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Lisa Dailey

Title: Sudden Unexpected Postnatal Collapse of the Healthy Term Infant: Keeping Mother and Baby Safely Together

Biography

Biography: Lisa Dailey

Abstract

Statement of the Problem: A relatively new clinical phenomenon has been identified in the healthy term infant, Sudden Unexpected Postnatal Collapse (SUPC). Sudden Unexpected Postnatal Collapse is characterized by apnea, bradycardia, cyanosis and cardiorespiratory collapse in the healthy term newborn shortly after birth, often during initial skin-to-skin care (SSC) or during the first breastfeeding attempt.  Unfortunately, the cause is not completely understood, but accidental suffocation of the infant related to poor positioning.  Skin-to-Skin care has become a common practice in the newborn period.  It is part of the World Health Organization’s “Ten Steps to Successful Breastfeeding” and is embraced as a part of the Baby-Friendly Hospital Initiative.  Despite the positive effects of SSC, this practice may pose a safety risk and result in SUPC in the neonatal period.

 

A majority of the SUPC occur in the first two hours of life, related to common findings in maternal, perinatal, neonatal and situational factors.  While the etiology of SUPC is not completely understood, but there are commonalities of maternal fatigue and distraction appear to play a key role.  It is critical to be able to identify at risk situations that may lead to SUPC, preventing fatal or near-fatal related to sleep, suffocation, and falls.

 

A lack of standardization in approach, discontinuous monitoring of the mother-infant dyad with times lapses greater than 10-15 minutes during the first few hours of life, lack of education and skills among the staff supporting the dyad, and staff unfamiliarity with the potential risks of unsafe positioning and approaches of assessment that may avert problems.

 

Conclusion: Early breastfeeding and SSC are beneficial to the healthy transition and bonding of the mother infant dyad.  Recognition of risk factors, maternal education and a heightened surveillance of the dyad can prevent catastrophic and can be prevented.