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Innovative approach keeping more moms and newborns together immediately after birth

For years, babies born to mothers with chorioamnionitis, a type of uterine infection, were brought to the NICU for special care. A new approach at The Birthplace at University of Minnesota Masonic Children’s Hospital is keeping more infants and moms together.
Early contact between moms and newborns is very beneficial for both, but moms with intra-amniotic infections (IAI), also known as chorioamnionitis, are typically separated from their child temporarily because of the severe risks the infection can pose to infants.

An innovative approach at The Birthplace at University of Minnesota Masonic Children’s Hospital is keeping more moms together with their newborns immediately after birth.

For years, babies born to moms with intra-amniotic infections (IAI)—also known as chorioamnionitis or intrauterine infections/inflammations (III)—would be brought to the Neonatal Intensive Care Unit (NICU) to be monitored and given antibiotics, a policy that’s still common practice across the United States.  At The Birthplace at University of Minnesota Masonic Children’s Hospital, a majority of babies born to moms with IAI are now able to stay with their moms.

Those initial hours after birth are developmentally crucial for infants, and allow for an early start to breastfeeding, said Pediatrician Alexander Gurfinkel, MD.

“Generally, the more time moms and babies spend together, the better it is for the babies,” he said. “For example, we know that simply hearing a mom’s soothing, comforting voice will immediately lower the baby’s anxiety and stress after childbirth.”

Despite the benefits of early contact immediately after birth, moms with an IAI and their babies are typically separated temporarily because of the risks an IAI can pose to infants. An IAI is an infection inside a pregnant mother’s uterus. The same bacteria that cause the mother’s infection can also affect a baby, causing a fever and an elevated heart rate. It can also eventually lead to sepsis, respiratory problems, and other potentially life-threatening issues for the baby.

But not all babies born to moms with an IAI develop an infection themselves.

Under the policy at University of Minnesota Masonic Children’s Hospital, babies that have a lower risk of developing an infection can stay with their mom after birth, though they’re still given antibiotics as a precaution. Pediatricians and nurses evaluate a variety of factors to determine whether a baby is likely to develop an infection and should go to the NICU. They also consider a newborn’s appearance and behavior at birth.

Learn more about The Birthplace at University of Minnesota Masonic Children’s Hospital.

Babies who still need to be separated typically stay in the NICU for 24 to 48 hours and are given IV antibiotics.

“These are typically the healthiest newborns in the NICU,” said Cindy Osborn, a nurse manager who helped implement the policy change at University of Minnesota Masonic Children’s Hospital. The policy not only keeps more babies and mothers together, it is also a cost-saving measure and frees up space in the NICU for other infants with more severe health complications.

Since the hospital implemented the policy in 2016, 36 babies have been born to moms with IAIs. Of those, 16 babies never left their parents and 20 went to the NICU to receive extra care. Of the 20 taken to the NICU, 12 returned to their moms within several hours of birth.

Learn more about our nationally recognized Neonatal Intensive Care Unit (NICU).

“That’s more than three dozen babies who were able spend to spend their first few hours with their mom instead of being separated,” Osborn said.

Osborn and Gurfinkel said the policy has spurred interest in medical circles and that other institutions have since begun exploring the possibility of implementing it themselves.

“This new approach serves as a testament to our commitment to high-quality care and excellent patient experiences,” Gurfinkel said, “More importantly, it’s in the best interest of our moms and newborn babies. That’s what really matters.”

Editor's note: This article was originally published on Dec. 28, 2017, and has been updated to ensure continued accuracy and comprehensiveness.