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Lactation Information and Discussion

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Subject:
From:
Mandy Schaub <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 26 Jul 2016 15:22:10 -0400
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For those of you who are in Baby Friendly facilities or on your way, I am looking for some help with our current skin to skin problem.  We are Auditing Step 4 and have some concerns.  Step 4 basically says baby goes skin to skin with mom within 5 minutes of vaginal birth and remains there until after the first feed or for at least 1 hours uninterrupted.  We use Epic for computer charting.  Epic requires the baby’s weight be entered in the delivering OB’s note before it can be completed.  Typically once baby is born they are going to mom immediately.  The issue is about 15-20 minutes in they are being taken away from mom for a weight and then being put back.  My understanding is this is considered an unnecessary interruption of skin to skin before the first hour/feeding is complete.  I’m not sure that doing the weight immediately after delivery before seeing mom is a solution, because we typically deliver baby and hand it right over.  Do we really want to not have mom be the first person to hold her baby or to wait for a weight to do so?  No.  At the same time the weight needs to be done before the first hour is up.  Apparently DHEC requires the weight be part of the delivering Doc’s note.  There is probably no way we can get Doc to add it later in an addendum.  We are lucky to get the charting we do.  How do other people do this???  We've tried putting a towel on mom drying baby off on mom, whisking it away for a weight and returning within 5 minutes to begin uninterupted skin to skin.  There is only 1 RN in the room being pulled in 100 directions, so it isn't working.  Please share your delivery work flow.  How do you get a weight, skin to skin within 5 minutes and uninterupted?  Do you utilize a baby RN in addition to your delivering RN?  In a perfect world the Doc, computer or charting wouldn't matter, but we have to consider it, so I need a real solution.  
Thanks for your expertise, Mandy Schaub 

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