title: Affect of Early Skin-to-Skin Mother-Infant Contact in the Maintenance of Exclusive Breastfeeding: Experience in a Health Department in Spain.
abstract: BACKGROUND
  Breastfeeding has been shown to result in extensive physical and psychological benefits for both the mother and the newborn. However, the rate and duration of exclusive breastfeeding (EBF) remains low worldwide. Mother-infant skin-to-skin contact (SSC) immediately after birth has demonstrated results that support the argument for breastfeeding continuation. Research aim: This study aimed to investigate the prevalence of EBF 3 months postpartum and the effect of early SSC in maintaining optimal EBF practices for mothers and their healthy newborns.
  
  
  METHODS
  We conducted an observational, retrospective study in Spain from 2013 to 2015. Pregnant women were interviewed immediately postpartum and again at 3 months postpartum regarding variables associated with breastfeeding initiation and continuation.
  
  
  RESULTS
  There were 1,071 women recruited. Early SSC was performed in 92% of vaginal births but only 57% of urgent cesarean births. Of women breastfeeding at discharge, 69.5% performed SSC with their newborn. We found that 68.6% of women were exclusively breastfeeding by discharge and 46.7% by 3 months postpartum. Type of feeding at discharge, country of origin, and parity were found to be associated with each other ( p = .003, p = .001, respectively). Early SSC was also significantly associated with type of feeding at discharge, 1 month, 2 months, and 3 months postpartum ( p < .001). Hypogalactia (19.8%) was the most frequently reported factor for breastfeeding discontinuation.
  
  
  CONCLUSIONS
  Breastfeeding promotion interventions are likely to improve breastfeeding rates at 3 months postpartum. Social and economic factors should be taken into account when such programs are planned to be implemented.
authors.affiliation: 1 Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Valencia, Spain.|2 Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Vila-Candel
authors.affiliation: 2 Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.
authors.forename: Kiri
authors.initials: K
authors.lastname: Duke
authors.affiliation: 2 Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.|3 Department of Obstetrics and Gynaecology, Hospital Lluis Alcanyís de Xativa, Valencia, Spain.|4 Department of Nursing, University of Alicante, Cta. San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain.
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Soriano-Vidal
authors.affiliation: 5 National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK.
authors.forename: Enrique
authors.initials: E
authors.lastname: Castro-Sánchez
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method / Q000379:methods / Q000523:psychology* / Q000592:standards; D009034:Mother-Child Relations / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D014110:Touch
keywords: breastfeeding; breastfeeding rates; early skin-to-skin contact; early weaning; risk factors