Parents’ experience of providing skin-to-skin care to their newborn infant

 

Background

Previously skin-to-skin care has shown many beneficial effects in neonatal care, for infants, as well as their parents. Positive outcome has been found on its effect on infant-maternal attachment, breast-feeding, temperature control and pain alleviation. Besides the positive physiological effects of skin-to-skin care, several studies have tried to explore parental experiences of caring for their newborn infant skin-to-skin.

Skin-to-skin care has in this study been defined as when a parent holds the infant vertically skin-to-skin to their chest. The infant is typically dressed only in a diaper and a hat. A blanket or the parent’s clothes cover the back of the infant.

Aim

The aim of this project was to synthesize and interpret the findings from the body of research focusing on parental experiences of skin-to-skin care.

Method

Meta-study (by the principles described by Paterson et al, 2001) based on 17 original papers with a qualitative design, from within health care research. The studies were performed in Brazil, England, Japan, Sweden, South Africa, Uganda and the US in the period of 1989-2008. The infants included in the studies were just newborn or premature born and a few days old at the start of skin-to-skin care. The studies reflect a wide variation in type and duration of intervention: skin-to-skin care from single occasions to continuously use.  Also the setting varied; from maternity units, neonatal intensive care units (NICU) to special Kangaroo Mother Care units. Interviews and/or diaries have been used for data-collection in the studies.

Initially a primary appraisal of the quality of the studies was performed. Case-reports were excluded. After the primary appraisal the results related to the aim of this meta-study was analysed by a qualitative content analysis, in order to find patterns in common and thereby gain a deeper knowledge of the phenomena skin-to-skin care. The method also includes analysing the methodological, as well as the theoretical approach used in the studies, in order to highlight their impact of the results reported.

Preliminary results

From a family centered perspective not only the health of the individuals in the family must be taken into account, but also the family health as a whole, as the members in the family form a symbiotic relationship. In line with this, the results shows that skin-to-skin care from the perspective of parents, is viewed as something concerning the individual parent, the other parent, as well as siblings and extended family.

It was found that by the skin-to-skin care the parents had a bonding experience, but were also afraid of hurting the infant. They experienced that they were important for the infant’s recovery and that the infant’s wellbeing was enhanced. The fathers expressed that they, at times, felt criticized by the staff when providing skin-to-skin care. Providing skin-to-skin care can make mothers ambivalent towards family and household matters. The family dynamics and responsibilities were altered. However, parents also described an increased family intimacy after experiencing skin-to-skin-care.

Conclusion

From a family centered perspective it is important to care for the whole family. In doing this, health care personnel must evaluate interventions designed to help families achieve goals from the perspective of the individuals, as well as from the perspective of the family as a whole.