The role of skin-to-skin contact in exclusive breastfeeding: a cohort study

Abstract

OBJETIVE To understand the role of exposure to skin-to-skin contact and its minimum duration in determining exclusive breastfeeding at hospital discharge in infants weighing up to 1,800g at birth. METHODS A multicenter cohort study was carried out in five Brazilian neonatal units. Infants weighing ≤ 1,800g at birth were eligible. Skin-to-skin contact time was recorded by the health care team and parents on an individual chart. Maternal and infant data was obtained from maternal questionnaires and medical records. The Classification Tree, a machine learning method, was used for data analysis; the tree growth algorithm, using statistical tests, partitions the dataset into mutually exclusive subsets that best describe the response variable and calculates appropriate cut-off points for continuous variables, thus generating an efficient explanatory model for the outcome under study. RESULTS A total of 388 infants participated in the study, with a median of 31.6 (IQR = 29–31.8) weeks of gestation age and birth weight of 1,429g (IQR = 1,202–1,610). The exclusive breastfeeding rate at discharge was 61.6%. For infant’s weighting between 1,125g and 1,655g, exposed to skin-to-skin contact was strongly associated with exclusive breastfeeding. Moreover, infants who made an average > 149.6 min/day of skin-to-skin contact had higher chances in this outcome (74% versus 46%). In this group, those who received a severity score (SNAPPE-II) equal to zero increased their chances of breastfeeding (83% versus 63%). CONCLUSION Skin-to-skin contact proved to be of great relevance in maintaining exclusive breastfeeding at hospital discharge for preterm infants weighing 1,125g–1,655g at birth, especially in those with lower severity scores.

Skin-to-skin contact and late-onset sepsis in newborns weighing up to 1,800g: a cohort study

“…22 In addition, they remain in the hospital for long periods, which contributes to greater exposure to hospital pathogens in a body that is more fragile due to its biological immaturity, justifying a high infection rate found in this group. However, SSC should be encouraged in this group of very preterm infants, in order to contribute to other benefits already demonstrated in the literature, such as maternal bonding, 23 shorter time to reach a complete enteral diet, 24 exclusive breastfeeding, 25,26 neuroprotection, 27 stress reduction, 28 among others.…”

Contato pele a pele e sepse tardia em recém-nascidos com peso até 1.800g: estudo de coorte

“…22 Além disso, permanecem por longos períodos de internação, o que contribui para maior exposição aos patógenos hospitalares em um corpo mais fragilizado devido a sua imaturidade biológica, justificando a alta taxa de infecção encontrada nesse grupo. No entanto, o CPP deve ser estimulado neste grupo de muito pré-termo, a fim de contribuir com outros benefícios já demonstrados na literatura, como vinculação materna, 23 menor tempo para alcançar dieta enteral completa, 24 aleitamento materno exclusivo, 25,26 neuroproteção, 27 redução de stress, 28 dentre outros.…”

Contato pele a pele e amamentação no nascimento: interfaces com aleitamento materno exclusivo na alta hospitalar [Skin-to-skin contact and breastfeeding at birth: interfaces with exclusive breastfeeding at hospital discharge] [Contacto piel a piel y lactancia materna al nacer: interfaces con lactancia materna exclusiva en el alta hospitalaria]

“…Cabe refletir se o curto tempo da duração do CPP encontrado no presente estudo influenciou negativamente no desfecho, pois não houve associação estatística entre a sua realização no momento do nascimento e a prevalência de aleitamento materno exclusivo na alta hospitalar. Estudo multicêntrico brasileiro mostrou que o CPP foi de grande relevância na manutenção do aleitamento materno na alta hospitalar, inclusive para RNs prematuros 25 .…”