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Hautkontakt von Frühgeborenen im Kreißsaal

Delivery room skin-to-skin contact for preterm infants

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Zusammenfassung

Für reife Neugeborene wird nach Geburt ein unmittelbarer, kontinuierlicher und ununterbrochener Hautkontakt mit der Mutter empfohlen. Dieser frühe Kontakt hat positive Effekte auf die Mutter-Kind-Interaktion und Bindung. Bei Frühgeborenen ist häufig eine Trennung von Mutter und Kind nach Geburt nötig, um die erfolgreiche Transition der unreifen Kinder zu überwachen sowie auftretende Probleme (insbesondere Störungen der Atmung) frühzeitig zu erkennen und entsprechend zu behandeln. Auch wenn Hautkontakt für Frühgeborene in Form der „intermittent kangaroo mother care“(iKMC)-Methode in den letzten Jahren als Standard in den westlichen neonatalen Intensivstationen etabliert wurde, findet dieser häufig erst nach Tagen oder Wochen statt. Zudem haben die ersten Stunden nach Geburt als sog. sensible Phase der Mutter-Kind-Interaktion eine besondere Bedeutung für die Entwicklung einer sicheren Bindung. Erste Studien, die einen frühen Hautkontakt bei Frühgeborenen untersuchten, konnten zeigen, dass dieser für moderate und späte, aber auch unreife Frühgeborene machbar und sicher ist, wenn die entsprechenden Voraussetzungen geschaffen werden. Ebenso konnten positive Effekte auf die Mutter-Kind-Interaktion und die Bindung für Frühgeborene mit frühem Hautkontakt nachgewiesen werden. Eine sichere Bindung stellt einen protektiven Faktor für Verhaltensauffälligkeiten oder neurokognitive Entwicklungsstörungen dar. Ziel der zukünftigen Versorgung von Früh- und Neugeborenen sollte sein, einen frühen Kontakt von Mutter und Kind unter Berücksichtigung der medizinisch notwendigen Unterstützung entsprechend der Unreife der Kinder zu ermöglichen.

Abstract

Continuous and uninterrupted skin-to-skin contact (SSC) immediately after birth is recommended for full-term infants and their mothers. Early contact has beneficial effects on mother-child interaction and the forming of a secure bond between mother and infant. Preterm infants are often separated from their mothers directly after birth for medical reasons. Immature infants are at risk of impaired transition to extrauterine life and it is of utmost importance to recognize signs of respiratory failure immediately and to treat them adequately. Even when SSC for preterm infants in the form of intermittent kangaroo mother care (iKMC) has been established in most modern neonatal departments within recent years, it is frequently delayed for days or even weeks. Moreover, the first hours after birth have been identified as a sensitive period for laying the basis for an optimal mother-child interaction that encourages the forming of a secure attachment pattern. Studies investigating early SSC in moderate, late and even immature preterm infants have demonstrated that early SSC is feasible and safe if certain requirements are met. Additionally, early SSC in preterm infants was shown to have positive effects on mother-child interaction and bonding. A secure attachment pattern may act as a protective factor in preterm infants decreasing the risk of neurodevelopmental delay and behavioral difficulties. Future efforts should aim at protocols of non-separation of mothers and infants while taking the medically necessary support into consideration.

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Authors and Affiliations

  1. Abteilung für Neonatologie und pädiatrische Intensivmedizin, Unikinderklinik Köln, Kerpenerstr. 62, 50937, Köln, Deutschland

    K. Mehler & A. Kribs

  2. Abteilung für Metabolismus und perinatale Programmierung, Unikinderklinik Köln, Köln, Deutschland

    E. Hucklenbruch-Rother

Authors
  1. K. Mehler
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  2. E. Hucklenbruch-Rother
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  3. A. Kribs
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Correspondence to K. Mehler.

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K. Mehler, E. Hucklenbruch-Rother und A. Kribs geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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C. Poets, Tübingen

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Mehler, K., Hucklenbruch-Rother, E. & Kribs, A. Hautkontakt von Frühgeborenen im Kreißsaal. Monatsschr Kinderheilkd 167, 18–25 (2019). https://doi.org/10.1007/s00112-018-0595-y

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