early skin-to-skin contact for mothers and their healthy newborn infants
TRANSCRIPT
SELECTED COCHRANE SYSTEMATIC REVIEWS
Early Skin-To-Skin Contact for Mothers and TheirHealthy Newborn Infants
G. C. Anderson, E. Moore, J. Hepworth, and N. Bergman
A substantive amendment to this systematic review waslast made on 17 February 2003. Cochrane reviews areregularly checked and updated if necessary.
ABSTRACT
Background: Early skin-to-skin contact involves pla-cing the naked baby prone on the mother’s bare chestat birth or soon afterwards (< 24 hour). This couldrepresent a ‘‘sensitive period’’ for priming mothersand infants to develop a synchronous, reciprocal,interaction pattern, provided they are together and inintimate contact. Routine separation shortly afterhospital birth is a uniquely Western cultural phenom-enon that may be associated with harmful effectsincluding discouragement of successful breastfeeding.
Objectives: To assess the effects of early skin-to-skincontact on breastfeeding, behavior, and physiology inmothers and their healthy newborn infants.
Search strategy: The Cochrane Pregnancy andChildbirth Group and Neonatal Group trials regis-ters (December 2002), the Cochrane Central Registerof Controlled Trials (The Cochrane Library, Issue 4,2002), MEDLINE (1976 to 2002).
Selection criteria: Randomized and quasi-random-ized clinical trials comparing early skin-to-skin con-tact with usual hospital care.
Data collection and analysis: Two reviewers independ-ently assessed trial quality and extracted data.We con-tacted study authors for additional information. Wecollected adverse effects information from the trials.
Main results: Seventeen studies, involving 806 par-ticipants, were included. We found statistically
significant and positive effects of early skin-to-skincontact on breastfeeding at one to three monthspostbirth (odds ratio (OR) 2.15, 95% confidenceinterval (CI) 1.10 to 4.22), breastfeeding duration(weighted mean difference (WMD) 41.99, 95% CI13.97 to 70.00), maintenance of infant temperature inthe neutral thermal range (OR 12.18, 95% CI 2.04 to72.91), infant blood glucose (WMD 11.07, 95% CI3.97 to 18.17), infant crying (OR 21.89, 95% CI 5.19to 92.30), and summary scores of maternal affection-ate love/touch (SMD 0.73, 95% CI 0.36 to 1.11)during an observed breastfeeding within the first fewdays postbirth. We found no statistically significantbenefit of early skin-to-skin contact for other majorclinical variables: breastmilk maturation, maternalchest circumference, infant heart rate.
Reviewers’ conclusions: Limitations included themethodological quality of the studies, variations inthe implementation of the intervention, and outcomevariability. Early skin-to-skin contact appears to havesome clinical benefit especially regarding breastfeed-ing outcomes and infant crying and has no apparentshort- or long-term negative effects.Further investigation is recommended. To facili-
tate meta-analysis of the data, future research in thisarea should involve outcome measures consistent withthose used in the studies included here. Publishedreports should also clearly indicate if the interventionwas skin-to-skin contact, and include means, stand-ard deviations, and exact probability values.
Citation: Anderson GC, Moore E, Hepworth J,Bergman N. Early skin-to-skin contact for mothersand their healthy newborn infants (CochraneReview). In: The Cochrane Library, Issue 2 2003.Oxford: Update Software.
• • •
206 BIRTH 30:3 September 2003
The preceding report is an abstract of a regularlyupdated, systematic review prepared and maintained bythe Cochrane Collaboration. The full text of the reviewis available in The Cochrane Library (ISSN1464–780X). The Cochrane Library is designed andproduced by Update Software Ltd.See http://www.update-software.com or contact
Update Software, [email protected], for more infor-mation. A more up-to-date abstract on the subject may
be available from the Update Software Ltd., web site.See http://www.update-software.com or contactUpdate Software, [email protected], for informa-tion on subscribing to The Cochrane Library in yourarea.
Update Software Ltd, Summertown Pavilion, MiddleWay, Oxford OX2 7LG, UK(Tel:+44 1865 513902; Fax:+44 1865 516918).
BIRTH 30:3 September 2003 207