with exciting results. Implementing this practice has led to improved thermoregulation, vital signs, blood glucose control, breastfeeding initiation, and maternal/newborn bonding.  The release of stress hormones is also decreased in both the neonate and mother. Often simple low technology interventions such as skin-to-skin care are overlooked in our high-technology era.

The standard nursing practice in our unit following delivery was to take the baby to the radiant warmer, dry the baby, obtain measurements, perform gestational age and physical assessments, give medications, and then swaddle the baby to return to family. This process could take anywhere from 20 minutes to 1 hour. The proposed practice change was to place the baby skin-to-skin with mom within 30 minutes after birth and have the baby remain there a minimum of 1 hour.

The problems that we encountered attempting to implement this practice were many. The nurses viewed placing a baby skin-to-skin as an inconvenience and disruption to the normal order of tasks. The patients were uncertain as to why it was necessary. Often family members were present who desired to see and hold the baby, which discouraged skin-to-skin care. Lastly, privacy issues with family presence hindered skin-to-skin care and breastfeeding.

To solve the obstacles listed above a multi-prong approach was taken to provide staff, patient, and community/family education. We began with staff education on the importance of family centered maternity care, non-separation of mother and baby, skin-to-skin care, and breastfeeding within the first hour of life. Patients received education in prenatal classes and a pamphlet was also developed and placed in the obstetrician’s offices. To educate both the patient and family, a flyer was developed and placed in each room encouraging privacy post-delivery and skin-to-skin care. Progress was monitored and analyzed with chart audits. Statistics were also able to be generated from the computer charting system. Patient satisfaction surveys were also evaluated for comments regarding skin-to-skin care.

As a result of all these interventions, we have seen amazing results. Patients upon admission are asking for skin-to-skin contact to occur, family members are readily leaving the room to allow privacy, and the nurses have come to see that providing skin-to-skin care makes breastfeeding easier and actually decreases their work. The nurses also readily educate the patients and encourage skin-to-skin care with more patients successfully getting the baby to breastfeed within the first hour of life. Patient satisfaction has also increased due to increased “bonding time” with their newborn.

In conclusion, it is possible to change nursing practice through education. We feel that taking a multi-prong approach with nursing, patient, and family education was what ultimately led to a successful change. Skin-to-skin has enabled us to provide the highest level of evidence based care to our babies through a relatively simple act.