As I have posted before, I have been working toward changing our delivery 
routine from routine separation for 15-20 minutes to immediate skin-to-skin 
until after the first breastfeed.  I have made a little bit of progress in this area 
but am again needing input.

Our OB docs were not very taken with the idea. They felt that mothers would 
not enjoy the experience of holding a "wet slimy baby", and that waiting up to 
90 minutes to record a weight was unacceptable to them and family members.  
I was proposing setting this as routine across the board, so that even non-
breastfeeding mothers would hold baby STS and benefit from the increased 
oxytocin and bonding.  They felt this would be an imposition on these moms, 
and too much pressure toward breastfeeding.

Our Peds were much more accepting and understanding of the benefits and 
importance to the baby and to breastfeeding.  However, they really don't want 
to 'give up' the assessment and intervention immediately post delivery.  They 
really want baby taken to the warmer to be dried thoroughly, freely assessed 
(not 'hands off' by nurse with baby face-down on mom), get a puff of O2 if 
needed, and get a quick weight (this is mostly for the OB's and family's 
benefits).  They agreed that the Vit K and eye ointment can be done STS.  
Baby would be back to mom before the 5 minute APGARs.

I feel this is certainly progress.  To be honest, my inclination right now is to 
stick with this approach since the docs have been so skeptical of changing 
and I'm already at risk of being labled 'radical'!  So my questions are these:  Is 
a brief, <5 minute separation really all that detrimental to the baby and to 
breastfeeding? (We have another LC on staff who, bless her heart, immediatly 
said "But that's not evidence based!"  She's right, of course.)  If I proceed in 
pushing for immediate STS, how should I best go about that without alienating 
the physicians?  Can anyone who practices immediate STS in their hospital let 
me know what their routine is?  Evidence based information is essential.  

Julie Conaway, RN, IBCLC

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