Effectiveness of early essential newborn care on breastfeeding and maternal outcomes: a nonrandomized controlled study

Abstract

Background Breastfeeding and maternal health play crucial roles in improving newborn health, which is closely related to the development of families and society. Early essential newborn care, which emphasizes early exclusive breastfeeding and skin-to-skin contact, is recommended by the World Health Organization. This study aimed to explore the association of early essential newborn care with breastfeeding and maternal outcomes. Methods A nonrandomized controlled study was carried out from May 2020 to January 2021 in a tertiary hospital in Chengdu city, China. Pregnant women were recruited from the maternity ward before they gave birth. Early essential newborn care was performed for 91 mother-newborn pairs after birth in the intervention group, while routine birth care was performed for 91 mother-newborn pairs in the control group. Data on breastfeeding and maternal outcomes were collected pre-test and post-test and were recorded by trained data collectors and retrieved from hospital case record files. Results Compared with the control group, the intervention group had a higher incidence of early breastfeeding initiation, an earlier initiation and longer duration for the first breastfeeding, a higher incidence of successful first breastfeeding, more exclusive breastfeeding at hospital discharge, higher maternal breastfeeding self-efficacy, a shorter duration of the third stage of labour, lower postpartum blood loss, and lower scores of maternal pain and anxiety postpartum; the differences were statistically significant (p < 0.05). Conclusion The implementation of high-quality early essential newborn care can help mothers initiate early breastfeeding, improve exclusive breastfeeding rates at hospital discharge, enhance breastfeeding self-efficacy, promote the woman’s recovery from labour, and reduce maternal anxiety and pain in the postpartum period. High-quality early essential newborn care is recommended to policymakers and medical professionals to improve breastfeeding and maternal outcomes. Trial registration Chinese Clinical Trial Registry, Retrospective Registration (27/7/2021), registration number: ChiCTR2100049231.

Skin‐to‐skin contact after birth: Developing a research and practice guideline

“…anxiety. 32 A systematic review reported that in the case of immediate, intraoperative skin-to-skin contact, maternal stress levels were reduced, whereas comfort, oxytocin and antioxidant levels increased. 33 The safety of skin-to-skin contact immediately after birth has been questioned.…”

“…63 When combined with EENC both the duration of the third stage of labour and blood loss have been shown to decrease. 32 A 2003 systematic review of 7 RCTs which evaluated the effect of mother/baby skin-to-skin care on successful breastfeeding reported that the evidence 'failed to support the current initiatives to implement changes in clinical practice to include skin-to-skin contact'. 64 However, a later review, published by the Cochrane Database of Systematic Reviews, included 38 studies and reported that 'the evidence from this updated review supports using immediate or early SSC (skin-to-skin contact) to promote breastfeeding'.…”

“…Measurements of operative time and blood loss showed no ill effects from skin‐to‐skin contact 62 and maternal plasma haemoglobin levels at discharge were significantly higher 63 . When combined with EENC both the duration of the third stage of labour and blood loss have been shown to decrease 32 …”

“…Skin‐to‐skin contact has been found to enhance maternal breastfeeding self‐efficacy, 22,70 self‐confidence 21 as well as the positive maternal perception of breastfeeding 71 . Some studies have examined breastfeeding outcomes and skin‐to‐skin contact in the context of EENC 32 or the BFHI 72 rather than as a singular intervention. Research indicates that skin‐to‐skin contact allows for the newborn to progress through Widström's 9 stages, a sequence of instinctive behaviours that increase the possibility of self‐attachment and suckling in the first hours after birth 21,69,73–77 …”

“…Research indicates that skin‐to‐skin contact for the first hour after birth relieves post‐traumatic stress in women who have had challenging birth experiences, 30 decreases the risk of early maternal depression and bonding problems, 31 and decreasing maternal anxiety 32 . A systematic review reported that in the case of immediate, intraoperative skin‐to‐skin contact, maternal stress levels were reduced, whereas comfort, oxytocin and antioxidant levels increased 33 …”