Trysha Hicks

tryshahicks@email.arizona.edu

BSN Nursing Program, 3rd Semester (4th Year)

Advisor: Melissa Goldsmith

 BEST PRACTICES IN NEONATAL MICROBIOME DEVELOPMENT

Trysha Hicks
BS Nursing Honors Student
University of Arizona
College of Nursing
Tucson, AZ

Melissa M. Goldsmith, PhD, RNC Sheila M. Gephart, PhD, RN

Clinical Associate Professor Associate Professor
University of Arizona University of Arizona
College of Nursing College of Nursing
Tucson, AZ Tucson, AZ

Purposes/Aims: The purpose of this thesis is to identify best practice recommendations for
nurses and new parents to encourage optimal microbiome development in neonates through
a variety of elective influences. Education of both parties regarding elective measures that
surround childbirth may result in neonates with the most optimal microbiome.
Rationale/Background: Newborn care practices immediately following delivery are
dependent on the setting, maternal decisions, prior education, and risks specific to each
family. With almost four million infants born in the United States in the last year, practices
focused on proper newborn microbiome development are especially important to foster
optimal health in infants. This best practice thesis will focus on elective postnatal choices
that the parents may initiate to encourage microbiota development. Specifically,
bifidobacteria plays a dominant role in a healthy microbiome formation, with proper
colonization leading to fewer infections, fewer Clostridia species colonized in the gut, and
reduced allergic responses. Although the effects of proper microbiome are especially
important for an infant’s health, the nursing staff must also be aware of the positive health
benefits for the child’s long-term growth.
Brief description of the undertaking/best practice, including the approach, methods,
or process used: A literature search was conducted using PubMed, CINAHL, and Google
Scholar with the following keywords: neonatal microbiome, infant gut microbiota, delayed
bathing, and vaginal seeding. Articles were narrowed to those published from 2007 to
2017. A total of 20 articles were reviewed in this thesis, ranging from randomized control
trials to cohort studies.
Outcomes achieved/documented: The proposed best practice model for postnatal practice
include vaginal birth when not medically contraindicated, exclusive breastfeeding for up to
6 months, delayed bathing for up to 24 hours, use of skin-to-skin contact immediately
following delivery, and limiting antibiotic exposure to the infant. Through education to
both the nursing staff and the expecting families, hospitals will be able to implement these
practices when it is safe to do so for the mother-infant dyad.
Conclusions, emphasizing implications for clinical or educational practices, and
recommendations for research or future undertakings: The aim of these best practice
recommendations is to educate health care professionals and expectant families on choices
that encourage optimal microbiome development for their newborns, while minimizing
adverse effects from improper microbiome development. Educating the nurses is pivotal to
implementing this change, as the nurses have a responsibility to educate the expectant
parents on the evidence supporting these interventions. As more evidence becomes
available recommendations can be adjusted to reflect practices that will be most beneficial
to the infant’s microbiome development.