Early Skin-to-Skin After Cesarean to Improve Breastfeeding
Early Skin-to-Skin After Cesarean to Improve Breastfeeding
复制标题
DOI：
10.1097/nmc.0b013e3182266314
复制
发表时间：
2011-09-01
影响因子：
2.4
通讯作者：
Berg, Ocean
中科院分区：
文献类型：
--
作者：
Hung, Kristina J.;Berg, Ocean
本文介绍了一个质量改进项目，早期皮肤接触（STS），在手术室（OR）和恢复期间，被用作干预措施，以增加成功的母乳喂养开始剖腹产后的健康婴儿，在一个大的，城市，急性护理教学医院。护理角色是干预的关键，但该计划涉及整个围产期团队，包括产科医生，儿科医生和麻醉师。在我们干预的前3个月，剖腹产健康婴儿的早期STS发生率从20%上升到68%。出生后4小时内未接触STS的婴儿比例从40%下降到9%。干预开始后9个月，60%的健康剖宫产在OR中使用STS，70%在出生后90分钟内使用STS。在手术室经历STS的剖腹产健康婴儿在医院的配方奶粉补充率较低（33%），相比之下，在90分钟内经历STS但不在手术室的婴儿（42%），以及那些在生命的前90分钟内没有经历STS的婴儿（74%）。我们的结论是，STS接触是可行的剖宫产后，可以提供给健康的母亲和婴儿剖宫产后立即。围产期和新生儿护士应在改变做法，将早期STS接触到剖宫产后的常规护理的领导者。
This article describes a quality improvement project in which early skin-to-skin (STS) contact, in the operating room (OR) 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 our 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 90 minutes of life (74%). We concluded that STS contact was feasible after cesarean and could be provided for healthy mothers and infants immediately after cesarean birth. Perinatal and neonatal nurses should be leaders in changing practice to incorporate early STS contact into routine care after cesarean birth.