Early skin-to-skin contact and breast-feeding behavior in term neonates: a randomized controlled trial.
OBJECTIVE
To evaluate if early skin-to-skin contact (SSC) improves breast-feeding (BF) behavior and exclusive BF (EBF) rates in term infants at 48 h of age.


METHODS
Term infants born by normal delivery were randomized at birth to either early SSC (n = 20) or conventional care (controls; n = 21). SSC was continued for at least 2 h after birth. Subsequently, one BF session of the infants was video recorded at about 48 h of life. The primary outcome, infants' BF behavior at 48 h of life, was assessed using the modified infant Breast-Feeding Assessment Tool (BAT; a score consisting of infant's readiness to feed, sucking, rooting and latching, each item scored from 0 to 3) by three independent masked observers. The secondary outcomes were EBF rates at 48 h and 6 weeks of age and salivary cortisol level of infants at 6 h of age.


RESULTS
Baseline characteristics including birth weight and gestation were comparable between the two groups. There was no significant difference in the BAT scores between the groups [median: 8, interquartile range (IQR) 5-10 vs. median 9, IQR 5-10; p = 0.6]. EBF rates at 48 h and at 6 weeks were, however, significantly higher in the early-SSC group than in the control group [95.0 vs. 38.1%; relative risk (RR): 2.5, 95% confidence interval (95% CI): 1.4-4.3 and 90 vs. 28.6%; RR: 3.2, 95% CI: 1.6-6.3].


CONCLUSIONS
Early SSC did not improve BF behavior at discharge but significantly improved the EBF rates of term neonates.
Division of Neonatology, Department of Pediatrics, WHO Collaborating Center for Training and Research in Newborn Care, All India Institute of Medical Sciences, New Delhi, India.
Anu
A
Thukral
Mari Jeeva
MJ
Sankar
Ramesh
R
Agarwal
Nandita
N
Gupta
Ashok K
AK
Deorari
Vinod K
VK
Paul
D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007194:India; D018730:Infant Behavior; D007231:Infant, Newborn; D008297:Male; D009034:Mother-Child Relations; D009769:Object Attachment; D010351:Patient Discharge; D011247:Pregnancy; D012463:Saliva / Q000378:metabolism; D012867:Skin; D013997:Time Factors; D014110:Touch; D014741:Video Recording; D055815:Young Adult
D006854:Hydrocortisone