BIRTH KC/VEKC (within 30 minutes of birth)                                        updated: 5/29/10

______2007 Newsline       Review of Moore et al. 2007 Cochrane analysis. More like to BF and for longer.
______2006. Aus J Nurs    Evidence based review that says two WHO 1997 recommendations that are graded
                          as A level recommendations are: “skin to skin contact should be promoted and
                          kangaroo care encouraged in first 24 hours after birth” to prevent hypoglycemia.
Ali&Lowry, 1981           FT, RCT of 45 min of KC ewith 6 and12 week age fu
Amer Acad BF Med 2005 FT, recommends birth kc for thermoregulation, maintenance of euglycemia
Amer Acad Pediatr 2005 FT, recommends KC immediately after birth until end of first feeding and delay all
                          care til feeding complete
AAP & AHA 2006            FT. lesson 1 page 18 recommends “thermoregulation can be provided by putting
                          the baby directly on the mother’s chest…Warmth is maintained by skin-to-skin
                          contact with the mother.”
ACOG 2000                 FT, recommends birth KC
ACOG,2007                 FT, recommends birth KC
Anderson et al., 2003     Cochrane review of early KC (mixed in with some birth KC). Better and more
                          Exclusive BF.
Argote et al.,1991        PT, Case study and descriptive of 6 infants given Birth KC for Respiratory distress.
                          All symptoms disappeared in 6 hours and infants went home at 24 hours post-birth
                          and have higher temps in KC.
AWHONN 2000               FT, recommends birth KC for breastfeeding
Awi & Alikor, 2004        FT, factors associated with onset of KC within 30 min of birth were delaying
                          cleaning/measuring of infant, providing BF assistance, and delaying repair of
Bergman et al. 2004       PT, birth KC started and infants were more stable in birth KC than incubator.
Bouloumie , 2008
Bramson et al., 2010      FT, descriptive of 21,842 moms. The more Kc they get in first 3 hours of birth, the
                          more likely they are to exclusively breast feed during the maternity hospital stay.
Branger et al., 2007      FT, sudden infant death to full terms in KC
Byaruhanga et al. 2008    FT, qualitative moms liked Birth KC but worried about transmission of HIV with
                           raw cord and some thought it was done to distract moms from episiotomy repair.
Bystrova et al.,2009      FT,RCT,
Calais et al., 2010       FT, survey of routine Postpartum KC with healthy term infants. Need to educate
                          moms antenatally, reduce visitors, provide support during Postpartum for effective
Cantrill et al., 2004     FT, descriptive questionnaire of nurses’ knowledge and support of 1st breastfeed
                          with Birth KC. Got high scores but practice is poor and poor understanding of
                          importance of “continuous, uninterrupted KC”
Cantrill, 2006            FT, dissertation abstract on influence of Birth KC on effective breastfeeding.
Carfoot et al., 2004      FT, Pilot RCT of success of 1st BF
Carfoot et al., 2005      FT, RCT. 102 KC moms more satisfied with their care than controls and infant
                          temp warmer in KC than controls
CDCP, 2007                FT, national survey of birth KC practices that support breastfeeding.
CDCP 2008                 FT, national survey results are not good, much work to do. Birth KC practices are
                          not being practiced.
Charpak et al., 2005      PT, Review. “KC should be started as early as possible, even in the DR or in
                          NICU” pg. 515.
Chandry 2005              FT, Academy of Breastfeeding Medicine guidelines that separating mom and baby
                          immediately after birth is NOT appropriate and KC is the recommended routine
                          because it actually is more likely to result in euglycemia. KC should be encouraged
                          because it prevents heat loss which in turns help prevents hypoglycemia.
Christensson 1992         FT
Christensson et al., 1995 FT
Christensson et al., 1996 FT
Christensson 1998         FT
Clarke, 2009             Review, KMC for improving child health in rich and poor nations.
Colonna et al., 2008     FT, Paternal KC in DR during Cesarean section.
Crenshaw et al. 2004     FT, review of evidence against separation and need to Birth KC as evidence for
                         Lamaze’s guidelines.
Crenshaw 2007            FT, review of evidence against separation and need for lots of Birth KC and
                         presents Lamaze International’s recommendation.
Curry, 1979              FT
Dabrowski, 2007          FT, parents wanted Birth KC and so they started it in L/D.
Dageville et al., 2008   FT, neonatal death during birth kc has occurred in France.
Davanzo, 2004            PT
Demott et al., 200       FT, UK guidelines for breastfeeding with many sections on Birth KC and need to
                         feed with KC within 30-70 minutes of birth.
DiGirolamo et al., 2001 FT, Birth KC is good for breastfeeding
Durand et al., 1997      FT, started KC 30 mins post birth and infants who BF in KC about 2 hours
                         postbirth reached temp between 36.5-37.8, but bottle fed infants under radiant
                         warmer did not.
European Commis2006 FT guidelines for Birth KC which are excellent.
Fardig, 1980             FT
Field et al., 2006       A survey of 25 neonatal nurseries in South revealed that in 83% of
                         them KC following birth in the delivery room was practiced.
Fransson et al. 2005     FT, descriptive of 27 newborns. started temp recordings 4-8 hours post-birth, so
                         really it is Early KC, not birth kc. All temps higher when in close contact with
                         mom than when in incubator. No heat loss when with mom
Gangal, 2007             FT, recommends breast crawl in KC to satisfy step 4 of Baby Friendly Steps.
                         And reports doing it with c/s moms and with preemies too. Page 15-16 lists
                         many advantages of breastcrawl within 30-60 minutes of birth. Says most babies
                         instinctively complete the crawl within 30-60 minutes of birth.
Gardner, 1979            FT, KC had less drop in temp than infants under radiant warmer
Gomez-Papi et al. 1998 FT, KC at birth, Infants stayed awake, if KC lasts more than 50min infants have
                         Nearly 8 times the probability of spontaneously breastfeeding. 21% of moms
                         Were tired.
Hake-Brooks et al. 2007 PT, RCT of very early KC (not right at birth but soon after). Better BF at 6 mos.
Hwang, 1981              FT.
Int Lact Assoc 1999      FT, recommends birth KC and non separation for breastfeeding.
Int Lact Assoc 2007      FT, and some PT. Trifold that reviews Birth KC to promote BF and how to
                         look for signs of readiness in the first hour of birth.
Komara et al. 2007       FT, report of incorporating birth KC in labor/delivery unit to increase BF
Kontos 1978              FT, RCT, maternal affectionate behavior at 3 months was higher in extended
                         contact (EARLY KC) group than controls.
Kovach 2002              FT. Most hospitals give KMC at delivery, some do APGARS
                         In KC.
Kramer et al. 2001       FT, RCT, testing of all Baby Friendly Initiative parts in 10 hospitals on BF
                         outcomes but independent effects of KC cannot be determined from article.
Kroeger & Smith, 2004 FT and PT, addresses the continuum of birth and says that taking babies away
                         and interrupting skin to skin contact is unnatural/harmful. Wonderful
Johanson et al 1992      RCT, FT & PT, KC as effective as swaddling and oil massage at keeping babies
                         warm immediately after birth
Lamp & Zadvinskis,09     FT. Poster for non-separation at birth and birth KC.
Lazarov 1994             FT, Reviews barriers to implementing very early Kc within 30 minutes of birth
                         For Baby Friendly hospitals.
Lindenberg et al.1990    FT. Use of early KC (not immediate) and breastfeeding support increases
                         breastfeeding initiation & duration.
Ludington-Hoe,et al,1999 PT, Descriptive report of KC with 14 preterms 34-36 week who began KC within
                         11 minutes of birth and had stable HR, RR, SaO2 and Temperature.
Ludington-Hoe,et al,1993 PT, Descriptive report of KC beginning within 11 minutes of birth Reports that
                           PT infants with 5 min APGAR of 6 or more who were in KC for 1st 6 hours
                           Postbirth were stable with HR, RR, SaO2, and were discharged 48 hours later.
                           Preliminary report of 1999 publication.
MacDonald, 2005            PT, FT, summary of European Blueprint for BF that says health care workers
                           should have commitment to best standard practices to promote BF (Ludington adds
                           that Birth KC is a best practice though article does not mention KC per se.
Mance, 2008                FT, PT review of strategies to keep babies warm at birth and says that KC can start
                           as soon as mother & infant are dried and head cap is placed (pg. 9).
Marin et al.,2010          FT, RCT, KC at birth increased frequency of exclusive BF at discharge, increased
                           infant temp by 0.07 deg.C, and decreased placental expulsion time.
Matthiesen et al., 2001    Ft, descriptive, 20 infants dried and then started KC. Massage of breast & nipple
                           and suckling stimulates oxytocin release in mom.
Mazur & Mikiel-K, 2000 FT, Descriptive, KC in first 2 hrs postbirth is not a factor in exclusive Bf of
                           fullterms at discharge.
Mazurek et al., 1999       FT, RCT, KC began 6-8 minutes postbirth, Skin thigh temp, HR, RR, and glucose
                           level best in KC group. KC grp cried 3 times less than gp 3 and less than grp 2. KC
                           group had optimal adaptation and special protection against hypothermia.
McCall et al., 2007, 2005 PT, LBW(<2500 g). KC was effective in reducing risk of hypothermia when
2008                       administered in first 10 minutes postbirth and did better than conventional
                           incubator care for PT and LBW infants.
McClellan&Cab1980          FT, RCT 20 KCers started KC in cesarean section recovery room and had it for 60
                           min. Maternal perception in hospital was significantly higher for KC than controls,
                           and higher mat behavior scores in hospital and at home.
Mikiel-Kostyra et al 2002 FT, descriptive/regression. Having > 20 minutes of KC starting early after birth
                           Is independent predictor of breastfeeding.
Mizuno et al., 2004        FT, RCT, 60 infants given 50 minutes of KC immediately after birth recognized
                           their own mother’s milk better than controls and breasfed 1.9 months longer.
Moore, E, 2005 .           FT, RCT, birth KC started at 15 mins and many + BF effectiveness outcomes
                           And # and onset of hunger cues greater and earlier in KC versus swaddled holding
                           group. Effectiveness scores higher in KC; exclusivity and duration of BF not diff.
Moore et al., 2007         FT, Cochrane update with 30 studies . VEKCers more likely to breastfeed and BF
Nagai et al., 2010         PT, RCT of 24/7 KMC beginning within 24 hours of birth vs after 24 hours post
                            birth. No differences in mortality in 1st 28 days, length of stay, adverse events or
                           morbidity, but birthweight loss in first 24 hours significantly less for early KC (-34
                           gms) than late KC (-73 gms).
Nakamura 2007              FT, case studies of infants in Birth KC who needed resuscitation. See Nakamura &
                           Sano for full report.
Nakamura & Sano, 2008 FT, 2 case studies of infants who were apneic, pale, hypotonic at 5 and 70 min
                           postbirth in KC at the breast. Advises close observation of HR, color, tone,
Nommsen-Rivers, 2003       FT, Review of Mikiel-Kostyra et al. 2002. She says no matter how short the
                           duration, if KC starts early it fosters successful breastfeeding
Nyqvist, 2009              PT, FT, KMC should being immediately after birth even with moderately preterm
                           infants but not necessarily with extremely preterm infants.
Phillipp &Jean-Marie 2007 Review, policy paper saying that Baby Friendly initiative includes Birth KC to
                           improve BF outcomes (pg. 11 of article).
Price & Johnson, 2005      FT, Implementation process. Birth KC went from 0% to 80% within 18 months in
                           British hospital trying to increase breastfeeding.
Ransjo-Arvidson et al 2001 FT, Descriptive. Placed in KC immediately after birth and better BF movements
                           Observed in babies who did not get exposed to maternal analgesia and others did
                           Not breastfeed within 2.5 hours of birth.
Romano 2007                FT, review of Moore’s Cochrane. Interesting views of Birth KC
Romano 2007                FT, review of Jonas 2007 article and says epidural prevents normal infant temp on
                           PPD2 and that babies need natural environment of birth KC continuing.
Romano 2009             Review. Criticizes KC studies at birth because they really do not start immediately
                        after bith and then they are only measuring adaptation to many disruptions.
                        Recommends KC immediately after birth and non-separation.
Rowe-Murray/Fisher 2003 FT, review of baby friendly practices and says that KC does not occur in first hour
                        post birth with c/s patients and that this is barrier to early initiation of breastfeeding.
Senarath et al, 2007    FT, RCT of hospitals, one group of hospitals taught WHO’s Essentials of Newborn
                        Care which includes Birth KC. Training increased Birth KC by 1.5 times.
Sheridan 1999           FT, practicing midwifes have concern over body temp regulation with KC
                        immediately after birth.
Sinclair, ????              FT, PT, on page 52 says babies will not get warm in KC but does review
                            Fardig andWhitelaw and Acolet studies about baby warmth and then on
                            page 224-225 has review of birth KC studies on maternal behaviors.
Sinusas & Gagliardi 2001 FT, clinical guidelines for docs about doing Birth KC (use head cap, delay
                         procedures, cover with blanket for warmth, do it immediately after birth.
Sizun et al. 1999        PT, Case study of birth KC and it improved bonding and better physiologic
Smith et al. 2008        FT, Cesarean birth KC is described.
Takahashi et al, 2010    FT, two groups, early initiation (< 5 mins or later) and short/long duration (<60
                         mins or > 60 mins) in first two hours post-birth. HR stability has higher
                         probabilitiy with early initiation and lower stress occurs with longer duration.
Taylor, 1985             FT, RCT of 50 primip moms 25 of whom got KC in first hour after birth, but
                         KC alone did not effect breastfeeding duration, but KC + suckling within 30-70
                         minutes of birth did, and those women who did KC+suckling were more likely
                         to still be breastfeeding at 2 months postpartum than moms who did not.
Thomson et al., 1979     FT, RCT of 15 controls and 15 KC who started KC 15-30 minutes post-birth.
                         Effect of very early KC on breastfeeding at discharge, months later and BF success
                         defined as BF for two months or longer. KC moms/infants did better in all
Uvnas-Moberg, 1996       Review, FT, animal and human studies showing that birth KC is optimal care
Uvnas-Moberg, 1999       Review, FT, animal and human studies showing less maternal stress with birth KC
Vaidya et al., 2005      FT. 92 moms given a few minutes of early postpartum KC and it more significantly
                         affected exclusive BF up to 6 months than early initiation of BF.
Varner 2008              FT, commentary of Smith et al. 2008 article on Cesarean KC, says that
                         evaluative criteria need to be presented.
Vaughans 1990            FT

Van den Bosch et al., 1993
Villalon et al., 1992
WABA 2007                  World Alliance of Breastfeeding says immediate KC is important.
Walters et al.,2007        FT, Birth KC with 10 infants who all went to breast by 52 minutes post birth and
                           none had hypoglycemia nor hypothermia and all had perfect MEALS
                           breastfeeding scores.
WHO/UNICEF 1989            FT, review. Position statement that infants should receive KC and be allowed to
                           breastfeed within 30 minutes of birth.
WHO/UNICEF 1992            FT. provides global guidelines for KC within 30 minutes of vaginal birth
WHO/UNICEF 1992            FT. provides guidelines for hospital adaptation of Baby Friendly step 4 which is
                           KC beginning within 30 minutes of birth to promote BF


Worku & Kassie, 2005         PT, RCT of 32 weekers started on KC at 10 hours postbirth and kept there for
                            4.6 days. 91% were discharged before 7 days of age and better survival in KC

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