An analysis of the effects of intrapartum factors, neonatal characteristics, and skin‐to‐skin contact on early breastfeeding initiation

Abstract

This study aims to determine relationships between intrapartum factors, neonatal characteristics, skin-to-skin contact (SSC), and early breastfeeding initiation after spontaneous vaginal and Caesarean section or operative vaginal birth. A total of 915 mother-newborn dyads were considered in a hypothetical model based on integrated concepts of breastfeeding initiation model, infant learning framework, and attachment theory. Multiple-group path analysis was used to determine whether differences exist between effects of immediate SSC (≤30 min) on early breastfeeding initiation in different modes of birth. SSC, mode of birth, labour duration, and neonatal intensive care unit admission were significantly associated with early breastfeeding initiation, as indicated by the path analysis model, which included all samples. Women with immediate SSC were more likely to initiate early breastfeeding in different modes of birth. In the spontaneous vaginal birth group, women showed a lower likelihood of initiating early breastfeeding when their neonates were admitted to the neonatal intensive care unit and presented an Apgar score of <7 at 1 min. Multiple-group analysis showed no significant difference between effects of immediate SSC on early breastfeeding initiation in different modes of birth (critical ratio = −0.309). Results showed that models satisfactorily fitted the data (minimum discrepancy divided by degrees of freedom = 1.466-1.943, goodness of fit index = 0.981-0.986, comparative fit index = 0.947-0.955, and root mean square error of approximation = 0.023-0.032). Our findings emphasize the crucial importance of prioritizing promotion of immediate SSC under different modes of birth. Key messages• Skin-to-skin contact (SSC), mode of birth, duration of labour, and neonatal intensive care unit admission show significant effects on early breastfeeding initiation during path analysis.• Immediate SSC was consistently and more likely to initiate early breastfeeding in different modes of birth.• In spontaneous vaginal birth group, women showed a lower likelihood of initiating early breastfeeding when their neonates were admitted to the neonatal intensive care unit and an Apgar score of <7 at 1 min.• Multiple-group analysis showed no significant difference between spontaneous vaginal birth and Caesarean section or operative vaginal birth concerning effects of immediate SSC on early breastfeeding initiation. of 11 LAU ET AL.bs_bs_banner Given the well-known benefits of early breastfeeding initiation (Sharma & Byrne, 2016), our team investigated factors associated with exclusive breastfeeding initiation within 1 hr in intrapartum women.Considering our lack of existing knowledge on intrapartum factors, infant characteristics, SSC, and early breastfeeding initiation, this study attempts to fill research gaps in literature. | Conceptual framework and hypothetical modelA hypothetical model (Figure 1 | MeasuresOn the basis of previous literature review ( Moore et al., 2016;Patel et al., 2015), our study used a structured ...

Worldwide prevalence of mother-infant skin-to-skin contact after vaginal birth: A systematic review

“…Four studies defined SSC as the placing of the naked baby on the mother’s chest or abdomen [ 14 , 16 , 18 , 19 ], whereas another study allowed the baby to wear cap, diaper and socks [ 13 ]. Two studies mentioned in their definition of SSC that both the mother and the infant need to be covered with a warm blanket or dry towel to stabilise the infant [ 17 , 18 ] Four studies explained in their definitions of SSC, that the newborn infant’s position should be placed prone on the mother’s bare chest or abdomen [ 16 , 18 – 20 ]. Three other studies stated the time that the newborn infant stayed SSC with the mother for 30 minutes [ 16 ], first hour [ 11 ] or two hours [ 21 ].…”

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

“…Few mothers in Kathmandu Valley reported holding their infant immediately after giving birth, which in this study served as a proxy for skin‐to‐skin contact between newborn and mother. Immediate skin‐to‐skin contact is a powerful covariate of early breastfeeding initiation and successful exclusive breastfeeding (Lau et al, ). Delaying this first skin‐to‐skin contact may contribute to breastfeeding difficulty and the provision of supplemental or replacement feeds of BMS soon after birth in Kathmandu Valley delivery facilities.…”

Breastfeeding practice in China from 2013 to 2018: a study from a national dynamic follow-up surveillance

“…Early initiation of breastfeeding can reduce both neonatal and early infant mortality [31][32][33] . Many factors are associated with early breastfeeding initiation, and skin-to-skin contact and health education have been proven effectively [34][35][36] . A recent review from the US concluded that baby-friendly practices can help increase prevalence of EIBF and EBF [37] .…”