The Impact of Increased Skin to Skin Contact with Mother in Breast Feeding Neonates On Exclusive Breast Feeding At Four Weeks and Eight Weeks Post Partum

Objective:  To investigate the research question: Is there a relationship between the number of minutes of skin to skin contact between mother and infant during hospitalization and the rate of breastfeeding exclusivity at four weeks and eight weeks postpartum? 

Design: This is a descriptive correlational study.

Setting: Urban non-profit hospital with an average of 1100 births per year.

Sample: Term pregnant women who have a vaginal delivery of a well newborn, with intent to exclusively breastfeed. Sixty-five women were enrolled into the study. Thirty women were excluded (Cesarean delivery, infant admission to level II nursery, incomplete data collection). Thirty-five women completed the inpatient data collection and follow up telephone calls at four and eight weeks postpartum to assess breastfeeding exclusivity.

Methods: After obtaining IRB approval, subjects were recruited from a midwifery practice during prenatal care.  At birth, newborns were placed STS with their mothers.  Mothers were educated on how to provide STS with their newborns while in the hospital, and maintained a self-reported log of the number of minutes of STS while in the hospital. Follow-up phone calls were made at four weeks and eight weeks postpartum for telephone assessment of exclusive breastfeeding, using the Index of Breastfeeding Status (Moore & Anderson, 2007). 

Results:  Data were analyzed using correlation and Chi square. The findings were: Total length of time of STS in the hospital was not correlated with breastfeeding exclusivity at four weeks and eight weeks. However, STS occurring immediately at birth was positively associated with exclusive breastfeeding at 4 weeks postpartum. Increased times to STS, and increased time to first breastfeeding, were both negatively associated with breastfeeding exclusivity.  Additionally, infants with increased length of stay and those who were supplemented with formula were less likely to be exclusively breastfed at 4 weeks and 8 weeks postpartum.

Conclusion/Implications for nursing practice: Skin to skin starting at birth was found to be significant for increasing breastfeeding exclusivity. Implications for practice include changing nursing and medical practice at delivery, placing healthy infants skin to skin with their mothers at birth, instead of routinely handing infants to the resuscitation team.  Weaknesses of this study include recall bias, and possible self-selection bias in recruiting women with intent to exclusively breastfeed.

Keywords:  Breastfeeding, Skin to skin, Kangaroo Care, Birth, Newborn.