Hi, Casey:  I have been a hospital-based LC for way more years than I care to 
count (25 years?).  Back in 1992, the hospital I was then the Lactation 
Consultant for implemented KMC in our Level II nursery.  It made the front 
page of the Neighbors section of our local paper - a full-color picture of a Dad 
KMCing his preemie triplets.  The day the article appeared, a dad whose baby 
was a normal term newborn on the Mother/Baby unit approached me in the hall 
(I was quoted in the article) and asked me if his baby had to be sick in order 
for him to do KMC.  I wrote the SCN KMC policy, and after my conversation 
with this dad, sat down and wrote a policy for term newborns.  This policy has 
existed in some form since, including the hospital I am now the Clinical Lead 
at.  I still get lots of resistance from the nurses, the chief concern being "cold 
babies".  But many of our younger, newer nurses, who are having their own 
babies are sold on the idea.  They have noted a pleasant side effect for 
themselves - it decreases their workload.  Our management is not sold on it, 
but realize it is not going away and have asked that we try other methods to 
interest the baby in feeding (cold washcloth, baby sit-ups, loosening the 
blankets, etc.) first before "resorting to stripping the baby".  I've been told by 
managers that the moms "don't like KMC" - our particular patient population 
isn't from "California" and aren't into the "hippie thing".  Interestingly enough, 
the parents absolutely love KMC and will do it for hours, including many of the 
dads.  Moms who were getting frustrated trying to nurse a sleepy uninterested 
baby will tell me that KMC was what worked to get the baby nursing well.
We are also working on making it a standard that healthy moms/babies will do 
KMC as soon as possible after delivery - I suspect that we will see an increase 
in good early 1st nursings.
To write your own hospital policy, follow your hospital's policy-writing 
guidelines.  You want to include why KMC is being performed and the protocol 
on how to do it. Incorporating both term and SCN protocols into the same 
policy can be easily done, especially in a Level I and Level II nursery.
Hope this helps.

Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA

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