Podcast: Early skin-to-skin contact for mothers and their healthy newborn infants

A Cochrane Review that might be applicable to hundreds of thousands of human beings every day looks at the effects of early skin-to-skin contact for mothers and their healthy newborn babies. This was updated in November 2016 and lead author, Elizabeth Moore from the School of Nursing at Vanderbilt University in Nashville USA describes the latest findings.

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John: Hello, I'm John Hilton, editor of the Cochrane Editorial unit. A Cochrane Review that might be applicable to hundreds of thousands of human beings every day looks at the effects of early skin-to-skin contact for mothers and their healthy newborn babies. This was updated in November 2016 and lead author, Elizabeth Moore from the School of Nursing at Vanderbilt University in Nashville USA describes the latest findings.

Elizabeth: In skin-to-skin contact, the baby is placed naked on the mother's bare chest at birth or soon afterwards. However, during the twentieth century, it became standard practice to separate mothers from their babies at birth, despite mounting evidence that it might be harmful to do so. Our Cochrane Review reinforces the value of early skin-to-skin contact by examining the available research on its effects on breastfeeding, maternal-infant behavior, and the baby's physiology.
We included research in which mothers and their healthy babies who had skin-to-skin contact starting less than 24 hours after birth were compared with those for whom this did not happen. We found a total of 46 trials with nearly 4000 mothers and their babies, and were able to use 38 of these trials, with just under 3500 mothers and babies, in our analyses. Eight trials had included mothers who had had a cesarean birth and six trials studied late preterm infants (greater than 35 weeks' gestation).
Overall, babies who were held skin-to-skin were 32% more likely to breastfeed successfully during their first feeding than those who were held swaddled in blankets by their mothers. And, women who experienced skin-to-skin contact were 24% more likely than women with standard contact to be breastfeeding at one to four months after birth. They also breast fed their babes for an average of 64 days longer. Babies who were held skin-to-skin had higher blood glucose levels but similar temperature to the other infants, and the early physiological outcomes for the healthy late-preterm infants who were held skin-to-skin were also better than for those who weren’t.
We’re less sure about the results for women giving birth by cesarean section because of the small number of such women in the studies, but the evidence there also supports early skin-to-skin contact, with more women breastfeeding successfully and still breastfeeding at one to four months.
But there are still some important caveats with our findings. Skin-to-skin contact was defined in various ways and different scales and times were used to measure similar outcomes in the trials. Women and staff knew they were being studied, and women in the standard care groups had varying levels of breastfeeding support. These differences lead to wide variation in the findings and a lower quality evidence.
However, in summary, our updated review supports using skin-to-skin contact to promote breastfeeding, which is important because we know that breastfeeding helps babies avoid illness and stay healthy. Early skin-to-skin contact should be normal practice for healthy newborns, including those born by cesarean section and babies born early at 35 weeks or more.

John: If you would like to read more about the trials and the outcomes for the mothers and their babies, you can find the full version of the review at Cochrane Library dot com. Go to the website and search ‘early skin-to-skin contact’ to see it at the top of the list.

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