Gupta, Deierl, A., Hills, E., & Banerjee, J. (2021). Systematic review confirmed the benefits of early skin‐to‐skin contact but highlighted lack of studies on very and extremely preterm infants. Acta Paediatrica, 110(8), 2310–2315. https://doi.org/10.1111/apa.15913

• CONCLUDED "This systematic review showed that early SSC in delivery rooms, operating rooms and NICUs in the 180 min after birth were beneficial for neonates. Further studies are needed that focus on preterm infants of varying gestations, because there are not enough data about the benefits, especially in very and extremely preterm neonates. Empowering and training staff and parents alike can help to overcome the barriers and technical challenges of providing all neonates with early SSC, including those born at very low gestational ages."

Tyrala, Goodstein, M. H., Batra, E., Kelly, B., Bannon, J., & Bell, T. (2021). Post-Partum Skin-to-Skin Care and Infant Safety: Results of a State-Wide Hospital Survey. Global Pediatric Health, 8, 2333794X21989549–2333794X21989549. https://doi.org/10.1177/2333794X21989549 

• CONCLUDED "Our survey has revealed deficiencies in the practice of SSC in maternity centers in PA that may have contributed to an unexpectedly high number of reports of adverse infant events. While we fully embrace the importance of SSC in promoting successful breastfeeding, our findings underscore the need for all maternity centers to provide both staff and patient education on infant safe sleep and the unique infant safety issues that occur during SSC. Strict policies and procedures guiding the practice of SSC in all locations must also be in place. This includes careful attention to staffing to allow appropriate observation of the mother-infant dyad as well as ongoing continuous quality improvement evaluations to assure maximum safety for the infant. We believe that our findings provide a starting point and reference for future work and discussion around the critical safety issues for newborns during SSC. Further research to delineate best practices for infant monitoring during SSC is critical to this process."

2020

Linnér, Westrup, B., Lode-Kolz, K., Klemming, S., Lillieskold, S., Markhus Pike, H., Morgan, B., Bergman, N. J., Rettedal, S., & Jonas, W. (2020). Immediate parent-infant skin-to-skin study (IPISTOSS): study protocol of a randomised controlled trial on very preterm infants cared for in skin-to-skin contact immediately after birth and potential physiological, epigenetic, psychological and neurodevelopmental consequences. BMJ Open, 10(7), e038938–e038938. https://doi.org/10.1136/bmjopen-2020-038938

• CONCLUDED (from abstract) "In Scandinavia, 6% of infants are born preterm, before 37 gestational weeks. Instead of continuing in the in-utero environment, maturation needs to occur in a neonatal unit with support of vital functions, separated from the mother’s warmth, nutrition and other benefits. Preterm infants face health and neurodevelopment challenges that may also affect the family and society at large. There is evidence of benefit from immediate and continued skin-to-skin contact (SSC) for term and moderately preterm infants and their parents but there is a knowledge gap on its effect on unstable very preterm infants when initiated immediately after birth"

Mehler, Hucklenbruch‐Rother, E., Trautmann‐Villalba, P., Becker, I., Roth, B., & Kribs, A. (2020). Delivery room skin‐to‐skin contact for preterm infants—A randomized clinical trial. Acta Paediatrica, 109(3), 518–526. https://doi.org/10.1111/apa.14975 

• CONCLUDED "DR‐SSC in preterm infants >25 (to 32 + 0) weeks of GA improves quality of MCI at 6 months of CA and reduces the risk of early post‐ partum maternal depression and impaired bonding without increas‐ ing short‐term complications of prematurity.. Consequently, DR‐SSC may have an impact on maternal sensitivity and maternal mental well‐being. These factors are associated with improved develop‐ ment in premature infants."

2019

Widström, Brimdyr, K., Svensson, K., Cadwell, K., & Nissen, E. (2019). Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatrica, 108(7), 1192–1204. https://doi.org/10.1111/apa.14754 

• CONCLUDED "Results: Strong scientific research exists about the importance of skin-to-skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short- and long-term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant’s instinctive behaviour and maternal responses while in skin-to-skin contact. Conclusion: The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant’s instinctive behaviour, practical, evidence-informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence-based routines of staff."

2018

Alenchery, Thoppil, J., Britto, C. D., de Onis, J. V., Fernandez, L., & Suman Rao, P. N. (2018). Barriers and enablers to skin-to-skin contact at birth in healthy neonates - a qualitative study. BMC Pediatrics, 18(1), 48–48. https://doi.org/10.1186/s12887-018-1033-y 

• CONCLUDED "Results: All subjects were aware of SSC at birth, some of its benefits and had practiced SSC. The major barriers identified were lack of personnel (nurses), time constraint, difficulty in deciding on eligibility for SSC, safety concerns, interference with clinical routines, and interdepartmental issues. Recall of an adverse event during SSC was also a major barrier. Furthermore, we found that most participants considered 1 h as impractical; and promoted 5–15 min SSC. Minor themes were gender bias of the newborn and cultural practices. The participants offered solutions such as assigning a helper exclusively for SSC, allowing a family member into the LR, continuing SSC after initial routines, antenatal counselling, constant reminders in the form of periodic sessions with audiovisual aids or posters in the obstetrics ward, training of new nurses and PG, and inclusion of SSC in medical and nursing curriculum. Conclusions: The major barriers to SSC at birth are lack of personnel, time constraint and safety concerns. Training, designated health personnel for SSC and teamwork are the key interventions likely to improve SSC at birth."

Straiton, J. (2018). Do c-section babies have a weaker immune system? Accessed https://www.biotechniques.com/immunology/birth-by-caesarean-can-alter-the-path-of-immune-system-development/

• New research has found that babies born via cesarean section may have an impaired immune system in later life due to the lack of exposure to maternal bacteria that would occur during the standard birthing process.

2017

Neczypor, & Holley, S. L. (2017). Providing Evidence-Based Care During the Golden Hour. Nursing for Women’s Health, 21(6), 462–472. https://doi.org/10.1016/j.nwh.2017.10.011

• CONCLUDED "Implementing an evidence-based Golden Hour protocol can improve breastfeeding rates, decrease maternal and neonatal morbidity, and promote mother–newborn bonding, with minimal cost and probable financial gain for hospitals. Although not all stakeholders will initially support this practice change, education for staff and families can help overcome logistical and institutional barriers, as well as attitudes and habits, that do not facilitate the Golden Hour. Providing women and newborns with the benefits of immediate skin-to-skin contact, delayed cord clamping, and early initiation of breastfeeding can improve health outcomes, rendering it imperative for birthing units in hospitals to implement the Golden Hour in their practice setting"

2016

Koopman, Callaghan-Koru, J. A., Alaofin, O., Argani, C. H., & Farzin, A. (2016). Early skin-to-skin contact for healthy full-term infants after vaginal and caesarean delivery: a qualitative study on clinician perspectives. Journal of Clinical Nursing, 25(9-10), 1367–1376. https://doi.org/10.1111/jocn.13227 

• CONCLUDED "Findings. Critical institutional factors included inadequate staffing and education of clinicians on early skin-to-skin contact. On a familial level, parental education and motivation were identified as important factors. Barriers to implementation included the absence of a clinical algorithm and unclear definitions for eligible mothers and infants. Conclusions. Various facilitating factors and barriers to early skin-to-skin contact of healthy full-term infants born via vaginal and caesarean delivery were identified."

2015

Sevelsted, A., Stokholm, J., Bønnelykke, K., & Bisgaard, H. (2015). Cesarean section and chronic immune disorders. Pediatrics (Evanston), 135(1), e92–e98. https://doi.org/10.1542/peds.2014-0596

2014

Neumann, Mounsey, A., & Das, N. (2014). Suctioning neonates at birth: time to change our approach: there’s a better way to clear secretions from a neonate’s mouth and nose, and it’s less likely to cause adverse effects.(PURLs[R]: Priority Updates from the Research Literature from the Family Physicians Inquiries Network). The Journal of Family Practice, 63(8), 461–.  Accessed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139400/

• CONCLUDED "Practice patterns in a delivery room can be difficult to change. As we work on improving our delivery room environment and changing ingrained habits, the evidence from this study should help support the use of wiping in place of suctioning. The transition from suctioning to wiping also would be facilitated by having easily accessible towels designated for wiping."

2012

Childbirth Connection (2012). Vaginal or Cesarean Birth: What Is at Stake for Women and Babies?   Accessed https://www.nationalpartnership.org/our-work/resources/health-care/maternity/vaginal-or-cesarean-birth-what-is-at-stake.pdf

• Often ignored, and usually not included in "informed" consetnt forms are the possible harms that can occur to babies as a result of caesarean birth.  These include such things as greater risk of neonatal death, respiratory problems, pulmonary hypertension, difficulty breastfeeding, autoimmune diseases such as asthma, diabetes and other, food allergies, obesity, cuts to baby and other. 

2009