Choosing Wisely:

Don’t separate mothers and their newborns at birth unless medically necessary. Instead, help the mother to place her newborn in skin-to-skin contact immediately after birth and encourage her to keep her newborn in her room during hospitalization after the birth.

Rationale and Comments: Keeping mothers and newborns together promotes maternal-infant attachment, early and sustained breastfeeding, and physiologic stability. Early initiation of skin-to-skin care and breastfeeding promotes optimal outcomes and can significantly reduce morbidity for healthy term and preterm or vulnerable newborns. Breastfeeding is the ideal form of infant nutrition and should be the societal norm. Given the numerous health benefits for infant and mother and the health care cost savings associated with breastfeeding, breastfeeding has become a global public health initiative that can improve the overall health of nations. Ideally, infants should be exclusively breastfed for the first six months of life; after the first six months, appropriate complementary foods should be introduced, and the infant should continue to breastfeed for one to two years, or longer as desired. Worldwide, the lives of an estimated 1.5 million children less than the age of five would be saved annually if all children were fed according to this standard.
Sponsoring Organizations:
  • American Academy of Nursing
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Obstetrical
  • Neonatology
  • References: • Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012 Mar;129(3):e827-41.
    • AWHONN position statement. Breastfeeding. J Obstet Gynecol Neonatal Nurs. 2015 Jan-Feb: 44(1);145-50.
    • Brodribb W, Kruske S, Miller YD. Baby-friendly hospital accreditation, in-hospital care practices, and breastfeeding. Pediatrics. 2013 Apr;131(4):685-92.
    • Conde-Agudelo A, Díaz-Rossello L. Kangaroo mother care to reduce morbidity and mortality in low birth weight infants. Cochrane Database Syst Rev. 2014 Apr 22;4:CD002771.
    • Marín Gabriel MA, Llana Martín I, López Escobar A, Fernández Villalba E, Romero Blanco I, Touza Pol P. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr. 2010 Nov;99(11):1630-4.
    • Moore ER, Anderson GC. Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. J Midwifery Womens Health. 2007 Mar-Apr;52(2):116-25.
    • Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD003519.
    • Breastfeeding key to saving children’s lives: ten steps to successful breastfeeding highlighted during World Breastfeeding Week. Geneva (Switzerland): World Health Organization. 2010 Jul 30. Available from: http://www.who.int/mediacentre/news/notes/2010/breastfeeding_20100730/en/.

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