Roni:  I agree with you that the near-termer is in a class all by itself.  
But I am unclear as to why you say that skin-to-skin has its limits.  If 
the baby is well and stable enough to be in the room with the mother, she 
(or dad) should be encouraged by everyone, not just the LC, to do skin-to-
skin 24/7 if the parents want.  Baby's vitals, etc. can be done on the 
mother's (or father's) chest. Even a heel stick to check glucose levels can 
be done on the parent's chest (if the lab tech is willing.  I have talked a 
few into it with particularly intimidating looks, in front of the 
parents!)  With some education on what the baby needs, most parents are 
willing to do skin-to-skin rather than risk the baby needing to be admitted 
to the nursery.  Even "observation" in the nursery is going to bring about 
more separation than the parents may want or expect.
Hope everyone had a blessed and peaceful holiday season!

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

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