Slovak preterm babies ‘denied’ crucial neonatal skin-to-skin contact

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Slovak hospitals are failing to fulfil the minimum recommended eight-hour-a-day skin-to-skin contact for preterm babies, which is considered critical for the survival and development of infants by the World Health Organisation (WHO). 

In 2022, Slovakia recorded 3877 preterm births, equivalent to every thirteenth child, while numbers are also increasing among other EU member states. In practice, Slovak preterm babies spend very little time in skin-to-skin contact, with the majority of the time spent in an incubator or a heated bed.

“It is one of the most significant challenges in paediatric healthcare. The current practices often fall short of upholding children’s rights and adhering to evidence-based medicine principles,” MP Vladimíra Marcinková told Euractiv.

Preterm babies born before 37 weeks of gestation are at higher risk of having neurological problems and can struggle with maintaining body temperature, breathing, or feeding. Immediate and prolonged skin-to-skin contact between the newborn and the caregiver has proven to increase survival chances.

The WHO guidelines recommend at least eight hours a day of contact between a parent (ideally the mother) and the infant.

Kangaroo Mother Care strongly recommended as routine practice

Kangaroo Mother Care (KMC) is an evidence-based method of prolonged skin-to-skin contact. Placing the baby on the mother’s chest and listening to her heartbeat stimulates psychomotor development, can improve vital functions, and shorten the hospitalisation time.

In Europe, preterm birth is one of the two leading causes of neonatal mortality and accounts for more than half of all deaths in later childhood. Prevalence rates of preterm birth range from 5.4 to 12% – an average of 7.3% of all live births.

The KMC provides several irreplaceable health benefits and is recommended as routine care for premature babies (born before 37 weeks of pregnancy are completed) and low-birth-weight babies (under 2.5 kg).

The WHO and the European Foundation for the Care of Newborn Infants (EFCNI) highlight that performing KMC on preterm babies has no evidence of harm, decreases mortality, and has shown a reduction in infections and hypothermia while improving feeding.

“The first embrace with a parent is not only emotionally important but also critical for improving chances of survival and health outcomes for small and premature babies,” Dr Karen Edmond, Medical Officer for Newborn Health at WHO, said in a press release.

“Even newborns in need of intensive care should be provided with kangaroo care since the mother’s body is a natural incubator,” Veronika Kmetóny Gazdová from NGO Malíček told Euractiv.

Additionally, healthcare facilities should allow for unlimited parent access to the preterm baby. Private and quiet spaces with appropriate lighting for a parent-infant KMC should be available—neither of which the wards are currently equipped for.

Slovak hospitals, however, fall short of implementing the WHO’s evidence-based procedural methods, and the wards do not conform to the recommended guidelines.

MP Marcinková emphasises that the state of neonatal wards underscores the premature babies’ low priority in healthcare, positioning them at the tail end rather than as a focal point.

Where lies the problem?

“Unfortunately, the practice in Slovakia is that premature babies spend a short, limited time with their mother (one to three hours), often in unsatisfactory conditions, where they do not have privacy with the child,” MP Marcinková continued.

Kmetóny Gazdová highlights that staff shortages and material, financial, or spatial barriers all present obstacles to ensuring that newborns spend as much contact with their mothers as possible.

The KMC and physical contact are, thus, not only beneficial for the infant but are crucial for the mother as well. It helps to start the breastfeeding process and reduces mental strains from separation.

A survey conducted by the NGO Malíček “Through Parents’ Eyes” showed that for 85 per cent of parents, the biggest psychological burden after a premature birth is separation from the child.

Marcinková added, “We have made positive strides. Nevertheless, we have already maximised the potential impact media coverage and raising awareness can have on the subject.”

“There are always different priorities other than premature babies. At this point, I see no other way than enforcing it through legal and sub-legal regulations,” Marcinková concluded.

[By Filip Áč, Edited by Vasiliki Angouridi |]

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