Mother-baby Separation Research Articles

Risk of Developmental Delay in Infants Born to Perinatal COVID-19-Positive Mothers at a Tertiary Care Hospital: A Cross-Sectional Study

Purpose: Prenatal and perinatal experiences of the mother are known to influence infant development. Maternal exposure to coronavirus disease 2019 (COVID-19) during pregnancy has been associated with increased morbidity and mother-baby separation. However, the developmental outcomes of infants born to COVID-19-positive mothers remain unclear. This study represents an initial exploratory effort to assess the developmental risks faced by infants born to mothers who tested positive for COVID-19. Methods: This cross-sectional study involved telephonic interviews and developmental screenings of 45 infants, aged 9 to 15 months, who were born to perinatal COVID-19-positive mothers between July 2020 and May 2021. The Ages & Stages Questionnaire was used for the developmental assessment. The impacts of maternal, infant and separation-related factors on development were analyzed. Results: Within the study population, 28.8% (13 of 45 infants) presented with a risk of developmental delay. The gross motor and problem-solving domains were the most frequently impacted. Among the factors studied, prolonged separation period (exceeding 7 days), advanced maternal age, and gestational age (preterm birth) were associated with higher proportions of infants at risk of developmental delay; however, these associations were not statistically significant.Conclusion: This study suggests that infants born to mothers who tested positive for COVID-19 during the perinatal period face a risk of developmental delay. Factors such as maternal age, gestational age at birth, metabolic disease during pregnancy, and infant-mother separation could exacerbate this risk. Future research should prioritize objective assessments of development and long-term follow-up to monitor developmental outcomes in this population.

Feeding Practices of Stable Term and Late Preterm Neonates Born at a Tertiary Hospital in the Philippines during the COVID-19 Pandemic.

We aimed to evaluate the impact of maternal COVID-19 infection and separation of the mother-baby dyad on feeding practices by determining modes of feeding upon discharge and following up at 2-3 days, 14 days, and 1 month post-discharge. This was a prospective observational cohort study conducted at the Philippine General Hospital, a tertiary government COVID-19 referral center in Manila. Mothers who delivered between the months of July and August 2021, and whose COVID-19 status was known were followed up on their baby's mode of feeding at 2-3 days, 14 days, and 1 month post-discharge via phone call. For babies of COVID-19 positive mothers, presence of any symptoms (up to the 14-day time point only) as well as adherence to infection prevention and control practices were also identified. For all time points post-discharge, breastfeeding rates were higher in babies born to COVID-19-negative mothers and in those who were roomed in. However, the differences were not statistically significant. Of the 108 infants, 72.90% remained exclusively breastfed by 1 month of age, with 4.67% formula-fed and 22.43% on mixed feeding. Perception of insufficient milk supply was the most common reason for shifting to formula or mixed feeding. We found a significantly higher direct breastfeeding rate upon discharge in the roomed-in population compared to those admitted to the NICU. Risk factors affecting breastfeeding at 1 month of age was the presence of COVID-19 infection in the mother and mother-baby separation due to NICU admissionCOVID-19-positive mothers were 66.02% less likely (p=0.016, 95% CI 0.1411 to 0.8183) to still be breastfeeding at 1 month, and separation was not found to be a significant risk factor. Feeding practices can be affected not only by COVID-19 infection in the mother and its attendant difficulties such as prolonged hospital stay and physical and social isolation, but also by limitations in the hospital environment that can have an impact on breastfeeding education, support, and opportunities for mother-child bonding.

Perinatal healthcare for women at risk of children’s social care involvement: a qualitative survey of professionals in England

BackgroundWomen with complex health needs are more at risk of having children’s social care involvement with their newborns than other mothers. Around the time of pregnancy, there are opportunities for...

Postnatal hospitalization and self-esteem in mothers

IntroductionHospitalization in neonatology constitutes a narcissistic wound for the mother. This mother-baby separation disturbs the maternal identity and generates a strong feeling of failure and guilt.ObjectivesTo assess self-esteem in mothers of babies hospitalised during the postnatal period in the neonatal unit and to identify risk factors associated with the persistence of low self-esteem 3 months after discharge.MethodsThis was a longitudinal, descriptive and analytical study conducted between April and September 2021. The sample consisted of mothers of babies hospitalized in the neonatology department of Sfax-Tunisia for a period ranging from 5 to 15 days. Socio-demographic data were collected using a pre-established form. Self-esteem was assessed during the baby’s hospitalisation and 3 months after discharge, using the Rosenberg self-esteem scale, with 10 items, validated in Arabic.ResultsThe sample consisted of 86 mothers with a mean age of 32.17 years.Low to very low self-esteem was found in mothers in 81.20% of cases when their babies were hospitalised and in 68.40% of cases 3 months after discharge.Some factors were significantly related to the persistence of low self-esteem in mothers after 3 months of their babies’ hospitalisation, such as a low educational level of the mother (p=0.017), an unattended pregnancy (p=0.034), the occurrence of a post-partum complication (p=0.043) and the absence of the first smile in the baby at the age of 3 months (p=0.008).ConclusionsThis study shows a high prevalence of low self-esteem in mothers following hospitalization of their babies in the postnatal period. The concomitance with several socio-clinical factors contributes to the persistence of this low level of self-esteem in these mothers.Appropriate early and multidisciplinary care helps to rebuild strong self-esteem in the young mother so that she can overcome her psychological difficulties and build a solid foundation for the mother-baby bond.Disclosure of InterestNone Declared

Postpartum psychosis treatment: review of mother-baby units

IntroductionPostpartum Psychosis is an underdiagnosticated psychiatric condition that may be suffered by mothers within a year since delivery. It is a severe syndrome in which symptoms such as delusions, hallucinations and disorganized thinking may appear. The traditional approach of admitting the mothers separated from their children has shown harmful consequences. This has led to the creation of Mother-Baby Units (MBU), psychiatric admission units dedicated to full-time housing mothers and their babies.Objectives To evaluate the evidence available regarding the potential benefits of MBU not only for the mothers, the babies, but for the mother-baby bond. To analyse postpartum psychosis risk factors and prognosis.MethodsA thorough review of scientific literature and databases regarding postpartum psychosis and MBU has been carried out. Additionally, international mental health care guidelines for perinatal mental disorders were analysed.ResultsA wide range of related aspects were studied for the present work, including characteristics of the patients, differences in the self- assessment scales of depression, anxiety, postpartum attachment of the mother to the baby at admission and at discharge and the work and social adaptation. Other studies analysed the percentage of mother-baby separation at discharge, as well as the most frequent delusions, and the potential effect of childhood trauma on these patients.ConclusionsThe available evidence suggest that MBU may be helpful for the improvement of the mental health in women suffering perinatal mental disorders and for the building of a secure attachment style in the baby. The results of the interventions included in MBU programs also show promotion of a positive mother-baby relationship.DisclosureNo significant relationships.

Potential Galactogogues: A Review

Worldwide many infants die every year due to malnutrition or disease. WHO advises breastfeeding as it is an inexpensive and effective form of feeding for saving life of infant’s health. Insufficient milk production in lactating mother is one of the main causes of death and malnutrition in infants. Main cause of milk deficiency is mother or child illness, preterm birth, mother-baby separation, lactation after long gape, anxiety, fatigue emotional stress, busy schedules, unhealthy life style of women’s and hormonal imbalance. This review aims to summarize that insufficiency of lactation should be treated in appropriate manner; there are substantial numbers of herbal drugs which are used to augment milk production in lactating mother. Alcoholic/Aqueous extract of different lactogenic drugs maintain or increase the lactation by different physiological changes in biological level. The systematic search for Herbal Medicine used as lactation considering all the articles published until 2021 through three scientific databases.

Potential benefit from the implementation of the Kaiser Permanente neonatal early-onset sepsis calculator on clinical management of neonates with presumed sepsis.

To assess the potential benefit from the implementation of the Kaiser Permanente early-onset sepsis calculator (EOS-C), in terms of antibiotic use and requested laboratory tests, in a network of neonatal intensive care units (NICUs) in Greece, and to determine the incidence of early-onset sepsis (EOS) in Greek NICUs, a prospective surveillance study was conducted in 7 NICUs between April 2018 and June 2019. Data were collected for all newborns ≥ 34weeks' gestation receiving empiric antibiotic therapy within the first 3days of life. The number of live births and positive blood or cerebrospinal fluid cultures within the first 3days of life were used for calculation of EOS incidence. Evaluation of possible impact of implementing the calculator was done by comparing the clinicians' recorded management to the calculator's suggested course of action. The unit-specific incidence of culture-proven EOS ranged between 0 and 2.99/1000 live births. The weighted incidence rate for all 7 units was 1.8/1000 live births. Management of EOS guided by the calculator could lead to a reduction of empiric antibiotic initiation up to 100% for the group of "well-appearing" neonates and 86% for "equivocal," lowering exposure to antibiotics by 4.2 and 3.8days per neonate, respectively. Laboratory tests for blood cultures drawn could be reduced by up to 100% and 68%, respectively. Sensitivity of the EOS-C in identifying neonates with positive blood cultures was high.Conclusion: Management strategies based on the Kaiser Permanente neonatal sepsis calculator may significantly reduce antibiotic exposure, invasive diagnostic procedures, and hospitalizations in late preterm and term neonates. What is Known: • Neonates are frequently exposed to antibiotics for presumed EOS. • The Kaiser Permanente sepsis calculator can reduce antibiotic exposure in neonates.. What is New: • EOS calculator can be an effective antibiotic stewardship tool in a high prescribing country and can reduce invasive diagnostic procedures and mother-baby separation. • Incidence of EOS in Greece is higher compared to other European countries.

Involvement of Protein Kinase A in Oxytocin Neuronal Activity in Rat Dams with Pup Deprivation.

Oxytocin (OT) neuronal activity is the key factor for breastfeeding and it can be disrupted by mother-baby separation. To explore cellular mechanisms underlying OT neuronal activity, we studied the role of protein kinase A (PKA) in OT neuronal activity in the supraoptic nucleus (SON) using a rodent model of pup deprivation (PD) Intermittent (IPD) or continuous (CPD) PD significantly reduced suckling duration and number of milkejections in lactating rats, particularly those with CPD. In Western blots of the SON, PD increased expressions of OT receptor (OTR) and its immediate downstream effectors, Gαq and Gβ subunits, particularly IPD, but reduced the expression of catalytic subunit of PKA (cPKA). In brain slices, inhibition of PKA blocked prostaglandin E2-evoked increase in firing activity including burst firing in OT neurons. In IPD dams, filamentous actin formed ring-like structures in the cytoplasmic region of OT neurons, which was reduced in CPD. Moreover, molecular association between actin and cPKA also reduced in PD dams. Incubation of brain slices with OT reduced the expression of cPKA, which was blocked by pretreatment with atosiban, an antagonist of OTR. These results indicate that PD disrupts OT neuronal activity through dissociating the Gq proteins and PKA in OTR-associated signaling cascade, which couples with reduced interactions between filamentous actin and PKA in OT neurons in the SON. This study highlights that PKA can be a novel target treating abnormal OT neuronal activity and its associated diseases.

COVID-19 Illness: Mother–Baby Separation, Viruses, and Breastfeeding

ObjectivesSome hospitals have instituted separation of mothers and their newborn(s) when SARS-CoV-2 is suspected or confirmed in the mother. Limited data are available for SARS-CoV-2 vertical transmission, including studies on breast milk. This article looks at SARS CoV-2 case studies and data to date as well as prior pertinent research.MethodsInformal searches of PUBMED, CINAHL and Ovid Emcare were used to identify early reports of vertical transmissions of the novel Coronavirus, case reports, and population based reports of early evolving protocols and their outcomes. As this is a novel virus the authors used previously identified anti-infectivity and antiviral mechanisms of human milk on other similar viruses to guide analysis. Further this article reviewed the well established literature regarding the risks of undue infant separation which negatively affect nearly every aspect of infant and maternal health.ResultsInformal searches conducted in the spring and early summer of 2020 identified 14 early reports attempting to analyze the initial and evolving global response to SARS-CoV-2 and the effects of the virus on the maternal-infant dyad.ConclusionThe feasibility of single-family rooms and support for breastfeeding as an alternative approach that addresses many of the risks favorably and reduces economic cost, both in lifetime disease burden and direct care are discussed. Initial reports seem to indicate that immediate separation of the mother from her newborn is likely to increase the risk to both mother and infant.

Impact of Covid-19 in pregnancy on mother\u2019s psychological status and infant\u2019s neurobehavioral development: a longitudinal cohort study in China

BackgroundEvidence concerning the long-term impact of Covid-19 in pregnancy on mother’s psychological disorder and infant’s developmental delay is unknown.MethodsThis study is a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020. Seventy-two pregnant patients with Covid-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). We collected data from medical records regarding Covid-19, delivery or abortion, testing results of maternal and neonatal specimens, and questionnaires of quarantine, mother–baby separation, feeding, and measuring of mothers’ mental disorders and infants’ neurobehavioral disorders.ResultsAll cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy. 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion. Among 57 live births, only one neonate was positive of nucleic acid testing for throat swab, but negative in repeated tests subsequently. The median duration of mother–baby separation was 35 days (interquartile range 16 to 52 days). After the termination of maternal quarantine, 49.1% of mothers chose to prolong the mother–baby separation (median 8 days; IQR 5 to 23 days). The breastfeeding rate was 8.8% at 1 week after birth, 19.3% at the age of 1 month, and 36.8% at the age of 3 months, respectively. The proportion of “monitoring” and “risk” in the social–emotional developmental domain at the age of 3 months was 22.7% and 63.6%, respectively. After the adjustment of preterm, neonatal sex, admitted to NICU, and the mother’s Covid-19 condition, the negative associations were significantly identified (p < 0.05) between mother–baby separation days and three developmental domains: communication, gross motor, and personal–social.ConclusionsThere is no definite evidence on vertical transmission of SARS-CoV-2. In addition to control infection risk, researchers and healthcare providers should pay more attention to maternal mental health and infant’s feeding, closeness with parents, and early development.

Effects of Intranasal Oxytocin on Pup Deprivation-Evoked Aberrant Maternal Behavior and Hypogalactia in Rat Dams and the Underlying Mechanisms

Oxytocin (OT), a hypothalamic neuropeptide, applied through nasal approach (IAO), could improve maternal health during lactation that is disrupted by mother–baby separation; however, the regulation of IAO effects on maternal behaviors and lactation as well as the underlying mechanisms remain unclear. Using lactating rats, we observed effects of intermittent pup deprivation (PD) with and without IAO on maternal behaviors and lactation as well as the activity of OT neurons in the supraoptic nucleus (SON) and the activity of hypothalamic pituitary-adrenal axis, key factors determining the milk-letdown reflex during lactation and maternal behaviors. The results showed that PD reduced maternal behaviors and lactation efficiency of rat dams as indicated by significantly longer latency to retrieve their pups and low litter’s body weight gains during the observation, respectively. In addition, PD caused early involution of the mammary glands. IAO partially improved these changes in rat dams, which was not as significant as IAO effects on control dams. In the SON, PD decreased c-Fos and increased glial fibrillary acidic protein (GFAP) filaments significantly; IAO made PD-evoked c-Fos reduction insignificant while reduced GFAP filament significantly in PD dams. IAO tended to increase the levels of phosphorylated extracellular signal-regulated kinases (pERK) 1/2 in PD dams. Moreover, PD+IAO significantly increased plasma levels of dam adrenocorticotropic hormone and corticosterone but not OT levels. Lastly, PD+IAO tended to increase the level of corticotropin-releasing hormone in the SON. These results indicate that PD disrupts maternal behaviors and lactation by suppressing the activity of hypothalamic OT-secreting system through expansion of astrocytic processes, which are partially reversed by IAO through removing astrocytic inhibition of OT neuronal activity. However, the improving effect of IAO on the maternal health could be compromised by simultaneous activation of hypothalamic pituitary-adrenocortical axis.

A randomized interventional study to promote milk secretion during mother-baby separation based on the health belief model: A consort compliant.

BackgroundBreast milk is the most important nutrition for premature babies, but mothers of premature infants have difficulty in initiating and sustaining lactation. Breastfeeding infants who are separated with mothers have decreased morbidity. Nevertheless, such decrease is limited due to insufficient milk supply resulting from mother–baby separation during lac.ObjectiveTo evaluate the effect of intervention methods based on the health belief model on promoting the secretion of milk among mothers who were separated with their babies.MethodsIn this prospective, randomized controlled clinical trial, we enrolled 260 separation mothers between September 26, 2016 and March 7, 2017, in a 3rd-grade women and children hospital of Chengdu. The mothers all had cesarean delivery and were randomized into 2 groups: the intervention group (educated by investigators based on the health belief) and the control group (routinely educated by obstetric nurses). Data on the onset of lactation and the milk volume during 3 days postpartum were collected. The breast swelling rate within 3 days postpartum and the exclusive breastfeeding rate at 42 days postpartum were compared. The psychologic scores of separation maternal in both groups were assessed with State-Trait Anxiety Inventory at the 3rd day postpartum.ResultsCompared with the control group, the intervention group had significantly earlier lactation time (P < .01), significantly larger milk volume (P < .01) during 24, 24 to 48, and 48 to 72 hours, and significantly lower psychologic scores (P < .01) at the 3rd-day postpartum.The onset of lactation among mothers who initiated milk expression within 1 hour after childbirth were earlier than those who initiated milk expression between 1 and 6 hours (P < .01); the milk volume within 24-hour postpartum did not differ significantly between the 2 groups (P > .05). However, the milk volume of the early-expression group (<1 hour) was significantly higher than that of the late-expression group (1–6 hours) during 24 to 48 and 48 to72 hours (P < .05).The breast swelling rate of separation mothers within 3 days postpartum in the intervention group was lower than that in the control group (P < .05). The exclusive breastfeeding rate of mothers in the intervention group was significantly higher than that in the control group (59% vs 35%; P < .01) at 42 days postpartum.ConclusionNursing intervention based on the health belief model can stimulate milk secretion in mothers who were separated with their babies.

Inevitable mother-baby separation in the immediate postpartum from a maternal perspective

Abstract Objectives: to understand the process of inevitable mother-baby separation in the immediate postpartum from a maternal perspective. Methods: this is a qualitative approach research study developed by interviewing 15 mothers who were separated from their children in the postpartum at a public maternity hospital in Belo Horizonte, Minas Gerais, Brazil. The analysis content was used for data interpretation. Results: the categories were evidenced through "Maternal feelings and perceptions regarding to the child's separation in the postpartum period" and "Women's perception about health professionals' performance at the time of the separation and the presence of their companions", the contradictions offeelings and challenges experienced by the mothers due to the separation as for, the happiness of her child's birth followed by the anguish of being separated and the fear of losing her child..The healthcare team plays a relevant role regarding the difficulties and helps to overcome these challenges. Conclusions: advances in healthcare actions are needed in order to offer directed care to the real necessities of these mothers and decrease the negative impacts caused by this separation.

Use of a Risk-Stratification Tool to Decrease Mother–Baby Separation After a Diagnosis of Maternal Chorioamnionitis

Use of a Risk-Stratification Tool to Decrease Mother–Baby Separation After a Diagnosis of Maternal Chorioamnionitis

Pregnancy in women with psychotic disorders: risk factors associated with mother-baby separation.

Pregnancy in women suffering from psychotic disorders is becoming more common. However, this psychiatric disorder is linked to the highest risk of early mother and child separation. The aim of this study was to evaluate risk factors associated with these separations. In an observational, naturalist, and multicentric study, 320 women suffering from a psychotic disorder and jointly hospitalized with their child in one of the sixteen mother-baby units (MBUs) in France and Belgium between 2001 and 2010 were assessed for risk factors associated with mother-child separation. Eighty-seven (27.2%) mothers were separated from their infant at discharge from MBUs. Early separation was linked to the placement of the mother herself in an institution in childhood (OR 4.44; CI 95% 1.12-18.69), to the mother being single (OR 3.84; CI 95% 1.38-11.44), to early hospitalization of the baby in neonatology (OR 2.88; CI 95% 1.27-6.59), and to maternal psychiatric decompensation during pregnancy (OR 2.60; CI 95% 1.15-6.20), independently from maternal neglectful behaviors. Low family/social support showed a trend towards association with separation (OR 2.17; CI 95% 0.91-5.42). This study shows that separation is mostly linked to mothers' environmental and interactive past and current history, to the child's health, and to maternal mental health decompensation. The identification of these factors is essential to implement antenatal prevention and social programs for these women. Further studies should focus on the long-term development of children of schizophrenic mothers, whether or not they have been placed, in order to help clarifying the impact of the risk factors.

Diálogo de pais e bebês em situação de risco ao desenvolvimento

Objetivo investigar as relações enunciativas estabelecidas entre pais e crianças com risco ao desenvolvimento infantil, sobretudo, os efeitos da presença do risco no processo de aquisição da linguagem. Métodos a amostra constituiu o estudo de três crianças que apresentaram risco ao desenvolvimento, acompanhadas de 0 a 18 meses a partir dos Indicadores de Risco ao Desenvolvimento Infantil, bem como, por filmagens da interação dos pais com as crianças. A análise dos dados considerou a perspectiva enunciativa proposta por Carmen Silva (2007, 2009) e a psicanalítica. Resultados nos três casos constatou-se dificuldade de separação da mãe com a criança o que refletiu no processo de semantização da língua, sobretudo, na ampliação dos possíveis interlocutores. Contudo, os sujeitos evidenciaram a possibilidade de domínio semiótico da língua tendo em vista que os três mecanismos enunciativos propostos por Silva (2007). Conclusões o estudo evidenciou que as dificuldades de separação mãe-bebê e a fragilidade da entrada da função paterna obstacularizaram a posição da criança na língua, uma vez que as crianças mostraram-se bastante dependentes da fala dos pais para suas produções.

G182 Implementation of a neonatal Transitional Care Ward

<h3>Context</h3> According to the British Association of Perinatal Medicine Categories of Care 2011, a baby receiving transitional care (TC) must be resident with the mother. <h3>Problem</h3> TC admissions and neonatal intravenous antibiotic administration (n-IVAB) on the neonatal unit (NNU), which was geographically remote from the postnatal ward, resulted in mother-baby separation soon after birth and suboptimal documentation. <h3>Assessment of problem and analysis of its causes</h3> Three audits over four months in 2012 showed that: 3–10% of admissions to NNU represented between 23–62 TC bed days per month There were 905 episodes of n-IVAB administration Only 30% of TC babies had complete/accurate documentation, 59% had an incomplete/inaccurate record and 11% were not recorded at all <h3>Engaging staff</h3> Audit results were presented to the stakeholders in a combined meeting across Maternity, Neonatal, Divisional Management, Pharmacy and Estates Departments <h3>Strategy for change</h3> Agreed criteria for admission to the TCW Introduced a proforma to allow accurate documentation for each TC admission, management and discharge plan <h3>Intervention</h3> Delineated a transitional care ward (TCW) within the postnatal ward Provided 24 h TCW cover with allocated neonatal nurses administering n-IVAB and undertaking neonatal observations Adopted the Neonatal National Early Warning Score (nNEWS) for recording observations on TC babies Initiated midwifery training in checking neonatal drugs and providing opportunities for practice development in neonatal care <h3>Measurement of improvement</h3> Following implementation, a 4 week pilot showed 34 TCW admissions and 183 episodes of n-IVAB administration on TC, matching previous TC activity and now no longer required to be undertaken on NNU. <h3>Effects of change</h3> All TC babies are now managed on TCW, preventing mother-baby separation and allowing improved quality of care via a new neonatal/maternity working partnership. <h3>Lessons</h3> learnt Service improvement to an inefficient but established NHS system has proved challenging because of changes required to the physical working environment and the impact on staff of new working patterns and documentation. <h3>Message for others</h3> The implementation of a neonatal TCW has been achieved by motivating buy in from diverse stakeholders, excellent interpersonal skills and a solution-based approach focussed on keeping TC babies together with their mothers to improve quality of care.

Mental health: outcomes of 10 babies of mothers with a history of serious mental illness.

Women with serious mental illness are frequently on antipsychotic medications to maintain their mental health. During pregnancy there is much debate as to whether to continue or cease these medications. The possibility of adverse effects is of concern to clinicians and the women. This study used a case study methodology to identify the outcomes for 10 babies of women with a history of serious mental illness. The results provide further evidence in regard to women and the use of antipsychotic medications throughout pregnancy and during the first year after birth. Separation of mother and baby occurred in five of the 10 babies. This study identifies the neonatal complications for these vulnerable babies as not outside the norm for births in Australia. The high rate of mother-baby separation is of great concern and needs further longitudinal studies.

Minimizing Mother‐Baby Separation to Promote Breastfeeding Exclusivity: Closing the Gap in Nursing Practice

Poster Presentation Objective To implement strategies to increase the time mothers and newborns spend together during postpartum hospitalization and ultimately increase the rate of breastfeeding exclusivity. Design A pre‐ postintervention design was used to measure rate of breastfeeding exclusivity, breastfeeding immediately following birth, and time newborns spent in the nursery before and after implementation of strategies to minimize mother–baby separation. Sample This project was implemented in a regional perinatal and neonatal referral center of a Magnet designated community teaching hospital. Care is provided to more than 3,000 mother–newborn dyads per year. Methods Nursery census was monitored during the hours of 11 p.m. and 7 a.m. pre‐ and postimplementation to determine progress toward nonseparation. Breastfeeding exclusivity and time to first feeding were also evaluated for improvement pre‐ and postimplementation. Implementation Strategies A multidisciplinary perinatal team used Lean Six Sigma methodology to decentralize newborn care: (a) portable equipment was purchased for assessing newborns at mother's bedside; (b) change in documentation providing more detail about newborn feeding methods; and (c) mandatory education was provided to nurses about the change in clinical practice. Results There has been an overall increase (54%) in rooming‐in during hospitalization. Newborns breastfeeding within 1 hour postvaginal birth has steadily increased to 96%. Breastfeeding exclusivity rate has shown an increase of 38%. Conclusion/Implications for Nursing Practice Research evidence supports that newborns who room‐in with their mothers are more likely to be exclusively breastfed at discharge compared to newborns that have been separated from their mothers. Rooming‐in of mothers and newborns has been found to improve breastfeeding, produce milk sooner and in more abundance, and improve mother's attention to their newborn needs resulting in less newborn crying. Professional organizations and regulatory agencies worldwide recognize breast milk as the ideal food for newborns recommending exclusive breastfeeding for its health benefits. Research has identified that hospital practices affect breastfeeding duration and exclusivity throughout the first year of life. At our hospital, mothers and newborns were separated during the first 2 hours of birth, for newborn assessments and procedures, and at mother's request. Separating mothers from their newborns creates missed opportunities for recognizing feeding cues in which a nurse could be readily available to teach and provide support for breastfeeding. Decentralizing newborn care to support nonseparation provides the opportunity for nurses to close the gap and champion breastfeeding exclusivity during hospitalization.

Study on the psychological state and its influencing factors of high-risk pregnancy mothers after being separated from their newborns

Objective To investigate the psychological state of high-risk pregnancy mothers af-ter being separated from their newborns and discuss the influencing factors of psychological state. Methods Nonexperimental descriptive study was used in this study. The investigation adopted state-trait anxiety inventory (STA-Ⅰ) and Edinburgh postnatal depression scale (EPDS). Results The moth-ers' anxiety score was significantly higher than normal women in China, and postnatal depression inci- dence rate was 57.9%. Mothers' psychological state was correlated with gestational age of new-borns, trait anxiety and pregnancy complications. Conclusions The psychological state of high- risk pregnancy mothers after being separated from their newborns should be paid more attention to, and cor-related nursing methods should be taken to improve their mental health. Key words: Mother-baby separation; High-risk pregnancy; Anxiety; Depression