Background Preterm birth remains the leading cause of neonatal mortality in the UK. There are well-documented multifaceted benefits attributed to parental skin-to-skin contact with premature neonates. It is imperative that we incorporate this safely into our care for the vulnerable population of preterm infants. Delivery room cuddles (DRC) aims to optimise this at the earliest opportunity.
Objectives To evaluate implementation of routine preterm DRC at the Great Western Hospital (GWH) with particular focus on feasibility and safety. To evaluate whether practice has changed during the COVID-19 pandemic and to review areas to improve future practice.
Methods Data was collected on babies born below 35 weeks’ gestation at GWH from two cohorts: those born between 1/11/2018 and 21/12/2019, and babies born during the COVID-19 pandemic (after 19/3/2020). Data was collected by retrospective review of Badger.net and of written clinical records.
The sample contained 164 neonates with a median gestation of 33 weeks and birth weight of 1849 g. Further demographics and the comparison between groups are detailed in table 1.
Results Overall, 75% of the 164 neonates had a DRC. 82% of babies were stable during the cuddle, and a further 13% clinically improved. 5% had cardiorespiratory or thermal instability. The 6 babies with instability were between 32–34 weeks gestation. 4 experienced respiratory distress during DRC prior to stabilisation. Another 32-week infant required ventilation breaths during DRC which was felt to be due to poor airway positioning. A 34-week infant had a period of bradycardia which had resolved when reassessed on the resuscitaire.
There was no significant difference in admission temperature between DRC and non-DRC groups. The percentage of infants receiving a DRC increased from 70% to 84% during the COVID-19 pandemic, with no change in mean admission temperature.
Conclusions Our results support DRC as a safe and feasible concept. The DRC ideology empowers women, supports bonding and provides preterm infants with the magnitude of benefits associated with early maternal contact. The recent BAPM maternal breast milk toolkit refers to early contact with parents as a key step in optimising MBM for preterm babies: DRC is an effective strategy in implementing this. Our instability data highlights the importance of following the standard operating procedure and ensuring continual close monitoring during DRC. Examining the mid and longer-term outcomes for DRC neonates and a larger, multi-centre study would be useful contributors to support standardising DRC in practice.
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