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Pediatrics. 2011 Apr;127(4):e1073-6. doi: 10.1542/peds.2009-3095. Epub 2011 Mar 14.

Apparent life-threatening events in presumably healthy newborns during early skin-to-skin contact.

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  • 1Neonatal Intensive Care Unit, La Conception University Hospital, Marseille, France.


The death or near death of a presumably healthy newborn in the delivery room is uncommon. We report here 6 cases of apparent life-threatening events (ALTEs) in the delivery room during the first 2 hours of life. In each case, the incident occurred in a healthy infant who was in a prone position on his or her mother's abdomen during early skin-to-skin contact. In most cases, the mother was primiparous, and in all cases the mother and infant were not observed during the initiation of skin-to-skin contact and breastfeeding. There are many benefits of early skin-to-skin contact and breastfeeding in the delivery room. However, in view of the risk of a rare but significant ALTE, we suggest that surveillance of newborns is needed. Although many ALTEs are apparently caused by obstruction, we suggest that a standardized investigational workup be performed after an ALTE.

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