Elsevier

Women and Birth

Volume 27, Issue 1, March 2014, Pages 37-40
Women and Birth

Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: A randomised control trial

https://doi.org/10.1016/j.wombi.2013.09.004Get rights and content

Abstract

Objective

To evaluate the effect of mother–infant immediate skin-to-skin contact on primiparous mother's breastfeeding self-efficacy.

Settings

The study was conducted in Omolbanin obstetrics hospital (large tertiary hospital), Mashhad, Iran.

Participants

114 18–35 year-old primiparous, Iranian, healthy and full term mothers who anticipated normal vaginal delivery and intended to breastfeed their babies.

Intervention

Skin-to-skin contact immediately after birth and then controlling breastfeeding self-efficacy at 28 days postpartum.

Main outcome measure

Maternal breastfeeding self-efficacy at 28 days postpartum and success in first breastfeeding and mean time of first breastfeeding initiation.

Results

A total of 92 mother–infant dyads (47 dyads in skin-to-skin care skin-to-skin contact group and 45 dyads in routine care group) were monitored and analysed. In skin-to-skin contact group, breastfeeding self-efficacy was 53.42 ± 8.57 SD as compared to 49.85 ± 5.50 SD in routine care group which is significantly higher in skin-to-skin contact group (p = 0.0003).

Successful breastfeeding initiation rate was 56.6% in skin-to-skin contact group as compared to 35.6% in routine care group (p = 0.02).

Time to initiate first feed was 21.98 ± 9.10 SD min in SSC group vs. 66.55 ± 20.76 min in routine care group (p < 0.001).

Conclusion

Mother–infant immediate skin-to-skin contact is an easy and available method of enhancing maternal breastfeeding self-efficacy. High breastfeeding self-efficacy increases exclusive breastfeeding duration.

Introduction

Breast milk is the optimal nutritional source for infants1, 2, 3, 4 and it provides species and age specific nutrients and the best nutritional balance for them.1, 2, 3, 4 Despite breast milk's great benefits for the health of infants, breastfeeding rates are declining all around the world,5, 6 as well as in our country Iran.7 This decrease in exclusive breastfeeding rate is partly due to separating mother and the infant after birth.8

The first 2 h after birth is called the sensitive period9 and this is the best time for mother to initiate breastfeeding the infant.10 In this period, maternal–infant separation, even for a short time, can decrease the neonate's ability to initiate breastfeeding and may also lead to a reduction in maternal confidence and self-efficacy.11, 12, 13 Immediate mother–infant skin-to-skin contact (SSC) after birth has been proven most effective in successful initiation and continuation of breastfeeding.14

Skin-to-skin contact is achieved by holding the naked baby against the mother's chest between her breasts.15 The effect of mother–infant skin-to-skin contact on breastfeeding behaviours of infants is well known.16, 17, 18

Importance of maternal self-efficacy on breastfeeding initiation and continuation has been demonstrated consistently.14, 19, 20 Breastfeeding self-efficacy refers to the confidence of a woman in her ability to breast feed her baby.21, 22 This study was conducted to assess the effect of early mother infant skin-to-skin contact on maternal breastfeeding self-efficacy.

Section snippets

Setting

A randomised control trial was conducted from 1st April 2012 to 31st July 2012 in Omolbanin obstetrics hospital (large tertiary hospital), Mashhad, Iran. This hospital is affiliated with the faculty of medicine of Mashhad University of Medical Sciences.

Participants

The study population consisted of 114 primiparous, Iranian, healthy, full term mothers between 18 and 35 years of age who anticipated normal vaginal delivery and intended to breastfeed their babies.

Mother–infant pairs were considered ineligible

Results

114 eligible mothers according to inclusion and exclusion criteria were enrolled in this research programme. At the end of the study 92 mother–infant dyads were assessed.

Demographic and clinical characteristics of the participants are shown in Table 2. There is no significant inter-group baseline difference between the 2 study groups.

Mean BSES score was 53.42 ± 8.57 SD in SSC group and 49.85 ± 5.50 in RC group and the student's t-test shows a significant difference between them (p = 0.0008).

Success in

Discussion

The results of this study show that immediate mother–infant skin-to-skin contact leads to higher breastfeeding self-efficacy in mothers. During skin-to-skin contact, mothers provide tactile and verbal stimulation to their newborn infants and this practice improves breastfeeding behaviours of healthy full term infants.16, 17, 28 This method of care is also associated with greater levels of maternal satisfaction and mothers gain higher confidence in their ability to breastfeed and care for their

Conclusion

Our study has shown that immediate mother–infant skin-to-skin contact is an easy, inexpensive and non-invasive method of increasing maternal breastfeeding self-efficacy and confidence. Improved breastfeeding self-efficacy will result in exclusive breastfeeding and can prevent premature discontinuation of breastfeeding. This shows that hospital practices can have an important influence on breastfeeding self-efficacy. Early separation of mother and infants should strongly be discouraged.

References (33)

  • E. Declercq et al.

    Hospital practices and women's likelihood of fulfilling their intension to exclusively breastfeed

    American Journal of Public Health

    (2009)
  • M. Bornstein

    Sensitive periods in development: structural characteristics and causal interpretation

    Psychological Bulletin

    (1989)
  • Wellstart International. Wellstart lactation management self-study modules 3rd ed.; 2009. Available from:...
  • C.W. Genna

    Supporting sucking skills in breastfeeding infants

    (2013)
  • E.R. Moore et al.

    Early skin-to-skin contact for mothers and their healthy newborn infants

    Cochrane Database of Systemic Reviews

    (2012)
  • E. Moor et al.

    Randomized controlled trial of very early mother–infant skin-to-skin contact and breastfeeding status

    Journal of Midwifery and Women's Health

    (2007)
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