Császár után

Egy éve dolgozom az egészségügyben. Egy év alatt annyit tanultam, mint azelőtt összesen. Többek között azt, milyen fontos néha csak ülni valahol, és nem csinálni semmit. Ilyen helyzet, amikor anya és baba először találkoznak.

Eddig bába és szülész ismerőseimtől hallottam arról, mekkora művészet valahol csak ott lenni, nem is szólni, szinte észrevétlenül belesimulni a környezetbe, csak annyira látszani, hogy az anya biztonságérzete meglegyen. Sokan erre képtelenek, úgy érzik, tenni kell valamit, különben miért is lennének ott. Vagy tenni kell valamit a fizetésükért/fizetségükért. Vagy azért, hogy bebizonyítsák: itt szükség van a szaktudásukra. Vagy azért, hogy végre történjen már valami. Pedig néha fontos, hogy úgy legyünk az anya mellett, mintha ott sem lennénk.
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Kinek az érdeke? – Bőrkontaktus és szoptatás a szülőszobán

Dr. Kun Judit előadása az “AnyaBaba-barát szülészeti ellátás bemutatása és gyakorlati megvalósításának lehetőségei” című továbbképzésen a Dél-pesti Kórházban.

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Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation.

Widström AM, Lilja G, Aaltomaa-Michalias P, Dahllöf A, Lintula M, Nissen E.
Acta Paediatr. 2011 Jan;100(1):79-85.


Aim: The aim of this study was to provide a more detailed analysis of the infant’s behavioural sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep.

Method: Twenty-eight full-term infants were videotaped immediately after birth. A video protocol was developed to examine infant behaviours identified from five random videotapes.

Results: When birth crying had stopped, the babies showed a short period of relaxation and then successively became alert. They went through an ‘awakening phase’, an ‘active phase’ with movements of limbs, rooting activity and looking at the mother’s face, a ‘crawling phase’ with soliciting sounds, a ‘familiarization phase’ with licking of the areola, and a ‘suckling phase’ and last a ‘sleeping phase’.
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Should Neonates Sleep Alone?

Morgan BE, Horn AR, Bergman NJ.
Biol Psychiatry. 2011 Nov 1;70(9):817-25.


BACKGROUND: Maternal-neonate separation (MNS) in mammals is a model for studying the effects of stress on the development and function of physiological systems. In contrast, for humans, MNS is a Western norm and standard medical practice. However, the physiological impact of this is unknown. The physiological stress-response is orchestrated by the autonomic nervous system and heart rate variability (HRV) is a means of quantifying autonomic nervous system activity. Heart rate variability is influenced by level of arousal, which can be accurately quantified during sleep. Sleep is also essential for optimal early brain development.
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Early Skin-to-Skin After Cesarean to Improve Breastfeeding

Hung KJ, Berg O.
MCN Am J Matern Child Nurs. 2011 Sep-Oct;36(5):318-24.


This article describes a quality improvement project in which early skin-to-skin (STS) contact, in the operating room (OR) and during recovery, was used as an intervention to increase the success of breastfeeding initiation among healthy infants after cesarean, at a large, urban, acute care teaching hospital. The nursing role is key for the intervention, but the program involves the entire perinatal team, including the obstetricians, pediatricians, and anesthesiologists.

During the first 3 months of our intervention, the rate of early STS among healthy babies born by cesarean increased from 20% to 68%.
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‘Kangaroo mother care’ to prevent neonatal deaths due to preterm birth complications

Lawn JE, Mwansa-Kambafwile J, Horta BL, Barros FC, Cousens S.
Int J Epidemiol. 2010 Apr;39 Suppl 1:i144-54.


Background ‘Kangaroo mother care’ (KMC) includes thermal care through continuous skin-to-skin contact, support for exclusive breastfeeding or other appropriate feeding, and early recognition/response to illness. Whilst increasingly accepted in both high- and low-income countries, a Cochrane review (2003) did not find evidence of KMC’s mortality benefit, and did not report neonatal-specific data.

Objectives The objectives of this study were to review the evidence, and estimate the effect of KMC on neonatal mortality due to complications of preterm birth.

Methods We conducted systematic reviews.
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Towards Universal Kangaroo Mother Care: Recommendations and report from the 1 European Conference and 7 International Workshop on Kangaroo Mother Care.

Nyqvist KH, Anderson GC, Bergman N, Cattaneo A, Charpak N, Davanzo R, Ewald U, Ibe O, Ludington-Hoe S, Mendoza S, Pallás-Allonso C, Peláez JG, Sizun J, Widström AM.

Acta Paediatr. 2010 Mar 6. [Epub ahead of print]


The hallmark of Kangaroo Mother Care is the kangaroo position: the infant is cared for skin-to-skin vertically between the mother’s breasts and below her clothes, 24 hours/day, with father/substitute(s) participating as KMC providers. Intermittent KMC (for short periods once or a few times per day, for a variable number of days) is commonly employed in high tech neonatal intensive care units. These two modalities should be regarded as a progressive adaptation of the mother-infant dyad, ideally towards continuous KMC, starting gradually and progressively with intermittent KMC.
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Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis

Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, et al.

Health Technol Assess 2009;13(40).

Objectives: To evaluate the effectiveness and costeffectiveness of interventions that promote or inhibit breastfeeding or feeding with breastmilk for infants admitted to neonatal units, and to identify an agenda for future research.

Conclusions: Despite the limitations of the evidence base, kangaroo skin-to-skin contact, peer support, simultaneous breastmilk pumping, multidisciplinary staff training and the Baby Friendly accreditation of the associated maternity hospital have been shown to be effective, and skilled support from trained staff in hospital has been shown to be potentially cost-effective.
All these point to future research priorities.
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Early contact versus separation: effects on mother-infant interaction one year later.

Bystrova K et al.
Birth. 2009 Jun;36(2):97-109.


BACKGROUND: A tradition of separation of the mother and baby after birth still persists in many parts of the world, including some parts of Russia, and often is combined with swaddling of the baby. The aim of this study was to evaluate and compare possible long-term effects on mother-infant interaction of practices used in the delivery and maternity wards, including practices relating to mother-infant closeness versus separation.

METHODS: A total of 176 mother-infant pairs were randomized into four experimental groups: Group I infants were placed skin-to-skin with their mothers after birth, and had rooming-in while in the maternity ward.
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Enhanced kangaroo mother care for heel lance in preterm neonates: a crossover trial

C C Johnston, F Filion, M Campbell-Yeo, C Goulet, L Bell, K McNaughton and J Byron

Journal of Perinatology (2009) 29, 51–56

Objective: To test if enhancing maternal skin-to-skin contact, or kangaroo mother care (KMC) by adding rocking, singing and sucking is more efficacious than simple KMC for procedural pain in preterm neonates.

Conclusion: The sensorial stimulations from skin-to-skin contact that include tactile, olfactory sensations from the mother are sufficient to decrease pain response in premature neonates.

Teljes cikk

Journal of Perinatology főoldal
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