Volume 40 Supplement 2

Proceedings of the XX National Congress of the Italian Society of Neonatology

Open Access

Preventing sudden unexpected postnatal collapse in term and late preterm newborn infants: a surveillance protocol

  • Riccardo Davanzo1Email author,
  • Laura Travan1,
  • Giuseppina Verardi1,
  • Elisa Corubolo1,
  • Angela De Cunto1,
  • Giulia Paviotti1,
  • Tamara Strajn1,
  • Francesca Marrazzo1,
  • Pierpeolo Brovedani1,
  • Jaquelyn Kennedy1,
  • Enrica Causin1 and
  • Sergio Demarini1
Italian Journal of Pediatrics201440(Suppl 2):A5


Published: 9 October 2014

Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on mother-infant relationship and breastfeeding. SSC may ease the infant’s transition to extra uterine life and helps to regulate the infant’s body temperature and nursing behavior.

However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term and late preterm neonates, in association with skin-to-skin contact, have raised concerns about the safety of this practice.

Based on the available evidence, the working group on breastfeeding of the Maternal and Child Health Institute of Trieste (Italy) developed a surveillance protocol to be implemented in the Delivery Room and Postnatal Ward. The aim of our protocol is: 1) promoting safe mother- infant bonding 2) establishing successful early breastfeeding and 3) correcting the risk factors for sudden unexpected postnatal collapse (SUPC). This protocol is especially focused on the first 2 hours of life, when about 1/3 of SUPC occur, but extends to the whole duration of the infant stay in the maternity ward.

The following interventions will be undertaken: 1. antenatal and early postnatal oral and written information to parents about: a) the risk of bed-sharing b) avoidance potentially suffocating infant positions (i.e. mouth/nose obstruction) c) the need of an adequate supervision of the infant in the first hours/days after birth 2. periodical assessment (position, colour, breathing) of the infant (at 10, 30, 60, 90 and 120 minutes of life) by midwives in the delivery room 3. discouragement of bed-sharing 4. encouragement of skin-to-skin contact only when mothers are fully awake 5. avoidance of mothers left alone with the baby in the first hours after birth particularly during skin-to-skin contact and first breastfeeding attempts.

As there is no evidence of effective interventions to prevent SUPC, our protocol has been written as a potential best practice. Evidence of its clinical effectiveness is obviously needed.

Authors’ Affiliations

Perinatal Medicine, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”


© Davanzo et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.