Resume

• 1996

  Healthy Children Project Center For Breastfeeding

  Director of Operations

  Healthy Children Project

  Inc

  Healthy Children Project Center For Breastfeeding

  PhD

  People

  Computers and Work

• 1994

  Blekinge Institute of Technology

  Union Institute & University

  Healthy Children Project

  Inc

  Healthy Children Project

  Director and Producer of Award Winning Educational Videos including The Magical Hour: Holding Your Baby Skin to Skin During the First Hour After Birth

  Healthy Children Project

  Blekinge Institute of Technology

• 1992

  Blekinge Tekniska Högskola

  Blekinge Tekniska Högskola

  Maternal Child Health Advisor and Professor

  Professor for Maternal Child Health courses including Anthropology of Childbirth

  Politics of Breastfeeding and Folklore of Childbirth. Advisor for MCH students.

  Union Institute & University

  MA

  Human Computer Interaction

• 1988

  Bachelor of Science (BS)

  Computer Science Engineering

  Worcester Polytechnic Institute

• Happy Birth Day - Home

  Happy Birth Day

  where birth is not a scary reality show

  but a beautiful normal human experience. Real births

  real stories. And real parents

  just like you.

  Happy Birth Day - Home

  Skin to Skin Practical Advice for Staff

  As the evidence of the benefits of breastfeeding and the risks of not breastfeeding mount

  improving breastfeeding rates has become an increasingly important public health strategy for promoting optimal health among mothers and their babies ( American Public Health Association

  2007; U.S. Department of Health and Human Services

  2005; Obama

  2010).

  Skin to Skin Practical Advice for Staff

  The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

  Intrapartum drugs

  including fentanyl administered via epidural and synthetic oxytocin

  have been previously studied in relation to neonatal outcomes

  especially breastfeeding

  with conflicting results....

  The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

  The Magical Hour

  The breathtaking award-winning DVD for prospective parents. Dr. Kajsa Brimdyr

  ethnographer and international expert in implementing skin to skin in first hour

  guides you through the beauty and magic of the first hour after birth.

  Public Speaking

  Qualitative Research

  Curriculum Development

  Birth

  Non-profits

  Community Outreach

  Grant Writing

  Adult Education

  Babies

  Research

  Editing

  Social Media

  Maternity

  Staff Development

  Higher Education

  Nonprofits

  Program Development

  Event Planning

  Microsoft Office

  Teaching

  Use of a Video-Ethnographic Intervention (PRECESS Immersion Method) to Improve Skin-to-Skin Care and Breastfeeding Rates

  Elizabeth Winslow

  Richard Gilder

  Jane Dimmitt Champion

  Kristin Svensson

  Ann-Marie Widstrom

  Karin Cadwell

  Jeanette Crenshaw

  Purposes: Skin-to-skin care after birth often is absent

  interrupted

  or delayed for routine procedures. The purposes of this project were to improve skin-to-skin care and exclusive breastfeeding at hospital discharge.\n\nMethods: For Part 1

  we used a descriptive observational design

  with video-ethnography and interaction analysis (PRECESS—Practice

  Reflection

  Education and training

  Combined with Ethnography for Sustainable Success)

  during a 5-day quality improvement pilot study in a U.S. hospital (August 13–17

  2010). For Part 2

  we used electronic health record review to test for differences in monthly rates of skin-to-skin care and exclusive breastmilk feeding (baseline

  July 2010; post-intervention

  August–December 2010).\n\nResults: In Part 1

  11 mothers and babies participated: 10 (91%) received immediate skin-to-skin care

  eight (73%) received uninterrupted skin-to-skin care

  nine (82%) planned to breastfeed

  six (67%) of these babies were exclusively breastfeeding at hospital discharge

  and five (83%) of the six babies who completed all nine instinctive stages during skin-to-skin care were exclusively breastfeeding at hospital discharge. In our subsequent review (Part 2)

  we found a significant improvement (25% above baseline) in the overall rate of skin-to-skin care across post-intervention months (Pearson χ2=23.798

  df=5

  p<0.000)

  predominantly from improvements in the cesarean section population. The rates of exclusive breastfeeding showed no significant change.\n\nConclusions: The PRECESS immersion method may help to rapidly improve skin-to-skin care. Babies who undergo all nine stages during skin-to-skin care may be more likely to exclusively breastfeed. Mothers need support during skin-to-skin care to recognize their baby's readiness to breastfeed. Skin-to-skin care during cesarean surgery may reduce maternal stress and improve satisfaction with the surgical experience.

  Use of a Video-Ethnographic Intervention (PRECESS Immersion Method) to Improve Skin-to-Skin Care and Breastfeeding Rates

  The importance of breastfeeding as a public health priority has increased\nas new research reinforces the health benefits to both mother and nursling

  \neven continuing years after weaning. However

  many women do not nurse as\nlong as they intend. Birth practices such as labor medications and the routine\nseparation of mother and baby are two of the several intrapartum influences\non breastfeeding outcomes. This paper seeks to elucidate the physiologic\nmechanisms affecting breastfeeding outcomes of the commonly administered\nintrapartum drug

  synthetic oxytocin.\nA modified ascending

  link tracing methodology was used to identify studies\nabout breastfeeding and human lactation which describe possible physiologic\npathways related to the intrapartum use of synthetic oxytocin on breastfeeding\noutcomes. A cascade model was constructed with the findings of three\nphysiologic pathways: dysregulation of the maternal OT system

  crossing of the\nfetal blood brain barrier

  and uterine hyper stimulation. Downstream negative\neffects related to breastfeeding include decreased maternal endogenous\noxytocin

  increased risk of negative neonatal outcomes

  decreased neonatal\nrest during the first hour with the potential of decreasing the consolidation of\nmemory

  decreased neonatal pre-feeding cues

  decreased neonatal reflexes\nassociated with breastfeeding

  maternal depression

  somatic symptoms and\nanxiety disorders. No positive relationships between the administration of\nsynthetic oxytocin and breastfeeding were found. Practices that could diminish\nthe nearly ubiquitous practice of inducing and accelerating labor with the use\nsynthetic oxytocin should be considered when evaluating interventions that\naffect breastfeeding outcomes.

  Intrapartum Administration of Synthetic Oxytocin and Downstream Effects on Breastfeeding: Elucidating Physiologic Pathways

  Kristin Svensson

  Ann-Marie Widstrom

  The authors used realistic evaluation to examine the real-world effectiveness of two 5-day training techniques on sustained optimal skin-to-skin practices that support Step 4 of the revised Baby-Friendly Hospital Initiative (BFHI). The authors found that education alone was insufficient to effect sustainable practice change. Exposure to the 5-day immersion model (Practice

  Reflection

  Education and training

  Combined with Ethnography for Sustainable Success

  or PRECESS) alone or combined with education was an effective strategy to change and sustain the standard of care for skin-to-skin practice (p < 0.00001). The intended outcome of sustained practice change toward implementation of skin-to-skin care through immersion or a combined approach shows promise and should be repeated in other localities.

  A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care

  Yuki Takahashi

  Evidence supporting the practice of skin-to-skin contact and breastfeeding soon after birth points to physiologic

  social

  and psychological benefits for both mother and baby. The 2009 revision of Step 4 of the WHO/UNICEF “Ten Steps to Successful Breastfeeding” elaborated on the practice of skin-to-skin contact between the mother and her newly born baby indicating that the practice should be “immediate” and “without separation” unless documented medically justifiable reasons for delayed contact or interruption exist. While in immediate

  continuous

  uninterrupted skin-to-skin contact with mother in the first hour after birth

  babies progress through 9 instinctive

  complex

  distinct

  and observable stages including self-attachment and suckling. However

  the most recent Cochrane review of early skin-to-skin contact cites inconsistencies in the practice; the authors found “inadequate evidence with respect to details … such as timing of initiation and dose.” This paper introduces a novel algorithm to analyse the practice of skin to skin in the first hour using two data sets and suggests opportunities for practice improvement. The algorithm considers the mother's Robson criteria

  skin-to-skin experience

  and Widström's 9 Stages. Using data from vaginal births in Japan and caesarean births in Australia

  the algorithm utilizes data in a new way to highlight challenges to best practice. The use of a tool to analyse the implementation of skin-to-skin care in the first hour after birth illuminates the successes

  barriers

  and opportunities for improvement to achieving the standard of care for babies. Future application should involve more diverse facilities and Robson's classifications.

  An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth

  Raylene Phillips

  Sarah Harrington

  Elaine A. Hart

  Monica Neumann

  Kristin Svensson

  Ann-Marie Widstrom

  Intrapartum drugs

  including fentanyl administered via epidural and synthetic oxytocin

  have been previously studied in relation to neonatal outcomes

  especially breastfeeding

  with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin‐to‐skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes. Results suggest that intrapartum exposure to the drugs fentanyl and synthetic oxytocin significantly decreased the likelihood of the baby suckling while skin‐to‐skin with its mother during the first hour after birth.

  The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth

  The World Breastfeeding Trends Initiative is an assessment process designed to facilitate an ongoing national appraisal of progress toward the goals of the United Nations Children's Fund (UNICEF)/World Health Organization (WHO) Global Strategy for Infant and Young Child Feeding. More than 80 countries have completed this national assessment

  including the United States of America. This article describes the process undertaken by the US World Breastfeeding Trends Initiative team

  the findings of the expert panel related to infant and young child feeding policies

  programs

  and practices and the ranking of the United States compared with the 83 other participating nations. Identified strengths of the United States include data collection and monitoring

  especially by the Centers for Disease Control and Prevention

  the US Baby-Friendly Hospital Initiative

  and the United States Breastfeeding Committee. The absence of a national infant feeding policy

  insufficient maternity protection

  and lack of preparation for infant and young children feeding in emergencies are key targets identified by the assessment requiring concerted national effort.

  How Does the United States Rank According to the World Breastfeeding Trends Initiative?

  Dr. Kajsa Brimdyr is an experienced ethnographer

  researcher and international expert in the implementation of continuous

  uninterrupted skin to skin in the first hour after birth. She is the Lead Ethnographic Researcher for Healthy Children Project

  Inc.

  a non-profit

  NGO agency and was Professor in Maternal Child Health at Union Institute and University for more than 15 years. She is a published author in peer reviewed journals. She is the award winning director

  videographer and producer of educational documentaries including the Happy Birth Day series

  The Magical Hour: Holding Your Baby for the First Hour After Birth

  produced with Ann-Marie Widström and Kristin Svensson

  and together the three also created and produced the groundbreaking DVD Skin to Skin in the First Hour after Birth: Practical Advice for Staff after Vaginal and Cesarean Birth. Her current research involves using video ethnography to change practice in hospital settings to improve continuous skin-to-skin for the first hour after cesarean and vaginal births

  and the implications of labor medications on this vulnerable time.

  Kajsa

  Cadwell Brimdyr