Thread by @astuebe

Next up: Panel Discussion: Skin-to-Skin Around the World #ABM2022, starting with Maite Hernandez-Aquilar

Context: skin-to-skin was not always recommended. Research in the early 1970s included initial contact, followed by 9 hours (!!) of separation... #ABM2022

Based on evidence, skin-to-skin should be standard practice... #ABM2022

Standard care in NICUs should also be skin-to-skin, kangaroo mother care - not babies in plastic boxes... #ABM2022

Implementation guidance from @UNICEF / WHO/BFHI: early, uninterupted skin-to-skin contact #ABM2022

ABM's protocol specifies key elements of skin-to-skin @abm2022 bfmed.org/assets/DOCUMEN…

Despite high quality evidence, skin-to-skin is not happening for many dyads around the world #ABM2022

COVID pandemic adversely affected skin-to-skin contact... #ABM2022

Mothers with COVID in Spain less likely to experiene skin-to-skin care #ABM2022

58% of mothers separated from their infants because of COVID were very upset or distressed... markedly lower exclusive #breastfeeding at 3 months pubmed.ncbi.nlm.nih.gov/33565900/ #ABM2022

Next speaker: Kajsa Brimdyr on implementing skin-to-skin in the first hour pubmed.ncbi.nlm.nih.gov/30762247/ #ABM2022

Challenge for measuring process: if "skin to skin at birth" is a check box, what are we checking off? #ABM2022

"One hour" - we should not be snatching the baby off at exactly 60 minutes... pay attention to what the baby is doing... #ABM2022

"There are so many things that happen during 20 minutes of familiarization that we can't stand it" - we need to sit on our hands and let baby lead... #ABM2022

How might we change practice? Recent review article explores barriers & solutions... pubmed.ncbi.nlm.nih.gov/30762247/ #ABM2022

Brimdyr: shared videos from Sweden of 9 stages... doctors & nurses in Egypt said, "our babies don't do this..." same story in Texas, California... this is the instinctive behavior of newborn humans! #ABM2022

Medical hypotheses paper: 9 stages follow order of intrauterine development sciencedirect.com/science/articl… #ABM2022

How do we support skin-to-skin in our clinical settings? Algorithm to guide implementation here: pubmed.ncbi.nlm.nih.gov/29230957/ #ABM2022

Next panelist: Pamela Douglas on skin-to-skin contact in community settings #ABM2022

Douglas: Our newborns are extro-gestate fetuses until 9 months after birth - evolutionary expectation to be in close contact with a loving adult's body #ABM2022

Daily SSC has been studied in an RCT @abm2022 pubmed.ncbi.nlm.nih.gov/35653761/

Low adherance -> need to think about what's feasible for skin-to-skin contact - "Minimize rules, optimise ease" #ABM2022

A vertical soft carrier offers an easy way to keep newborns skin-to-skin #ABM2022

Mixed data on skin-to-skin / laid back nursing to prevent breastfeeding problems #ABM2022

With contextual support, skin-to-skin has benefits in community settings #ABM2022

Panel conversation with global representation - Spain, Australia and Maryland 😊 #ABM2022

What to do when skin-to-skin falls of the priority list? When you appoint a single clinical champion, they get tired and burned out. It needs to be muscle memory, and we all need to own it! #ABM2022

Creating an appetite for skin-to-skin care: show "the magical hour" video on hospital TV during labor - make this the expectation! #ABM2022