Publication:

Evaluating the optimal duration of skin-to-skin contact for normothermia in a newborn: an observational study

Background The Neonatal Resuscitation Program (NRP) emphasizes the prevention of hypothermia by providing skin-to-skin contact (SSC) immediately after birth on the mother’s abdomen as a part of routine care for all neonates who cry immediately after birth. However, the duration of SSC in achieving normothermia immediately after birth has not been studied. The duration of SSC for 1 hour is usually consensus-based. In a public sector tertiary care hospital, practicing SSC for one hour may not be feasible because of the high delivery load. Therefore, we studied the minimum duration of SSC immediately after birth necessary to attain normothermia in newborns.

Methods 525 newborns (≥34 weeks and weight≥1800 grams), who cried immediately after birth, were placed on the mother’s abdomen for routine care. Axillary temperature was monitored using a digital thermometer at 20 min, 30 min and 40 min during SSC. Newborns were observed for breastfeeding within one hour and exclusive breastfeeding at discharge.  The chi-square test was used to analyze the data.

Results 389/525 (74.1%), 507/525 (96.6%) and 525/525 (100%) of newborns achieved normothermia at 20 min, 30 min and 40 min of SSC, respectively. 391/525 (74.5%) of babies were breastfed within the first hour and 486/525 (92.6%) of babies were discharged on EBF. Breastfeeding within 1 hour of birth was significantly higher in the group of newborns who achieved normothermia within 20 minutes of immediate SSC (p value<0.001).

Conclusions A minimum of 30 minutes of SSC immediately after birth is required to achieve normothermia in a term or near-term newborn, which is feasible and scalable in high delivery load facilities.