Health

'Skin-on-skin' cuddle straight after a C-section puts both mother and baby at risk


A ‘skin-on-skin’ cuddle straight after a C-section birth could put both mother and baby at risk, anaesthetists have warned. 

Doctors have reported two cases of newborns suckling or grabbing at electrical patches stuck to the mother’s skin to monitor her heart rate. 

This means the mother and newborn’s heart activity can merge on the monitors, causing alarm bells to sound. 

Medics may then mistake the alarm for a life-threatening problem in the mother, experts have warned.

There are fears it could even lead to wrongly administered drugs or jolting the mother with an electric shock. Although this isn’t believed to have happened yet. 

In one case, the baby was found suckling an electrode on their mother’s chest after mistaking it for a nipple.

But experts working in the UK have cast doubt over the concerns and said the embraces are usually safe and are an important moment during the birth.

Cases of a newborn suckling or grabbing a piece of equipment called electrodes (pictured) used to monitor the mother's vitals have been reported

Cases of a newborn suckling or grabbing a piece of equipment called electrodes (pictured) used to monitor the mother’s vitals have been reported

A cuddle straight after birth is an important part of mother and baby bonding because it helps the baby to feel safe and learn to breastfeed. 

But after a C-section, the mother’s chest has electrodes attached to the skin.

The electrodes sense cardiac activity, producing a visual graph on a screen called a electrocardiogram (ECG).

Medics can continuously monitor heart rate during the procedure. They also check blood pressure, breathing and blood oxygen level.

But there is potential for the baby’s own heart activity to be picked up, if they come into contact with the electrode, causing haywire results. 

Writing in the European Journal of Anaesthesiology, doctors described two recent cases. 

The first case involved a 37-year-old first-time mother having a C-section at La Zarzuela University Hospital, Madrid.

Dr Nicolas Brogly, who works at the hospital and co-authored the paper, said: ‘The newborn was found suckling the right electrode of the ECG.’ 

In the Netherlands, a baby grabbed a wire (pictured) measuring his mother's heart rate

In the Netherlands, a baby grabbed a wire (pictured) measuring his mother’s heart rate

It was not explained how this may be a danger to the baby, but it is presumed unsafe for a newborn to put electrical equipment in their mouth. 

Doctors placed the electrodes elsewhere on the woman’s skin and the abnormal rhythm – a combination of her own and her baby’s heartbeats – vanished.  

The second case was recorded by Dr Leonie Slegers and her team at the St Antonius Hospital in Woerden, the Netherlands.  

A 36-year-old woman had just given birth to her second child, a healthy baby boy, who was then placed on her chest.

Soon afterwards, her heart rate became abnormally fast – known as tachycardia – which can trigger heart failure or a stroke.

The patient still had the baby on her chest, while doctors checked her other vital signs.

They were normal, and the ECG appeared to contain two different ECG rhythms in one recording.

Dr Slegers said: ‘A quick inspection of the baby showed that he had taken the right ECG lead in his hand.

In one case study an ECG (pictured) gave doctors a scare because it was picking up both the mother's and baby's heartbeat and gave the impression of a dangerous condition

In one case study an ECG (pictured) gave doctors a scare because it was picking up both the mother’s and baby’s heartbeat and gave the impression of a dangerous condition

‘After carefully moving this to lead to the mother’s right shoulder, the ECG returned to normal.’

Dr Brogly said: ‘This novel source of electric interference represents a risk for both the mother and the baby. 

‘The alarm on the monitor could have led to a misdiagnosis with of supraventricular arrhythmia, which could then have led to administration of antiarrhythmic drugs, or even worse, using the defibrillator on the mother to stabilise her heart rate.’

But Pat O’Brien, spokesman for the Royal College of Obstetricians and Gynaecologists, said early contact is vital – particularly with C-sections on the rise.

‘Early skin-to-skin contact between a mother and her newborn baby can improve breastfeeding which is associated with many health benefits for women and their babies,’ he said.

‘Skin-to-skin contact is usually not difficult to achieve during a caesarean, as long as the mum and baby are well. 

‘It is very important in this setting to make sure that the newborn baby doesn’t get cold.

‘Ideally, the baby should be dried, placed skin-to-skin on the mother’s chest, and covered with a warm towel or blanket.’

There is very little evidence of electrical interference events after a C-section, the doctors said.

But this may be because skin-to-skin cuddling is not always be possible after an emergency C-section.

Electrical interference could also happen if a woman is having a vaginal birth and a transcutaneous electrical nerve stimulator treating labour pain.

The authors conclude that midwife teams should be aware of the placement of electrodes. They could instead be placed on the back or chest sides.  

BABY GRABS ELECTRODES AFTER BIRTH 

Doctors reported two cases of a mother and her baby’s heart activity merging in the European Journal of Anaesthesiology.

A 37-year-old first time mother having a C-section at La Zarzuela University Hospital, Madrid.

The baby’s head was too large to fit through the mother’s pelvis and she was given a standard epidural.

Soon after, a healthy baby boy was delivered with no major bleeding.

After initial examination of the baby, he was placed on his mother’s chest to provide early SSC. 

Co author of the paper, Dr Nicolas Brogly, who works at the hospital, said: ‘Shortly after this, the heart rate alarm was triggered on the monitor, due to an apparent dramatic increase of the mother’s heart rate.

‘However, the woman remained conscious and with no complaint.’

The mother’s other vital signs were showing as normal, including her radial pulse and blood pressure remained normal. 

The positioning of the electrodes were checked to investigate potential interference of the baby heart electric activity.  

The newborn was found suckling the right electrode of the ECG, which was immediately replaced to another site on the mother’s skin.

The second case was cared for by Dr Leonie Slegers and her team at St Antonius Hospital, Woerden, the Netherlands. 

A 36-year-old woman, having her second child, had been pregnant for 40 weeks and, like the first woman, had no history of heart disease. 

The baby’s head was struggling to come out, so doctors proceeded to a C-section.

The woman remained stable throughout and the operation produced a healthy baby boy who was placed on her chest, with warm blankets put on both of them. 

Soon after, the ECG changed to an abnormally fast rhythm, called tachycardia. 

The patient still had the baby on her chest, and while her other vital signs were normal, the ECG appeared to contain two different ECG rhythms in one recording.



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