The Relationship Among Skin-to-Skin Contact, Breastfeeding, and Mother-Infant Interaction: Implications for Nursing

Sunday, June 16, 2013

Title: The Relationship Among Skin-to-Skin Contact, Breastfeeding, and Mother-Infant Interaction: Implications for Nursing

Ryman Hall B4 (Gaylord Opryland)
Marion R. Alex, MN, RN, CNM , School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada
Janis MacLellan-Peters, RN, MN , School of Nursing, St. Francis Xavier University, Antigonish, NS, NS, Canada

Discipline: Advanced Practice (AP), Childbearing (CB), Newborn Care (N)

Learning Objectives:
  1. Identify how mother-infant skin-to-skin contact (SSC) can facilitate the maintenance of breastfeeding, especially during the first three months postpartum.
  2. Describe how SSC can enhance mother-infant interactions.
  3. Describe how nurses can educate and support mothers in their decisions related to SSC
Submission Description:
Objective: to investigate the effect of mother-infant skin-to-skin contact (SSC) on the maintenance of breastfeeding over the first three months and the effect of breastfeeding on mother-infant interaction. In SSC, the infant is placed between the mother's breasts so that frontal body contact of mother and infant is skin-to-skin.  Although numerous studies have shown SSC to benefit newborns' physiological adjustment, few studies have investigated the effect of SSC on breastfeeding duration beyond the newborn period. 

Design: longitudinal quasi-experiment

Setting: Home visits, eastern Nova Scotia. 

Sample: Seventy-seven full-term infants and their mothers were seen in their homes at one week, one month, two months, and three months. 

Methods: Mothers in a SSC group were requested to provide SSC; no request for SSC was made to control group mothers.  All mothers kept daily records of the SSC they provided.  SSC group mother provided approximately five hours/day of SSC in the infants' first week and then more than two hours/day until the infants were one month.  Control group mothers provided little or no SSC.  At each home visit, mothers reported whether they provided exclusive breastfeeding, partial breastfeeding, or no breastfeeding.  Mother-infant interactions were assessed at each visit using the Nursing Child Assessment Feeding Scale (NSAFS). 

Results: SSC group mothers provided more SSC than control group mothers (week 1:  SSC M=4.92 hours/day, control M=0.48 hours/day; weeks 2-4 SSC M=2.77 hours/day, control M=0.19 hours/day.  At one week, the percentage of breastfeeding dyads was similar in both groups (exclusive:  SSC=77%. control=69%; exclusive + partial: SSC=81%, control=75%/  The percentage of breastfeeding dyads (exclusive + partial) declined in the control group as the infants aged but remained stable in the SSC group.  Breastfeeding dyads had significantly higher scores on the NCAFS Caregive Scale, indicating more positive maternal interactions at one week, two months, and three months. 

Conclusion/ Implications for Nursing Practice.  SSC facilitated the maintenance of breastfeeding during the infants' early months and breastfeeding was associated with increased positive maternal interactions.  The findings imply the importance of the promotion of SSC to help mothers maintain the decision to breastfeed to the benefits of infants, mothers, and the developing mother-infant relationship.  As providers of postpartum care, nurses are uniquely positioned to educate and support mothers in SSC and to influence broader public health policy about maternal-child health. 

Keywords: skin-to-skin contact; breastfeeding; mother-infant interaction

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