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1999 LLLI Conference Sessions:
Perinatal Care in the 21st Century

By Karen Zeretzke
Baton Rouge LA USA
From: NEW BEGINNINGS, Vol. 16 No. 5, September-October 1999, p. 168

Marshall Klaus' knowledge and wisdom about mother-baby attachment at birth has been gleaned over the years from watching, listening, and research. I wanted to attend Klaus' session because I have heard him speak before and admire him for his great respect for mothers and babies. Dr. Klaus gave five recommendations to improve perinatal care in the next century.

During labor and delivery, every mother should be offered continuous physical and emotional support by a knowledgeable, caring doula in addition to her partner.

Wherever possible, analgesic medications and epidural analgesia during childbirth should be avoided so there will be no interference with the infant's ability to latch on to the breast and breastfeed.

Immediately after birth and a thorough drying, an infant who has a good Apgar score and appears normal should be offered to the mother for skin-to-skin contact, with warmth provided by the mother's body and a light blanket covering her and her baby. The baby should not be removed for a bath, footprinting, or administration of Vitamin K or eye medication until after the first hour. The baby should be allowed to decide when to start the first suckling.

Central nurseries in hospitals should be closed. All babies should room-in with their mothers throughout the short hospital stay unless this is prevented by illness of mother or infant. A small nursery area should be available for infants of mothers who are ill.

Early and continuous mother-infant contact appears to decrease abandonment of infants and increase the length and success of breastfeeding. Mothers should begin breastfeeding in the first hour, nurse frequently, and be encouraged to breastfeed for at least the first two weeks of life, even if they plan to go back to work. Early, frequent breastfeeding has many advantages, including removing bilirubin from the digestive system and promoting mother-to-infant attachment.

Klaus opposes routine interventions and tells why this is a better plan. His promotion of practices that support the mother and protect the baby is both heartwarming and valid.

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