title: Prevention of postpartum smoking relapse in mothers of infants in the neonatal intensive care unit.
abstract: OBJECTIVE
  Approximately 40% of women who smoke tobacco quit smoking during pregnancy, yet up to 85% relapse after delivery. Those who resume smoking often do so by 2 to 8 weeks postpartum. Smoking mothers are more than twice as likely to quit breastfeeding by 10 weeks postpartum. The hospitalization of a newborn, while stressful, is an opportunity to emphasize the importance of a smoke-free environment for babies. Supporting maternal-infant bonding may reduce maternal stress and motivate mothers to remain smoke free and continue breastfeeding. The objective of this study was to reduce postpartum smoking relapse and prolong breastfeeding duration during the first 8 weeks postpartum in mothers who quit smoking just before or during pregnancy and have newborns admitted to the Neonatal Intensive Care Unit (NICU).
  
  
  METHODS
  This study was an Institutional Review Board-approved prospective randomized clinical trial. After informed consent, mothers of newborns admitted to the NICU were randomized to a control or intervention group. Both groups received weekly encouragement to remain smoke free and routine breastfeeding support. Mothers in the intervention group were also given enhanced support for maternal-infant bonding including information about newborn behaviors, and were encouraged to frequently hold their babies skin-to-skin.
  
  
  RESULTS
  More mothers were smoke free (81 vs 46%, P<0.001) and breastfeeding (86 vs 21%, P<0.001) in the intervention than in the control group at 8 weeks postpartum.
  
  
  CONCLUSIONS
  Interventions to support mother-infant bonding during a newborn's hospitalization in the NICU are associated with reduced rates of smoking relapse and prolonged duration of breastfeeding during the first 8 weeks postpartum.
authors.affiliation: Loma Linda University, School of Medicine, Loma Linda, CA, USA. rphillips@llu.edu
authors.forename: R M
authors.initials: RM
authors.lastname: Phillips
authors.forename: T A
authors.initials: TA
authors.lastname: Merritt
authors.forename: M R
authors.initials: MR
authors.lastname: Goldstein
authors.forename: D D
authors.initials: DD
authors.lastname: Deming
authors.forename: L E
authors.initials: LE
authors.lastname: Slater
authors.forename: D M
authors.initials: DM
authors.lastname: Angeles
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001942:Breast Feeding / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007363:Intensive Care Units, Neonatal; D053208:Kaplan-Meier Estimate; D008429:Maternal Welfare; D009034:Mother-Child Relations; D010353:Patient Education as Topic / Q000379:methods*; D011181:Postnatal Care / Q000379:methods; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D018709:Statistics, Nonparametric; D055815:Young Adult