Skin-to-Skin Contact and Early Initiation of Breastfeeding Rate

Sireesha Tirumalaraju, Rajeev Santosh Peethala, Apoorva Taduri, Abhishek Peapally Venugopal, Beulah Suhasini

Abstract

Aim: To increase the rate of skin-to-skin contact (SSC) and early initiation of breastfeeding (EIBF) among healthy term and preterm neonates (born at ≥ 34 wk of gestation) from 83% to 90% in 6 weeks

Materials and Methods: The study was implemented in 3 phases—baseline phase, intervention phase, and sustenance phase. A quality improvement (QI) team was formed including neonatologists, perinatal nurses, and midwives. Problem assessment was done using a fishbone analysis, and hindering factors were identified. Multiple change ideas were tested with plan-do-study-act cycles. Interventions included sensitizing nursing staff, doctors, and midwives and prenatal counseling for expectant mothers and birth attendants about the importance of SSC and EIBF. Ensuring proper documentation, conducting monthly audits, and identifying and training newly joined health care staff were also a part of the implementation phase. The outcome indicators and process indicators were continuously monitored.

Results: The median compliance to SSC and EIBF was 83% during the baseline period, which improved to 91.4% by the end of implementation phase. During the implementation and sustenance phases, the median compliance to SSC and EIBF was 89% for normal vaginal deliveries and 91% for lower segment cesarean sections.

Conclusion: QI initiative is a cost-effective strategy to improve the compliance to/implementation of evidence-based practices without additional manpower or resources. Prenatal counseling to mothers and birth attendants and frequent auditing of the process indicators and implementation of appropriate actions helped us sustain the practice of SSC and EIBF in our unit.