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Read this report of inspiring stories from Phase One of the Be Our Voice project.

Immediate Skin-to-Skin Contact Boosts Breastfeeding Rates

January 14, 2013

by Cindy Hutter


Procedural Changes to Support Skin-to-Skin Contact

Staff at Centra Virginia Baptist Hospital and Palmetto Health Richland report that incorporating skin-to-skin contact has meant several adjustments to their labor and delivery room processes. These include:

• No longer taking babies to a warmer
• Cleaning baby while skin-to-skin
• Performing all assessments and medication procedures while the baby is skin-to-skin
• Delaying recording a baby’s weight until after skin-to-skin
• Transitioning baby with mother instead of bringing the baby to the nursery

You only get one chance to make a first impression. The age-old saying holds true for mothers initiating breastfeeding for the first time. Hospitals that put a newborn directly on a mother’s chest after birth, a practice known as skin-to-skin contact, are finding its helping new mothers be successful in their choice to breastfeed.

“We now start skin-to-skin contact within five minutes of a vaginal delivery and keep the baby there for at least an hour or until the baby initiates breastfeeding,” says Stacey Tribbett, unit manager of the Centra Virginia Baptist Hospital birth center. “Our exclusive breastfeeding rates have been increasing and we’re seeing an increase in our non-exclusive breastfeeding rates too.”

Centra Virginia Baptist Hospital is one of 89 hospitals participating in Best Fed Beginnings, a first-of-its-kind, nationwide learning collaborative in which NICHQ is helping hospitals improve maternity care and increase the number of Baby-Friendly designated hospitals in the United States. To achieve the Baby-Friendly designation, participating facilities are working to fulfill the 10 Steps to Successful Breastfeeding, as outlined by the World Health Organization. One of the steps is helping mothers initiate breastfeeding within an hour of birth.

Best Fed Beginnings teaches participants how to use quality improvement techniques to make system-level changes to maternity care practices. Using the Model for Improvement, hospitals identify small tests of change, execute them and keep repeating small tests until their aim is achieved.

“Before Best Fed Beginnings, we were doing a good job initiating breastfeeding, now we’re doing a great job,” says Tribbett. “Our nurses are focusing on skin-to-skin contact, which helps them focus on initiating breastfeeding. We started trying it on a few patients to see how it went, but before I knew it nurses were educating each other. The process change didn’t take as long as I thought it would. If a baby is stable at delivery, 80 percent are now going skin-to-skin.”

Palmetto Health Richland in South Carolina, another facility participating in Best Fed Beginnings, has also had success with their skin-to-skin testing cycles. Now that medical staff are on board with putting the baby on the mother right after delivery, the project team is focused on making sure mothers understand why the hospital practices skin-to-skin contact and its benefits.

  Mother and baby skin-to-skin


One barrier has been mothers who prefer to have the baby cleaned off before being placed on them. Babies going directly from delivery onto mom are typically still covered with the protective coating that helps to maintain the baby’s vital functions, such as normal body temperature and blood sugar, and even fight infection. Experts say skin-to-skin contact immediately after delivery is the safest and healthiest transition regardless of feeding preference, and typically facilitates breastfeeding.

“We’re now talking to moms in labor so they know what to expect about skin-to-skin contact, the baby breast crawl and feeding cues,” says Erica Kimrey, lactation consultant and Best Fed Beginnings team lead at the hospital. “We want to make sure moms know why we are doing this and understand it is better for the baby.”

Interestingly, Palmetto Health Richland has found a strong correlation in patient satisfaction surveys between a mother going home feeling confident about breastfeeding and feeling positive about her entire hospital experience.

Patient education about the benefits of breastfeeding and the practice of skin-to-skin is something Centra Virginia Baptist Hospital is hoping to improve as well. While breastfeeding is one of the most highly effective preventive measures a mother can take to ensure the health of her infant and herself, the percent of mothers who are breastfeeding or exclusively breastfeeding at six months are low: 44 percent and 15 percent respectively, according to the Center for Disease Control. Tribbett says the team plans to test starting education about breastfeeding in the medical office, instead of initiating it at the birth center.

“I think people believe that breastfeeding is good, but maybe don’t think as much about the benefits,” says Tribbett. “We need to educate staff and mothers on the benefits and the importance of skin-to-skin contact. Until they know the reasons behind why we are doing these things, they are not always on board with skin-to-skin contact. But once they know what the benefits are it makes it easier to implement the improvement.”

Read more about the Best Fed Beginnings project. 


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