| Complying with state and federal laws from Emily Taylor, MPH |
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 "Many healthcare professionals have expressed confusion about the guidelines for 'eyes & thighs.' Clearing up some of this confusion may help you become even more comfortable with maintaining skin-to-skin care while attending to other clinical tasks. Because newborns are born vitamin K deficient, we administer vitamin K to prevent excessive bleeding. Many people have expressed their belief that providers are legally bound to administer vitamin K immediately, even if it delays first feeding. This is not true. No state or federal laws require administration of vitamin K. AAP and ACOG recommend administration within six (6) hours of birth. Furthermore, as delayed and inadequate feeding is related to vitamin K deficiency bleeding (VKDB), it is important to prioritize first feeding within one hour of birth. Should your current hospital policy require administration in first hour, vitamin K may be administered during or after the first feeding, while the baby and mother are maintained skin to skin.
To prevent gonococcal ophthalmia neonatorum, a prophylactic agent (usually 0.5% erythromycin or 1% tetracycline) should be applied topically to infants' eyes. North Carolina Law requires healthcare professionals to abide by CDC guidelines. The CDC guidelines suggest instilling the prophylaxis into both eyes of all neonates within one hour of birth. It is ideal to wait until the end of the hour in order to increase the neonate's opportunity to lay his or her sights on the target: mom's nipple. As with Vitamin K injection, this prophylaxis should be done with mother and baby skin-to-skin. "
TIP: In order to balance first feed with other clinical tasks, conduct newborn care while mother and baby are skin-to-skin. Babies (and moms) will stay more calm and comfortable if procedures are done while skin-to-skin and eating.
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| Resources shared |
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 Emily Taylor shared information about an effective DVD: Skin to Skin in the First Hour After Birth: Practical Advice for Staff after Vaginal and Cesarean Birth. From the website (www.healthychildren.cc) "This video is intended to assist staff in providing behaviorally appropriate, individualized, baby adapted care for the full term newborn using the best practice of skin to skin contact in the first hour after birth. The video is divided into three sections: the importance of skin to skin and examples of the baby's stages during the first hour; practical advice for staff after a vaginal birth; and practical advice for staff after a cesarean birth. DVD, 2010, 39 minutes, $39.00"
Dana Sanford, Nurse Manager, CMC-Pineville, shared this resource www.preciousimagecreations.com with the comment that it is important to not imply to the mom that she must have one in order to be successful.
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| Contact |
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 Karen Metzguer
PQCNC Improvement Advisor
metzguer@med.unc.edu
Work: 919-966-8391
Mobile: 919-619-6332
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