Postnatal unit bassinet types when rooming-in after cesarean birth: implications for breastfeeding and infant safety.
BACKGROUND
Postnatal unit rooming-in promotes breastfeeding. Previous research indicates that side-cars (3-sided bassinets that lock onto the maternal bed frame) facilitate breastfeeding after vaginal birth more than stand-alone bassinets (standard rooming-in). No study has previously investigated side-car bassinet use after cesarean, despite the constraints on maternal-infant interactions that are inherent in recovery from this birth mode.


OBJECTIVE
To test the effect of the side-car bassinet on postnatal unit breastfeeding frequency and other maternal-infant behaviors compared to a stand-alone bassinet following cesarean birth.


METHODS
Participants were recruited and prenatally randomized to receive the side-car or stand-alone bassinet for their postnatal unit stay between January 2007 and March 2009 in northeastern England. Mother-infant interactions were filmed over the second postpartum night. Participants completed face-to-face interviews before and after filming. The main outcome measures were infant location, bassinet acceptability, and breastfeeding frequency. Other outcomes assessed were breastfeeding effort, maternal-infant contact, sleep states, midwife presence, and infant risk.


RESULTS
Differences in breastfeeding frequency, maternal-infant sleep overlap, and midwife presence were not statistically significant. The 20 dyads allocated to side-car bassinets breastfed a median of 0.6 bouts/ hour compared to 0.4 bouts/hour for the 15 stand-alone bassinet dyads. Participants expressed overwhelming preference for the side-car bassinets. Bed sharing was equivalent between the groups, although the motivation for this practice may have differed. Infant handling was compromised with stand-alone bassinet use, including infants positioned on pillows while bed sharing with their sleeping mothers.


CONCLUSIONS
Women preferred the side-car, but differences in breastfeeding frequency were not statistically significant. More infant risks were observed with stand-alone bassinet use.
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kristin.tully@unc.edu
Kristin P
KP
Tully
Helen L
HL
Ball
D000328:Adult; D001513:Beds; D001942:Breast Feeding; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D009034:Mother-Child Relations; D061214:Patient Safety; D017060:Patient Satisfaction; D011247:Pregnancy; D012386:Rooming-in Care / Q000379:methods*; D012890:Sleep; D014741:Video Recording