Immediate skin-to-skin contact with unstable newborns improves survival chances • Hacker News Board

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#61

Post by gibrown » Thu, May 27, 2021, 3:01 PM UTC

reacharavindh wrote: post #33

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s…

We had both our kids at a birth center in the US (actually both born in the same room three years apart) and it was a great experience. There are certainly cases where you can’t but I really liked not being in an overly medical setting. Also (as a new exhausted Dad) taking that first nap in the same bed your baby was just born in and your wife is beside you wide awake… magic. Then about 6-8 hours later we are back home for when my wife was ready to crash as the hormones wear off.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#62

Post by gibrown » Thu, May 27, 2021, 3:04 PM UTC

snikeris wrote: post #43

kazen44 wrote: post #39

Earlier quoted context omitted.

using midwives is quite common in most European countries. in some countries people usually bear there children at home instead of in the hospital as well.

My son would probably be dead if we didn't give birth in a hospital. The cord was wrapped around his neck three times and he wasn't breathing when he came out. A small team of doctors (angels) came in and saved his life. An hour or so later, they had to do it again. It was a short part of their work day, but made all the difference for us.

Don’t know your specific circumstances and it sounds like it was kinda a rough birth so sorry. I will say that the cord wrapped around the neck is super common and something midwives deal with all the time.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#63

Post by drknownuffin » Thu, May 27, 2021, 3:07 PM UTC

neilpmas wrote: post #37

I'm sceptical of single study medical research and especially that which involves the crazily political world of birth. It might be better to wait until the Cochrane collaboration does a meta analysis on multiple studies before anyone changes what they are currently doing.

Skin-to-skin for children has been studied for a few decades, and the consensus is strongly in its favor, after a pile of studies have all pointed in the same direction.

This study isn't "skin to skin care is good." This study was aimed to answer the question, as contextualized, "We have established that skin-to-skin care for healthy children is good (pile of studies); for unhealthy children that have been stabilized is good (pile of studies), but is it good for kids that are still unstable? (controversy)"

"I'm skeptical of a single study" is only a valid criticism if you're familiar with the body of scientific literature. Otherwise, what you're actually saying is, "I'm skeptical of results that pop magazines and press releases have only surfaced to my attention once" - which is a shoddy mechanism for curating your knowledge.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#64

Post by drknownuffin » Thu, May 27, 2021, 3:08 PM UTC

PragmaticPulp wrote: post #24

jeduehr wrote: post #5

I will say this is something we've known for a while: https://pubmed.ncbi.nlm.nih.gov/27885658/

Yes, and it’s standard practice in hospitals. Additionally, our doctor prescribed a certain quota of skin-to-skin contact daily for the first several weeks after birth.

Skin-to-skin is standard. Skin-to-skin for unstable neonates is not, which is the debate in the medical field and the question that the study sought to answer.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#65

Post by doggodaddo78 » Thu, May 27, 2021, 3:09 PM UTC

reacharavindh wrote: post #33

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s…

I just watched the Frontline episode on the Healthcare Divide where US safety-net hospitals (accept anyone hospitals of last resort) have been closing or being sold to vulture investors who buy, trim costs, and sell them at the cost of reduced care.

For-profit healthcare should be like for-profit prisons: illegal.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#66

Post by dools » Thu, May 27, 2021, 3:11 PM UTC

Lots to be learned about the microbiome, and how vaginal birth, breastfeeding and skin contact feeds that. The trend towards caesarian births and formula feeding countervenes this trend in health research.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#67

Post by drknownuffin » Thu, May 27, 2021, 3:14 PM UTC

prionassembly wrote: post #52

Spooky23 wrote: post #22

Earlier quoted context omitted.

You pay for a nurse or aide to be ready to intervene if there’s an issue in a post-caesarean situation. In our case, the hospital my wife delivered in pushed skin to skin heavily, but after a minute or two, I ended up holding our son, skin to skin for the next 10-15 minutes becuase their policy didn’t allow mom to hold the baby while they sutured and did their thing. Once they were done in the OR, back to mom. Usuall…

> You pay for a nurse or aide to be ready to intervene if there’s an issue in a post-caesarean situation. We had a pediatrician in the room (which is also a perfectly opportunistic for the ob/gyn to score a referral). OR theater was main OB/GYN (which we chose), his assistant (also ob/gyn, younger and oddly published), anesthesiologist, instruments clerk and pediatrician. I don't think we had a nurse at all.

What country were you in? In the US, a nurse is highly standard.

If you're not getting a c-section, the usual array is: OB/GYN, plus or minus a resident or assistant, doing the delivery and doing any post-delivery laceration repairs; and a nurse who brought in instruments and is on hand to assist with repositioning the mother, getting more equipment, etc. In most places it's 1-2 nurses. If everything is expected to be, and remains, stable a pediatrician will swing by at some point to check in. This isn't generally a major source of referrals for the pediatrician - (a) many people have already established a relationship with a pediatrician in anticipation of the birth, and (b) in many reasonably sized hospitals the guy who drops by is either a hospitalist or a neonatologist, and they don't have an outpatient practice. Anesthesiologist may drop by to start an epidural, but otherwise isn't present on a continued basis.

If in the OR for a c-section, you'll have the OB and a resident or an assist; one nurse just looking after scrub and tools; a second nurse on hand for additional assistance and to receive the kid for the initial clean-up; an anesthesiologist handling your anesthesia; plus/minus a med student or two either holding instruments for the OB or speaking with the anesthesiologist. If everything is and remains stable, peds will swing by. If the kid is unstable or things go sideways, peds +/- their resident will be on hand for the delivery - a neonatologist if the hospital has one.

I've seen some variation in different places of course, but that's pretty much par for the course.

(When I was in the latter part of med school I had a brief fling thinking I'd do OB/GYN, so I did sub-I's in a few different hospitals around the country. Thank god that idea passed.)

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#68

Post by mikepurvis » Thu, May 27, 2021, 3:15 PM UTC

prionassembly wrote: post #58

reacharavindh wrote: post #33

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s…

> 1. Childbirth is handled by midwives (Jordemothers) instead of doctors. Doctors are brought only when medication or any treatment is necessary. This is perfectly rational in the context of publicly-funded healthcare; for many mothers (younger and in optimal health) pregnancy has little complications. On the other hand, we really benefited from high-intensity pre-natal care with frequent ultrasounds, as we were able…

Surely frequent contact with a lower-cost specialist who is trained to monitor for situations requiring escalation very much implies better care?

Maybe I'm misreading your tone, but it sounds like you're dismissing midwifery as being only about cost savings. I don't think that's true at all (parent of three; we did a midwife for the younger two), but even if that was a major motivation, it's like saying SpaceX is only about cost savings. The cost savings are a game changer in terms of access/frequency/etc.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#69

Post by afavour » Thu, May 27, 2021, 3:21 PM UTC

syntaxing wrote: post #46

reacharavindh wrote: post #33

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s…

I’m in the US and most hospital does the same now. They call it the golden hour where it’s just an hour of skin to skin just like you mentioned with no baby health routine until after such.

...and despite it being essentially a time period where the hospital leaves you alone, you still get billed for it.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#70

Post by blhack » Thu, May 27, 2021, 3:25 PM UTC

reacharavindh wrote: post #33

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s…

This sounds exactly like the process my wife and I are going through in the US right now.

I’ve never heard of pregnancy being treated like an “illness” (??).

Midwives are also extremely common here.

Granted I live in Arizona, and I know much of HN lives in SF. So maybe this is unique to Arizona in some way?