golden hour

A recent article presented different factors which may help healthcare professionals provide optimal care during the golden hour — a critical period following birth.

Neonates, or newborn babies, need to adapt to a lot of changes from the intrauterine environment to the outside world. The first hour after birth is the most difficult and has important long-term implications. In paediatrics and neonatology, this critical period is called the golden hour. The different physiological characteristics and immaturity of different organ systems in the newborn often make it hard for them to adapt to the outside environment, and this may create inter-related and complex conditions for physicians to manage.

In a recent article, published in Maternal Health, Neonatology, and Perinatology, Deepak Sharma from the National Institute of Medical Science in India, proposed guidelines which can help physicians and other allied health professionals in providing the best medical care for neonates during the golden hour.

Sharma identified 13 different components during the first hour after birth which are critical in establishing good long-term clinical outcomes.

The following components are:

1) antenatal counselling and team briefing
2) delayed cord clamping
3) temperature regulation
4) support the respiratory system
5) support the cardiovascular system
6) early nutritional care
7) prevention of hypoglycaemia
8) infection prevention
9) initiation of breastfeeding
10) setting of therapeutic hypothermia after birth asphyxia
11) laboratory investigation
12) proper monitoring of the neonate
13) communication with family members

The components identified are based on the physiological characteristics of neonates and their ability to adapt to the outside environment. The currently available evidence has supported this approach by showing a reduction in newborn complications in hospitals using this checklist. This is a new and evolving strategy to provide the absolute best care for our most vulnerable patients.

Overall, the concept of a golden hour can help physicians and other healthcare professionals in providing optimal care for both the mother and her newborn child. The components, identified above, aid members of the healthcare team in helping the neonate adapt to the outside environment. Members of the healthcare team should be educated about the importance of the golden hour and its components to the health outcomes of newborns.

Written by Karla Sevilla

Resource: Sharma, D. (2017). Golden hour of neonatal life: need of the hour. Maternal Health, Neonatology, and Perinatology, 3, (16). DOI 10.1186/s40748-017-0057-x

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