Horizon Star - September 2019

How skin-to-skin during painful procedures supports babies, children, parents and health care providers


At theMother Baby Clinic, we

offer the option for skin-to-skin

during heel pokes for all babies and parents. It has become a routine practice; we don’t even give it a second thought.

I would not have it any other way. To me it felt normal. Madelyn got a little bit of milk and it seems like it

It was amazing, Hayes didn’t

even cry when he had his shot because he was on me, he was nursing. For him, it was like nothing even happened. As a parent, it is comforting to know I can take away a little bit of their pain by being close. Jenna

Horizon’s Baby-Friendly Initiative team encourages all staff— and parents, guardians and family members—to promote and perform skin-to-skin with their newborns, toddlers and young children during painful procedures. Skin-to-skin means your baby is placed belly-down (wearing only a diaper), directly on your bare chest.

This can be immediately after birth (or as soon as the baby is born), frequently during your hospital stay, and when a young child is having any painful or upsetting test or procedure and many moments in between. Skin-to-skinwith breastfeeding and/or sucking is an effectiveway to decrease their pain!

I find giving parents a chance to hold their newborn not only gives baby a sense of security and helps with pain but empowers parents and builds confidence in their parenting skills. The initiative has made my job a lot easier. The baby is calmer, allowing for more efficient and effective results. It’s also a much more pleasant experience, during what can be a very stressful event for both parent and baby. Someone recently said if a child fell and started to cry our instinct would be to console them by picking the child up and holding them close. Skin-to-skin provides that very same comfort — it’s a basic instinct. Amanda Campbell Registered Nurse and International Board-Certified

soothed her so much faster. I find she cried a

lot less than any other child would have. I really think it’s great that this is the new normal. Anya


When my daughter was around

It was my midwife who first recommended breastfeeding my baby during injections. I was amazed at the comfort it provided for my then infant. Now,

18-months-old she dislocated

Adjusting to the practice of heel pricks while the baby is skin- to-skin has been, at times, a struggle. It has been worth it, though, as I have now observed its benefits. The most obvious and No. 1 benefit is for the comfort of the infant. They are often calmer and cry

Several years ago, bloodwork, PKU test (a blood test looks for rare conditions, including phenylketonuria (PKU)) and immunizations on a newborn for

During my career, I have seen a shift of practise in recommending breastfeeding during painful experiences for infants and young

her elbow. The ER doctor was able to quickly set the arm back in place while she nursed, and she didn’t

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the most part did not happen in the roomwith the parents. We now know and educate new (and not so new) parents on the importance and benefits of newborns being skin-to-skin or breastfeeding during painful procedures. In 2011, as a new nurse in obstetrics, I watched as coworkers struggled to get bloodwork or fill a PKU card as newborns lay on their backs, wiggling in their basinets and crying. I was pregnant with my first son at the time, so I too felt when my son was born I didn’t want to watch or listen tomy baby cry during bloodwork. Both of my sons were taken out of the room for painful procedures and I was okay with that because I was unaware of the benefits of skin-to-skin. Fast forward to 2016: On my orientation, the LPNwas orientating me was showing me how to do a PKU in the roomwith the parents. Nurses were being courage to not take baby from the room during painful procedures. She showedme how to get baby all snuggled onto MomorDad’s chest andworkwith gravity to help the blood flow. Also, it also gives parents an active role in helping comfort their child. As parents we hold our childrenwhen they get stitches in the emergency department so why should painful procedures on a newborn be any different? My daughter was born in 2017 and I breastfed her while a nurse did her PKU. She didn’t cry, and the blood flowwas great, filling up the PKU card in a few short minutes. As a mom it felt good to be able to comfort her during that uncomfortable test. Kia Bridges LPN, Obstetrics, Horizon’s Upper River Valley Hospital

even flinch. I love that breastfeeding provides more than just nutrition for my child; it is also giving comfort. Deanna

three children later, I’ve seen this soothe them time and time again, frommy newborn, who snuggled in a little closer with a tear down his cheek, to my almost three-year-old child receiving his flu shot who said, “Mommy’s milk made it feel all better.” Dana

children. There are a few scenarios that stand out: The first was a mother breastfeeding her infant (over six months) during a urinary catheter. The infant tolerated the procedure with increased ease during the procedure and obtaining the specimens. Remarkably, when the procedure was completed the infant continued breastfeeding as the above never had taken place. The second occasion was with a young child (from 12 to 24 months) requiring their immunizations. During this scenario, the mother sat in a chair and breastfed during the immunizations. The young child was not fond of the procedure, however quickly recuperated and continued breastfeeding post-immunizations. Throughout my career, I have seen several other scenarios with breastfeeding during painful procedures. On many occasions I have been told by both parents that breastfeeding has aided in the decrease of their anxiety overall. Being a nurse for many years, this is what we do in the profession: We advocate pain relief during painful procedures. When we can include the parents along with a non- pharmalogical resources, it truly is a win-win scenario for the children and families. My best advice prior to any painful experience is to always have the discussion with the family on how best we can support the child and the family. Patient-and family-centered care truly is the focus here at Horizon. Misty Spencer RN / Nurse Educator, Women and Children’s Health Program, Horizon’s TheMoncton Hospital

Lactation Consultant, Mother Baby Clinic, Horizon’s Saint John Regional Hospital

much less if they are skin-to-skin or being held or fed by a parent. I find their feet easier to hold as they are not moving around as much, and it often means that the foot is hanging down so gravity actually aids in getting good blood flow to the foot. The parents are also much calmer and appear to have less anxiety when it is done this way. I find they feel they are actively helping their child during the procedure instead of just standing by the basinet and attempting to soothe the infant while looking on. This initiative is made possible when there is cooperation and understanding between the nursing staff and the lab staff. On my end, I have learned to take my time and make sure that the parent and child are comfortable and that I make the proper adjustments, so I am in the best position while performing the procedure. I have found that, in the majority of cases, we are all nowworking together to perform this necessary procedure in the least traumatic way possible for the newborns.

You are your baby’s whole world. Imagine them

Dads can do skin-to-skin, too! Dads can and should take part in skin-to-skin whenever and as often as possible (if Dwayne “The Rock” Johnston can do it, so can you!). Holding your baby close to your chest during a painful procedure will provide comfort and help decrease the baby’s pain during needles and blood tests. Being skin-to-skin will lower the baby (and Dad’s) stress level and reduce tears. Not only that, but it will help the baby develop and feel secure – all while bonding with Dad. Get comfortable and snuggle up!

facing a painful procedure like a needle or a blood drawwithout you. Holding your baby next to you, skin-to-skin, makes your baby feel secure,

protected and “home.” Dr. Nils Bergman’s research tells us that a mother’s chest is the baby’s natural habitat. Breastfeeding your baby during scary, painful procedures lets your baby know the breast is more than food — it’s their safe place. As a Public Health Nurse Lactation Consultant, I promote skin-to-skin for all babies and breastfeeding in addition to skin- to-skin during immunization. It makes the world of difference for baby, for Mommy and forme. The baby does somuch better with the needle — it’s remarkable. Kim Scott Nurse Lactation Consultant, Healthy Families, Healthy Babies Program, Public Health, Miramichi

You’ve read the success stories and can see the benefits of holding a baby or child close. Performing skin-to-skin during a painful procedure provides comfort and security, something every parent wants to be able to do for a baby or child in pain. As health care providers, Horizon staff should encourage parents to hold their child close during any painful procedure. The direct skin- to-skin contact will benefit everyone involved: baby will be less fussy, the parent more confident and staff better able to care for both. Help Horizon and Canada celebrate World Breastfeeding week Oct. 1 to 7 by encouraging parents to hold their baby close and perform skin-to-skin whenever possible!


Every time your baby is skin-to-skin, make sure your baby’s: • shoulders and chest face you • face is visible • head is up (in ‘sniffing’ position), not looking down • nose andmouth are not covered

Lauren Graham Medical Lab Technologist, Laboratory Services, Horizon’s Upper River Valley Hospital

• head is turned to one side • neck is straight, not bent

• legs are in a frog-leg position; and • back is covered with a blanket. (Source: GNB)

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