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STS in the OR?

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We all know how important skin-to-skin (STS) contact is for a newborn and his mother.  Most hospitals are moving towards immediate skin-to-skin for all newborns (breastfeeding mothers or not) in our delivery rooms!   But what about the operating rooms? 

At a time when families are under the additional anxiety of a surgical delivery, skin-to-skin care increases family togetherness and satisfaction with the birth.  We have known for years that a cesarean delivery delays lactogenesis II and negatively affects breastfeeding duration.  With a cesarean rate of 33% in many areas, this is an issue that affects many families. 

A systematic approach makes this change more acceptable to all involved: nurses, obstetricians, anesthesiologists and lactation consultants.  An organized process of planning, testing a pilot protocol, staff training will reduce the anxiety of all staff.  Involve stakeholders from all disciplines in planning and executing the changes.  An influential champion can provide the leadership to engage staff and create enthusiasm for the process of change.   Finally, implement a preliminary protocol and refine it as needed, then make it policy.

Continual surveillance is needed to assure that the procedural changes are incorporated into practice and maintained and that there is no back-sliding into old habits.  Analyzing the improvement in Quality Assurance measures can reinforce the hard work of the staff.

How this skin-to-skin procedure is implemented will vary from hospital to hospital depending on their facility and their staff.  But Moms, infants and families will benefit as skin-to-skin becomes a normal and routine practice.

Want to explore this further?

Facilitating Skin-to-Skin Contact in the Operating Room After Cesarean Birth.

Stone S, Prater L, Spencer R.  Nurs Womens Health. 2014 Dec;18(6):486-99.

Early skin-to-skin after cesarean to improve breastfeeding.

Hung KJ, Berg O.  MCN Am J Matern Child Nurs. 2011 Sep-Oct;36(5):318-24

An interprofessional quality improvement project to implement maternal/infant skin-to-skin contact during cesarean delivery.

Brady K, Bulpitt D, Chiarelli C.  J Obstet Gynecol Neonatal Nurs. 2014 Jul-Aug;43(4):488-96

Skin-to-skin contact after cesarean delivery: an experimental study.

Gouchon S, Gregori D, Picotto A, Patrucco G, Nangeroni M, Di Giulio P.  Nurs Res. 2010 Mar-Apr;59(2):78-84

Postcesarean Section Skin-to-Skin Contact of Mother and Child.

de Alba-Romero C, Camaño-Gutiérrez I, López-Hernández P, de Castro-Fernández J, Barbero-Casado P, Salcedo-Vázquez ML, Sánchez-López D, Cantero-Arribas P, Moral-Pumarega MT, Pallás-Alonso CR.

J Hum Lact. 2014 May 20;30(3):283-286

Immediate or early skin-to-skin contact after a Caesarean section: a review of the literature.

Stevens J, Schmied V, Burns E, Dahlen H.  Matern Child Nutr. 2014 Oct;10(4):456-73.

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Vergie Hughes has a long history of experience in Maternal Child Health including labor and delivery, post-partum and pediatrics, and for the past 25 years she has been involved in lactation management. Ms. Hughes has a BSN from Pacific Lutheran University and a MS from Georgetown University. She has been a board certified lactation consultant since 1985. At Georgetown University Hospital, she was the director of the Human Milk Bank. She created and developed the National Capitol Lactation Center and the one week Lactation Consultant Training Program. This course has trained more than 4,000 Lactation Consultants since its inception in 1990.


She has been a private practice lactation consultant and business owner, and operated her own lactation center, Washington’s Families First. Lactation Education Resources On-Line is her website, offering training to professionals and information to parents as well. Ms. Hughes has served on the International Board of Lactation Consultant Examiners and has served on the IBLCE exam writing committee. Her first love is teaching and that is exemplified by the creativity of the courses she has developed. A series of courses “The In-patient Breastfeeding Specialist,” "The Out-patient Breastfeeding Specialist” and “The NICU Breastfeeding Specialist” are all designed to advance the lactation management skills of nurses at the bedside. She regularly teaches skills to labor and delivery nurses and just recently developed the course “Towards Exclusive Breastfeeding.”


Ms. Hughes is the program director and content manager for all of the on-line Lactation Education Resources courses. Ms. Hughes was recently honored with a “lifetime achievement award” as Fellow of the International Lactation Consultant Association (FILCA).

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Guest Monday, 20 November 2017