Proposed guidelines for skin-to-skin treatment of neonatal hypothermia.
Hypothermia is not uncommon in full-term, low-risk newborns during the first days of life. Standard care for treating hypothermia often involves the separation of the mother and the newborn while the infant is placed under a warmer and observed in the nursery. Because one important role of the postpartum nurse is to promote mother-infant attachment by encouraging the mother to spend time "getting to know" her infant, this separation can be problematic. This article proposes that skin-to-skin (STS) care, also called kangaroo care, an intervention in which the unclothed, diapered infant is placed on the mother's bare chest, be used to promote thermoregulation instead of using separation and a warmer. STS care has been recognized as a way to facilitate maternal-infant attachment and promote thermoregulation. The literature review here provides an analysis of the available evidence and the author's conclusion that the research supports the use of STS care as an alternative to traditional rewarming. The evidence was graded and organized into an evidence-based practice guideline for the use of STS care in the treatment of mild hypothermia in the low-risk infant. Suggestions for further research and outcomes measurement are included.
Galligan
Maura
M
Beth Israel Deaconess Medical Center, Boston, MA, USA. galliganm@gmail.com
D015400:Clinical Nursing Research; D003020:Clothing; D019317:Evidence-Based Medicine / Q000458:organization & administration; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007035:Hypothermia / Q000145:classification / Q000175:diagnosis / Q000517:prevention & control*; D007224:Infant Care / Q000458:organization & administration*; D007231:Infant, Newborn; D007258:Informed Consent; D008991:Monitoring, Physiologic / Q000451:nursing; D009034:Mother-Child Relations; D009035:Mothers / Q000193:education / Q000523:psychology; D017283:Neonatal Nursing / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment / Q000458:organization & administration; D009733:Nursing Diagnosis / Q000458:organization & administration; D018579:Patient Selection; D011187:Posture; D017410:Practice Guidelines as Topic; D012107:Research Design; D017694:Rewarming / Q000379:methods / Q000451:nursing; D012307:Risk Factors; D012720:Severity of Illness Index; D014110:Touch