Skin-to-Skin Contact and the Incidence of Transient Tachypnea of the Newborn

Objectives: To compare the incidence of transient tachypnea of the newborn (TTN) before and after the implementation of a Baby-Friendly protocol and to determine changes in the rates of TTN symptoms, interventions, completion of skin-to-skin contact. Design: Retrospective cohort study using data in the electronic medical record. Setting: Community-based tertiary obstetric facility. Participants: We reviewed 934 charts of neonates born at or greater than 34 weeks gestation to women ages 18 years or older and included 790 neonates: 491 in the preimplementation group and 299 in the postimplementation group. Group assignment was based on time of Baby-Friendly protocol implementation. The preimplementation group included neonates born in April, August, and December of 2014, and the postimplementation group included neonates born during these months in 2018. Methods: The primary outcome was incidence of TTN. Secondary outcomes were rates of the following: tachypnea symptoms, hypoglycemia, antibiotic administration, and completion of skin-to-skin contact. Results: The incidence of TTN was 2% (n = 8/491) in the preimplementation group and 1% (n = 4/299) in the postimplementation group (p = 1.000). The rate of tachypnea symptoms decreased from 5% (n = 25/491) to 1% (n = 3/299, p = .003), the rate of hypoglycemia decreased from 11% (n = 54/491) to 3% (n = 10/299, p < .001), and the rate of antibiotic administration decreased from 13% (n = 66/491) to 4% (n = 11/299, p < .001). The skin-to-skin completion rate increased from 16% (n = 79/491) to 61% (n = 183/299, p < .001). Conclusion: Although skin-to-skin contact facilitates physiologic transition to extrauterine life, incidence of TTN was not significantly reduced after the implementation of the Baby-Friendly protocol. However, increased practice of skin to-skin contact was an improvement in care with implications for the transition to extrauterine life. JOGNN, 50, 724-731; 2021. https://doi.org/10.1016/j.jogn.2021.09.001