Cawley, Paul

Clarke, Paul

English

University of East Anglia digital repository

DOES	OFFERING	DELIVERY	ROOM	CUDDLES	TO	MOTHERS	OF	NEWBORN	EXTREMELY	PRETERM	INFANTS	AFFECT	NEONATAL	ADMISSION	TEMPERATURES?Paul	Clarke1,2	 @Norwich_NICUMD	FRCPCH	Paul	Cawley1 MRCPCH	1	Neonatal	Unit,	Norfolk	and	Norwich	University	Hospital	NHS	Foundation	Trust,	Norwich	UK	2	Norwich	Medical	School,	University	of	East	Anglia,	Norwich	UKBACKGROUNDParents of extremely preterm babies (<27 weeks’ gestation) are rarely allowed a delivery-room cuddle of theirnewborns because urgent NICU admission is usually considered the highest priority. The abrupt separation andremoval to NICU of the baby who has already been with mother for 6+ months is mutually traumatic. Oncestabilised, a calm, supervised, initial cuddle is a marvellous opportunity for the neonatal doctors and nurses toprovide initial reassurance for parents, for parents to meet and form an initial bond with their baby, and for babyto feel a first loving embrace (Figure). If a cuddle is not allowed before NICU admission, it is often many weeksbefore a first cuddle is possible. However there are virtually no published data to show the safety of the practice.AIMOur aim was to assess the thermal safety of allowing mothers of extremely preterm infants a brief delivery-room cuddle of their baby prior to their baby’s NICU admission.METHODS• Single centre, retrospective, case control study • We reviewed neonatal records of babies inborn at <27 weeks’ gestation and admitted to our tertiary-level centre in the 12-year period 2006–2017• Babies whose mothers had been allowed to hold and cuddle them in the delivery room were identified from the records and all were then matched for birth gestation, gender, delivery mode, and multiplicity with contemporaneous inborn control babies whose mothers had been only ‘shown’ their babies before the NICU admissionRESULTS• Of 396 babies admitted at <27 weeks’ gestation in the study period, 233 were inborn• Once stabilised, following the initial resuscitation and intubation, 27 (12%) of inborn babies had received a documented neonatologist-supervised delivery-room cuddle with their mother prior to NICU admission• The Table shows NICU admission times and temperatures in cuddled versus control babies:CONCLUSIONS• Parents immensely value being offered a deliveryroom cuddle before their baby’s NICU admission• Practising it for extremely preterm babies did notsignificantly delay NICU admission, nor adverselyaffect the neonates’ admission temperatures• Closely supervised, the delivery room cuddle issafe - but good communication with parents is vital• With increased family-centred care, we predict thedelivery room cuddle will in time become standardcare at birth for most babies born preterm• Birth day delivery room cuddles are irreplaceable!Figure: Precious delivery room cuddle of Jack, a 23+1 week gestationtwin born in 2006. Jack’s first cuddle with both parents was in thedelivery room when aged ~30 minutes postnatal. Jack is within apolythene bag, swaddled, and the attendant neonatologist is providingmanual ventilation via the endotracheal tube using T-piece with hosingstill connected to the resuscitaire ventilator system. Admissionobservations in the NICU at 41-minutes postnatal, were: temperature38.0°C, pH 7.38, glucose 2.4 mmol/L. Jack died of sepsis on day 11.

Does offering delivery room cuddles to mothers of newborn extremely preterm babies affect neonatal admission temperatures?

https://ueaeprints.uea.ac.uk/id/eprint/73044/1/ClarkeP_EAPS_2018_EAPS8_1386.pdf

Does offering delivery room cuddles to mothers of newborn extremely preterm babies affect neonatal admission temperatures?

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University of East Anglia digital repository