Laetitia Piwowarczyk, paediatric nurse
Atopia: “Action can be taken even in the maternity hospital” 
A health professional in gynaecology-obstetrics and paediatric nurse, Laetitia Piwowarczyk is currently working at the maternity unit in the hospital of Saint-Quentin, in the department of Aisne.
What have you learnt about atopia?
I firstly observed that the issues at stake in atopia had become much more complicated than they were ten years ago when I was still working in paediatrics, with cross-sensitivities, reactions to food etc. Even at the maternity hospital, we are increasingly faced with problems linked to dry skin. We try to respond to this in different ways, by applying cream on the babies’ skin (on medical prescription) and the use of bath and massage oils. We also advise mothers to offer their children water on a regular basis, to stimulate perspiration and therefore moisturising the skin’s superficial layers.
However, the maternity hospital at Saint-Quentin does not specialise in dermatology. In Milan, I was therefore happy to learn practical “tips” to fight against atopia. Italian doctors believe, for example, that the temperature of the bath water - a short bath is best – should not exceed 36°C. They have also calculated that half-a-centimetre of cream on the mother’s finger helps to moisturise an area corresponding to the surface of a baby’s hand. This constitutes a good reference point, more precise than the notion of a “dab” of cream that we usually use! Finally, massages, via the resulting tactile stimulation, seem to represent a good way of reducing atopia. This is great for the maternity hospital in Saint-Quentin, where we encourage baby massages!
All of this shows that, in the fight against atopia, action can be taken even in the maternity hospital.
What did you learn from your visit to the Mangiagalli obstetrics and gynaecological clinic?
The short stays in hospital surprised me: 48 hours on average for a natural birth, sometimes including 24 hours on a stretcher before a bed is found in the unit, as explained by the Italian midwives. After a Caesarean section, the stay lasts four days. At the maternity hospital in Saint-Quentin, patients stay four to six days!
Of course, 7000 babies are born in this Milanese maternity hospital a year and that is a considerable number. However, how can advice on how to clean and breastfeed a baby be passed on to young mothers in such a short amount of time? A telephone hotline, Pronto Mamma, has been set up to answer questions from young mothers after leaving hospital. This could inspire some of our reforms, such as the project for birth centres (‘maisons de naissance’) in France, even though we tend to have more visual, demonstrative practices in this area.
What did you think of the facilities and equipment in the structures you visited?
Oddly enough, the premises of the dermatological clinic in Milan resembled our old ‘hospital complexes’, now destroyed or allocated to other uses. Wood is still present whereas we now prefer to choose easier materials to maintain and clean.
As for the paediatric hospital, it appeared to be well structured, welcoming and designed with children in mind. Each wing has been allocated an animal reference. The nurses wear coloured tops and striped or polka dot trousers, which breaks with the conventional hospital outfit, that slightly frightening white uniform. However, much like France, the lack of staff is manifest!
In general, signs seemed to me better designed that in French hospital; thus, in the ER, arrows indicate the order of priority with which patients will be treated.
