The Birthday Cuddle: Enhancing Family-Centered Care in Neonatal Units
Providing insights into the importance of initiating family-centered care right from birth, the guidelines outlined in the content focus on enabling higher acuity babies to experience the irreplaceable birthday cuddle. The process involves preparation, effective stabilization, and clear communication with the obstetric/midwifery team to facilitate a brief cuddle session between the baby and parent(s) in the delivery room. Safety audits and positive feedback from parents highlight the significant impact of this practice on both infants and families.
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Presentation Transcript
The Birthday Cuddle Dr Peter Reynolds
Background Example of Family Centred care* Higher acuity babies get imprisoned in incubators, shackled with leads and it may be weeks before they can be held by their parents Babies who die may never have been held We aim for every baby, whenever clinically possible, to be given a cuddle after birth * Clarke P. Family-centred care right from birth: the irreplaceable birthday cuddle. Acta P diatrica. 2017:106;1534 1535
Decision Prepare parents beforehand Prepare obs/midwifery staff beforehand (!) Senior neonatal support (reg, nurse, cons) Effective stabilisation / resus (we need to talk) Temperature management (we need to talk)
Delivery Room (Birthday) Cuddle guideline Neonatal team in attendance at delivery Explain to obstetric/midwifery team before delivery that we plan for baby to be held by mother (or father) for up to 5 mins after delivery if stable Baby requiring stabilisation; both intubated and NIV babies are eligible Baby has pulse oximetry on right hand/wrist with good signal Less than 15 minutes since birth No Yes Clinically stable with FiO2 <0.3 No Yes Confirm to obstetric and midwifery team that plan for mother to cuddle baby. Not for 5min delivery room cuddle but show baby to parents, try to allow them to touch / kiss their baby. Baby with hat, wrapped in towels, can be handed to mother/father for 5 minute cuddle provided stability maintained. Offer to take photographs using family s phone Transfer to NICU Complete audit form (below)
Safety Prospective Audit Staff Mainly 5 mins achieved Did not hinder management 19/19 Baby was safe 19/19 Normal admission temperature 18/19 (36.3 C) Blood glucose: 12( 2.0mmol/L) 2 ( 1.0mmol/L) 2 ( 1.0mmol/L) 3 not recorded (grrrr!)
Safety Prospective Audit Parents Very positive 19/19 I was really happy to be able to cuddle him This was the most amazing experience of our lives (other Twin had undergone feticide) I got to hold my baby
Why do it? Positive impact on Bonding (both parents) Breast feeding Coping with death
Next Steps and Aim Normalise and anticipate Continue safety audit Temperature management Process design to facilitate* Delayed cord clamping (5 mins) with simultaneous stabilisation then birthday cuddle * Baylis R, et al First time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units. Acta Paediatr 2014;103: 1045 52.
Thank you peter.reynolds1@nhs.net
