The Impact of Nursery Staff’s Knowledge on Skin- to- Skin Mother-Infant Contact (SSC)

By Lui Wing Lam, Zoie, RN, RM, IBCLC, BSc(Nursing), MSc(Nursing), Department of Obstetrics


  • A mother’s body is the natural and healthy environment for the baby
  • Skin- to-skin and eye contact between the mother and the baby facilitates the development of pleasure-related brain pathways
  • Unfortunately, twentieth century high technology practice has led to separation of mother and child being accepted as necessary and normal when in fact separation is abnormal and harmful

Skin-to-Skin Contact (SSC):

  • Calms and relaxes both mother and baby
  • Regulates the baby’s heart rate and breathing
  • Stimulates digestion and an interest in feeding
  • Regulates temperature
  • Provides protection against infection
  • Stimulates the release of hormones to support breastfeeding
  • Improves breastfeeding behavior

Skin-to-Skin Contact 

  • Improved neurobehavioral development
  • Better cardiovascular and temperature stabilization
  • Critical component for successful breastfeeding initiation and bonding between mother and baby

The Importance of skin-to-skin

  • SSC is a key part of the UNICEF UK Baby Friendly Initiative standards
  • SSC helps the baby to adjust to life outside the womb and is important for supporting mothers to initiate breastfeeding
  • SCC is a common practice in the newborn period for healthy newborns as outlined in the World Health Organization’s “Ten Steps to Successful Breastfeeding”

Limitations in labour ward

  • Lack of staffing resources
  • Time constraints
  • Safety concerns
  • Interference with clinical routines

Reasons to choose postnatal ward for Skin-to-skin contact

  • Duration of stay in postnatal ward after delivery:
    • Normal delivery (3 days and 2 nights)
    • Caesarean section (5 days and 4 nights)
  • Current staffing:
    • Postnatal ward (36 nurses) and Nursery (37 nurses) versus Labour ward (24 nurses)

Purpose and Problem Statement

Does the reinforcement of nursery staff’s knowledge impact the Skin-to-Skin mother-infant Contact (SSC) rate in a postnatal ward?

Implementation Plan

Baseline Data

  • Recruit 5 out of 39 nursery staff
  • Skin-to-skin knowledge check of staff
  • Promote skin-to-skin in postnatal ward
    • SSC ~30 minutes in the postnatal ward

Reinforcement of Nursery’s Staff Knowledge

Assessment of infant and parents                           

  • Preparation
  • Education
  • Evaluation
  • Documentation
  • Reflection

Description of practice change

  • Initiate skin-to-skin practice in postnatal ward
  • Reinforce staff knowledge of SSC through education
  • Skin-to-skin contact ~30 minutes or more during hospitalization


Nursery nurses’ comments about parents’ experiences with the skin-to-skin contact project:

  • “I feel like a real mum when I do skin-to skin contact with my baby.”
  • “I can show my love to my baby through skin-to skin contact.”
  • “I feel calm when I cuddle my baby.”
  • “It’s an amazing time!”
  • “It is an unforgettable moment after delivery.”

Recommendations and Next Steps

  • Nurses in the nursery spoke positively about parents’ experiences with the skin-to-skin contact
  • Reinforcement of knowledge through education is one effective way to increase skin-to-skin contact for our patients
  • More staff would help with educating patients

Short-term goals

  • Recruit more staff in postnatal ward and nursery

     Long-term goals

  • Evaluate parent’s satisfaction
  • Involve fathers in plan of care