'Skin-to-skin' and 'rooming in' are on the rise in maternity wards | August 9, 2013 | Palo Alto Weekly | Palo Alto Online |

Palo Alto Weekly

News - August 9, 2013

'Skin-to-skin' and 'rooming in' are on the rise in maternity wards

Efforts to boost breastfeeding make well-baby nursery a thing of the past

by Chris Kenrick

In today's hospital maternity wards, the growing practices of "skin to skin" and "rooming in" have turned the traditional newborn nursery into a relic of the past.

Lucile Packard Children's Hospital at Stanford now routinely postpones a baby's first bath in favor of immediate and sustained "skin-to-skin" contact with its mother — and aims to expand that practice.

Rather than whisking off a healthy baby for a bath and a checkup, as in the past, nurses place the undressed newborn on the mother's chest and cover it with a blanket.

"The initial goal is that the baby is left there continuously until it has had its first breastfeed," Packard obstetrician Susan Crowe said. That practice, along with having the baby sleep in the mother's hospital room, fosters successful breastfeeding and other healthful measures, she said.

New statistics from the U.S. Centers for Disease Control, released in conjunction with National Breastfeeding Month, show a rise in breastfeeding in the U.S. as well as in hospital practices of "skin to skin" and "rooming in" — defined as the baby sleeping in the mother's hospital room at least 23 hours a day.

"These are two of the most influential things a hospital can do to support moms in reaching their breastfeeding goals," said Crowe, also a clinical assistant professor of obstetrics/gynecology and maternal fetal medicine at Stanford's School of Medicine.

"Skin to skin has been going on at some levels for awhile, but we're now making changes so we can uniformly offer this to families," even after Caesarean births, she said.

Rooming in has become so common at Packard that "there are very few babies in our well-newborn nursery," she said.

In cases where mother or baby must be taken for immediate medical attention after a birth, Crow said the hospital tries to promote skin-to-skin time later, when both are medically stable.

In the Neonatal Intensive Care Unit, the practice of skin to skin has long been known as "kangaroo care."

Across the country, the percentage of hospitals where "most infants experience skin-to-skin contact" following birth increased from 40.8 percent in 2007 to 54.4 percent in 2011, the CDC said.

The percentage of hospitals in which most infants room in with their mothers went from 30.8 percent in 2007 to 37.1 percent in 2011.

Breastfeeding itself is on the rise, with California leading the way, according to the CDC.

Nationally, the percentage of infants who were ever breastfed rose from 70.9 in 2000 to 76.5 in 2010. At age 6 months, 16.4 percent were still exclusively breastfeeding.

In California, 91.6 percent start out breastfeeding — the highest of any state except Idaho (91.8 percent). At 6 months, 27.4 percent of California babies are still exclusively breastfeeding, the highest percentage of any state.

In a 2011 "call to action," then-U.S. Surgeon General Regina M. Benjamin suggested steps to remove barriers to breastfeeding — including education and employer support — for mothers who wish to do so.

Breastfeeding protects babies from infections and illnesses including diarrhea, ear infections and pneumonia, Benjamin said. Breastfed babies also are less likely to develop asthma, and those who are breastfed for six months are less likely to become obese, she said. Mothers who breastfeed have a decreased risk for breast and ovarian cancer, she said.

A study published in 2010 in the journal "Pediatrics" estimated the nation could save $13 billion a year in health care costs if 90 percent of babies were exclusively breastfed for six months.

At the same time, Benjamin said, "The decision to breastfeed is a personal one," adding, "No mother should be made to feel guilty if she cannot or chooses not to breastfeed."

Staff Writer Chris Kenrick can be emailed at ckenrick@paweekly.com.


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