Implementing Skin to Skin

Maternity care facilities across the United States are honoring the mother baby bond by implementing skin to skin contact immediately after birth and later. Evidence shows that skin to skin contact provides baby with a gentle transition from the inner womb to the “outer womb” (baby nestled between mother’s breasts) where mother’s body regulates baby’s temperature, heart and breathing rates and blood sugar levels. After passing through the birth canal, baby is colonized by maternal bacteria; this colonization continues when placed skin to skin protecting baby from dangerous microbes, as suggested by Dr. Lars Hanson in the Magical Hour.

Studies also show that early skin to skin contact increases the duration of exclusive breastfeeding. Although, skin-to-skin contact immediately after delivery is the safest and healthiest transition regardless of feeding preference. The benefits of skin to skin contact to the premature baby are even more significant.

With so many advantages, it’s no wonder health care providers are adopting this practice. In many facilities though, this seemingly easy transition does not come without challenges.

NICHQ-BF-Course-BannerThat’s why the National Institute for Children’s Health Quality (NICHQ) has developed a series of virtual learning programs for healthcare professionals to help improve maternity care practices. The first in the series, Mastering Skin-to-Skin, is comprised of three one-hour interactive, virtual coaching sessions on April 29, May 13 and May 27. Mastering Skin-to-Skin focuses specifically on how to overcome barriers to implementing skin-to-skin contact immediately after birth, a key component in Baby Friendly’s Ten Steps to Successful Breastfeeding.

“The most common challenges we’ve heard in our years of work with hospital teams across the country trying to implement skin-to-skin contact involve systems, staff and space,” NICHQ’s Senior Communications Manager Cindy Hutter says. “When you want to make a change like implementing skin-to-skin, it is a change to the procedures and flow of the labor and delivery room system.”

Implementing proper skin to skin contact requires care providers to:

  •  no longer take babies to a warmer
  •  delay cleaning
  • perform assessments and procedures after baby has completed first feed
  • delay bath and recording baby’s weight
  • transition baby with mother instead of bringing baby to the nursery.

 Hutter acknowledges that these are “significant changes.”

“…And change, as we all know, isn’t easy,” she continues.

Health care providers are often up against getting provider and staff engagement and buy-in for implementing procedural changes.

“There is often the resistance of ‘This is how we’ve always done it’ or ‘We don’t have time for that’,” Hutter says.

Educating staff and families about the importance of skin to skin contact is key to orchestrating change.

Mastering Skin-to-Skin expert instructors Lori Feldman-Winter, MD, MPH, FABM and Jennifer Ustianov, RN, MS, IBCLC will cover other common barriers associated with implementing skin-to-skin and provide proven solutions for overcoming them, Hutter says.

Participants will be asked to complete homework assignments between each webinar.

NICHQ-BF-Course-SummaryNote“The course action steps (a.k.a. homework) between classes consist of running small tests of change known as Plan-Do-Study-Act (PDSA) cycles,” Hutter explains. “This isn’t just a sit back and listen type of course. We challenge people to test one (or a portion of one) of the implementation ideas and then report back on how it went.”

This type of course work allows for an “all-teach-all-learn” approach.

In a virtual learning environment, NICHQ is better able to spread knowledge to a wide audience and more broadly achieve the goal of better supporting mothers who chose to breastfeed, Hutter explains.

A virtual learning environment also allows for an online discussion forum where conversations between participants and instructors can continue beyond class time. The coaching webinars will be recorded so participants can efficiently share with other hospital team members.

The deadline to register for Mastering Skin-to-Skin is April 28. For more information or to register for the program, visit

81w1gcyiyuL._SL1402_Healthy Children Project also offers a variety of educational materials for anyone looking to implement skin to skin. Skin to Skin in the First Hour After Birth; Practical Advice for Staff after Vaginal and Cesarean Birth assists staff in providing behaviorally appropriate, individualized, baby adapted care for the full term newborn using the best practice of skin to skin contact in the first hour after birth. You can order the Practical Advice DVD on Amazon, Health Education Associates or rent the video for 24 or 48 hours or download to own with unlimited viewing from Healthy Children.

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