Learning Objective #1: The learner will be able to identify evidence based practices and principles of care for the nuclear family in the transitional phase of newborn life.

Learning Objective #2: The learner will be able to facilitate parents to apply practices that promote ongoing nurturing and care of their infants following the immediate transitional period.

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Research reveals the importance of early contact between mothers and their newborn infants. Research also clearly supports the importance of breastfeeding immediately following birth while the infant is in the quiet alert phase. Visitors are noted to frequently hold and pass around babies in the immediate postpartum period, often delaying the mother holding and touching her baby for extended periods of time. In turn, the infant is delayed in the infant-mother attachment process. Multiple visitors also impact the ability of the nuclear family to bond as a new and distinct family unit. Infants are often cold and have delayed breastfeeding attempts, leading to significant negative physiological effects. The labor and delivery department nursing staff of a large Midwestern teaching hospital undertook implementation of an “optimal transitional care concept” for the first hours(s) of life for the nuclear family of mother, significant other and baby, cared for as an integral whole. Goals are bonding and attachment by maximizing the infant's quiet alert state following birth; appropriate developmental care; early breastfeeding for all associated physiologic and psychological benefits; thermal synchrony; and establishment of the foundation of the family entity. This philosophy of care is described as BABY FIRST by the nurses involved in bedside care (Baby's first hour After Birth with You: Families and Infants Relating and Sharing in the Transitional hour). Practice changes to facilitate these goals include immediate skin-to-skin contact (kangaroo care) between mother and infant as a routine practice following birth and the establishment of a protected time during this period for the nuclear family. A nursing task force provided education regarding practice changes for staff involved in both direct and supportive care of the obstetrical patient population. Evidence of practice changes and staff and patient satisfaction will be measured by interview during the postpartum period.