Toby - I hear the echoes of your screams from here!  Our baby-friendly
hospitals have changed their protocols to ensure that mothers and babies
enjoy one hour of uninterrupted skin-to-skin contact immediately following
delivery, during which time breastfeeding is initiated.  As I am a national
BFHI Assessor I have often been tasked with observing that this is complied
with.  I guess we are a little primitive here, we don't have radiant
warmers, we have winter temperatures which fall to zero (Celsius) and why,
oh, why do MOST of the deliveries occur at night?  But the hospitals have
developed an effective way of keeping the babies warm.  The baby is
delivered on to the table, cord clamped etc. face wiped, mouth suctioned if
necessary and then the baby is held up so that the mother can see if it is
boy or a girl, and IMMEDIATELY placed on the mother's naked abdomen with the
face between her breasts.  The baby is then covered with a clean nappy
(diaper) which the mother brings with her into the delivery room, then a
towel, and then both of them are covered over with blankets. A nappy is used
immediately over the baby as the first layer because it gets messy from the
blood and vernix and the mother will be able to wash it more easily later.
The midwives then attend to delivery of the placenta, stitches if necessary,
change the sheets from under the mother and clear up and write their notes.
All this time the mother and baby are lying together undisturbed.  After
about 2O minutes or so the midwife will see if the baby is ready to start
breastfeeding, if so they assist with latching, still on the delivery table.
Once the baby has breastfed they weigh and measure the baby, put on the
nappy and clothes (if any), wrap the baby and place with the mother in the
wheelchair to go to the post-partum ward.  Once there mother and baby get
into bed together (no cribs) and bed-in for the next 2 - 3 days. There is no
way this baby can get cold.

Unfortunately, the private hospital where I occasionally call to see clients
is not "baby-friendly" and they have a different system - hence the latching
difficulties, late initiation of breastfeeding that I am asked to assist with.
The BFHI really is extremely effective - the problem seems to be in getting
the powers-that-be interested in TRYING it out.

Best wishes,

Pamela, Zimbabwe.