Background: Neonatal hypoglycemia (NH) is a common disorder affecting 5 to 15% of otherwise healthy infants, such as late preterm, small or large for gestational age, or born to mothers with diabetes. Early management of NH in these at-risk infants is often achieved with administration of formula and/or intravenous (IV) dextrose, which may potentially impair normal metabolic adaptation. Multiple studies have demonstrated that early infant skin-to-skin contact with mother has many advantages such as better physiologic stability including increase in blood glucose levels. In May 2014, we instituted a new guideline in our newborn nursery to encourage prolonged skin-to-skin care (SSC) during the entire period of blood glucose monitoring for late preterm and term infants at-risk for NH. We hypothesized that fewer at-risk infants born after this SSC intervention would require admission to the neonatal intensive care unit (NICU) for hypoglycemia. Objective: The objective of this study was to evaluate the effects of this SSC intervention in late preterm and term infants at-risk for NH. Study design: We conducted a retrospective before and after cohort study comparing the late preterm and term infants at-risk for NH born in a one-year period prior to the implementation of SSC intervention (Pre-SSC) to the at-risk infants born in the year following the implementation of SSC intervention (Post-SSC). Results: There were no differences in maternal and infant characteristics between both groups. Similarly, the proportion of infants of diabetic mothers, small or large for gestation or late preterm infants was similar in the two time periods. The number of hypoglycemia admissions to NICU among at-risk infants for NH decreased significantly from 8.1% Pre-SSC period to 3.5% Post-SSC period (P = 0.018). The number of infants receiving IV dextrose bolus in the newborn nursery also decreased significantly from 5.9% to 2.1% (P = 0.02). Number of infants discharged exclusively breastfeeding increased from 36.4% to 45.7%, although not statistically significant (P=0.074). There were no adverse events associated with SSC intervention. Conclusion: This SSC intervention was safe, feasible and associated with a significant decrease in newborn hypoglycemia admissions to NICU.
The Effects of Skin-to-Skin Care on Late Preterm and Term Infants At-Risk for Neonatal Hypoglycemia
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Arpitha Chiruvolu, Kimberly Miklis, Veeral Tolia; The Effects of Skin-to-Skin Care on Late Preterm and Term Infants At-Risk for Neonatal Hypoglycemia. Pediatrics May 2018; 142 (1_MeetingAbstract): 683. 10.1542/peds.142.1MA7.683
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