Nursing Ethics and Caring for Infants - Literature review Example

Background In what ways does skin-to-skin contact improves breastfeeding, physiological adaptation and behavior between mothers and babies’ interaction?Skin to skin contact means placing the newly born naked baby on its mothers chest (Philips, 2013 p.67). This procedure has a significant impact on how breastfeeding starts, how the baby adapts physiologically and more importantly, the relationship between the mother and the infant for the rest of its life.The main rationale of this research question is an objection to the many hospital routines, which overshadow skin-to-skincontact (Sears et.al, 2013). In most hospitals, the mother holds the baby for less than a minute before it undergoes other procedures such as injection of vitamin k and eye drops. The baby is then rushed to the incubator without sufficient skin-to-skin contact with its mother. After all this, the baby is swaddled, preventing any skin-to-skin contact with the mother. This research question is profoundly relevant to the field of nursing ethics and caring for infants. A newborn baby is initially helpless, dependent and vulnerable. Good nursing and mothering therefore dictates that a newborn should be handled with compassion, nurturance, kindness, empathy and sympathy (Butts & Rich, 2013).Thevalues that were traditionally invaluable have been eroded gradually from many societies and need to be re-instilled. Nurses and other clinicians should be in terms with the fact that even a newborn baby has its own basic dignity as any other human being (Lawn et.al, 2014 p.210). Denying the baby a fundamental right that will later affect many of its physiological developments such as latching on, breastfeeding and crying is unethical. A good start out will definitely help the baby in its first stage of basic trust and mistrust and enable it to bond with its mother easily. Paper 1 Aghdas, K, Talat, K &Sepideh, B 2014, ‘Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: A randomised control trial,’ Women and Birth, Vol.27, no. 1, pp.37-40 The report mainly examined the effect of mother to infant immediate skin-to-skin contact on the self efficacy of breastfeeding of primiparous mothers. Participants of the research included 18 to 35 year old mothers who were primiparous and Iranian. The participants had to achieve the expectations of the research by having requirements such as being healthy, full term mothers whose anticipation for delivery was vaginal and for those who expected to breastfeed their babies. The Omolbanin obstetrics hospital in Iran was the setting for the study. The researcher used two groups to validate the study: skin-to-skin contact infants and a routine care group. The scorecard for the interaction was a feeding measure on the infant breastfeeding assessment tool. The quality of the interaction between a mother and infant at the early stages of childhood greatly determines the performance of a child in life. Based on the research question of this study, the report suggested that skin to skin contact between infants and mothers resulted to a higher self efficacy in the breastfeeding of mothers. There was proof that skin to skin contact in the breast feeding process stimulated verbal and tactile factors that improve the breastfeeding capacity of infants. This report was particular on the assessment of the quality of SSC interaction between mothers and newborn infants and the self efficacy of breastfeeding mothers. The report, in addition, contributed to the main research question by giving evidence that skin to skin contact between mothers and infants immediately after birth is a simple and inexpensive method of increasing the confidence of mothers in breast feeding thus leading to positive performance of the child in the course of its growth. Paper 2 Hung, K & Berg, O (2011), ‘Early Skin-to-Skin after Caesarian to Improve Breastfeeding’, MCN, The American Journal of Maternal/Child Nursing, Vol.36, no. 5, p.318-324 The article principally focused on the description of the improvement on quality projects that have been designated to augment the rate of contact between mothers and infants born through caesarian. The contact is mainly skin to skin. The contextual research was effectively carried out through timing skin to skin initiation, the use of the LATCH (Latch, Audible swallowing, Type of nipple, Comfort, Hold) tool and use of supplemented formulae. The subjects for the study were infants born through caesarian. Feedback from the mothers was positive with regards to the skin to skin initiation process immediately after surgery. Infants who experienced STS scored higher on the LATCH score as compared to those who were taken to the nursery immediately after surgery. Inasmuch as the project for STS was implemented to improve the performance of a newborn during its growth, the process was met with the challenge of the mother and baby care being understaffed due to the additional of duties with no additional staff. Despite the challenges, the effectiveness of the research was proved through the multiple times that the STS process was implemented after caesarian to determine the viability of skin interaction between the baby and its mother after caesarian. This article in particular is profusely effective in substantiating on the research question where the skin-to-skininteraction between the mother and newborn succeeding caesarian resulted to a stronger bond between the mother and the baby and consequently growth for the infant. Paper 3 Marín , GM, Llana MI, López EA, Fernández VE; Romero BI &Touza PP 2010, ‘Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn,’ ActaPædiatrica, Vol.99, no. 11, pp.1630-1634 This particular study was out to approximate the control that contact of skin between mother and child has on the infant’s management of temperature and the rate of breastfeeding. The subjects for the study were healthy mothers who had single pregnancies. This study was conducted for four months in the HospitalMadrid-Torrelodones. Based on the results of the study, SSC proved to provide better thermal regulation for newly born infants. The infants under SSC were however more prone to succumbing to hypothermia though the results showed that they recovered from this fast enough. Furthermore, SSC infants’ breastfed exclusively as compared to controlled infants. Skin to skin contact is therefore inarguably effective in physiological stabilization of the infant and establishes a mature bond between the mother and the new born which accordingly results to excellent growth of a child. Though successfully proving the significance of SSC in infant thermal regulation and breastfeeding rates, the study failed to place under consideration other necessary contributing factors such as room temperature during the study and the temperature of the mother which would greatly influence the results if reflected into the study. Evidently, this study achieved a modicum of conviction to effectively contribute to the research question in the subject under study. It thus goes to show that the potential benefits of SSC in the delivery room, bearing the temperature and feeding considerations are positively interrelated. Nevertheless, the conditions of the mother and the environment at the time of delivery require definite intervention to clearly manifest the accurate results. Paper 4 Gribble, K D 2006,’ Mental health, attachment and breastfeeding: implications for adopted children and their mothers,’ International breastfeeding journal, Vol.1. no. 1, pp.5 The chief focus of this paper was to scrutinize the implications of psychological health, attachment and breast feeding between children that have been adopted and their mothers. The article bases its evidence from case studies to expound on the significance of breast feeding to both the mother and the adopted child. Breast feeding involves contact of skin between the mother, natural or adopted, and the infant. For both the mother and the adopted child, breast feeding is practically one very vital process where attachments can be formed therefore optimistically affecting the future of the child. An intricate observation into the beginnings of adopted children shows that most of them have experienced dire forms of loss which lead them to an adoptive setting. The building of an attachment is therefore inarguably vital in bonding the mother and child and coming close to giving a childhood that is almost similar to that of a natural mother and child. The challenges faced in breastfeeding an adopted child are unavoidably more than in a normal situation as pointed out in the article. Strict considerations are required and well followed procedures need to be implemented. The situation is completely different from direct birth as the infant misses out on the initial contact with its parent. The relevance of this article to the study is raised on the grounds of the different scenarios that skin to skin contact improves an infant’s well being. Clearly, this article discusses further on the varied occurrences under the question being researched consequently contributing to an expansive study on the skin-to-skin touch interaction between newborns and mothers and the implications. Discussion The findings of all the four papers converge towards the importance of skin-to-skin contact between mothers and their newborn babies. This is in relation to breastfeeding self-efficacy of primiparous women, caesarean section full term babies, adopted babies and matters connected to body temperature and breastfeeding (Gray et.al, 2000). Any mother giving birth for the first time would look forward to breastfeeding the baby and starting the process of bonding right away. Administering SSC to such a mother will automatically trigger senses of confidence and motivation towards breastfeeding the newborn baby (Andres et.al, 2011 p.1075. This is especially because the baby itself will initiate the breastfeeding process by looking for the mother’s breast even without much intervention by the mother or the nurses. It is therefore true that SSC has a positive impact on the acceptance, feasibility and compliance of the breastfeeding self-efficacy of primiparous mothers. In most hospitals, SSC is not implemented as it should. Health practitioners are more concerned with other procedures such as cleaning, weighing and dressing the baby and taking it to the warmer (Chess & Hassibi, 2013). The chances of SSC are even slimmer with a C-section birth even if the baby is preterm. With the chances of hypothermia being so high, the caregivers would be more concerned with taking the baby to a warmer place, thereby leaving out SSC (Shankaran et.al, 2012 p.374). However, since not necessarily all C-section babies suffer hypothermia, there should be room allowed for the mother and baby to skin contact. This would be in line with the findings of paper 2 that a strong bond is created between mother and child while the infant displays a more positive growth compared to those who missed SSC. Skin to skin contact after birth has positive reinforcements on breastfeeding. Though the possibility of hypothermia questions SSC, it has been proven that the babies faced with it, having gone through SSC, recover fast from hypothermia (Shankaran et.al, 2012 p.380). A baby who is born and goes through SSC early enough is able to find the mothers breast and starts breastfeeding even without assistance from the nurse or mother. This is a clear indication that SSC goes miles in helping the baby to starts breastfeeding. A positive response is therefore presented to the research question with regard to breastfeeding and physiological adaptations. Similar to all the other babies SSC is crucial for adopted babies. These babies often are faced with the distress of losing their natural mothers. It is therefore the duty of the adoptive mother to create another bond with the baby. SSC can scale heights especially if the adoptive mother has the opportunity to breastfeed the baby (Pollard, 2013). Though it may not be easy to recreate an unbroken bond, SSC has proven to be an important tool for connecting and interaction between babies and their adoptive mothers. Conclusion It is rather unethical for nurses and other caregivers to leave out such an important part of a baby’s post birth rights (Butts & Rich, 2013). According to the findings of the four papers, skin-to-skin contact between mothers and their babies is crucial for a baby’s breastfeeding and physiological adaptations. Though more research has to be conducted especially regarding primiparous mothers and C-section babies, there is undeniably convincing evidence that a baby and its mother need SSC (Andres et.al, 2011 p.1075). This is a process that will most likely affect the positive growth of the baby in future. An international campaign should be launched to inform all mothers and the rest of the world on the importance of SSC. Any nurse, clinician, midwife and health practitioner who upholds ethics in practice should be an advocate of SSC in all hospitals so as to ensure that babies are not denied such a fundamental right. Reference List Aghdas, K, Talat, K &Sepideh, B 2014, ‘Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: A randomised control trial,’ Women and Birth, Vol.27, no. 1, pp.37-40 Andres, V., Garcia, P., Rimet, Y., Nicaise, C., & Simeoni, U. (2011). Apparent life-threatening events in presumably healthy newborns during early skin-to-skin contact. Pediatrics, 127(4), e1073-e1076. Butts, J. B., & Rich, K. L. (2013). Nursing ethics: Across the curriculum and into practice. Jones & Bartlett Publishers. Chess, S., & Hassibi, M. (2013). Principles and practice of child psychiatry. Springer Science & Business Media. Feldman, R., Rosenthal, Z., & Eidelman, A. I. (2014). Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biological psychiatry, 75(1), 56-64. Gray, L., Watt, L., & Blass, E. M. (2000). Skin-to-skin contact is analgesic in healthy newborns. Pediatrics, 105(1), e14-e14. Gribble, K D 2006,’ Mental health, attachment and breastfeeding: implications for adopted children and their mothers,’ International breastfeeding journal, Vol.1. no. 1, pp.5 Hung, K & Berg, O (2011), ‘Early Skin-to-Skin after Caesarian to Improve Breastfeeding’, MCN, The American Journal of Maternal/Child Nursing, Vol.36, no. 5, p.318-324 Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C., Waiswa, P., ... & Lancet Every Newborn Study Group. (2014). Every Newborn: progress, priorities, and potential l beyond survival. The Lancet, 384(9938), 189-205. 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