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Early Skin-to-Skin Contact and Breast-Feeding Behavior in Term Neonates: A Randomized Controlled Trial

Thukral A.a · Sankar M.J.a · Agarwal R.a · Gupta N.b · Deorari A.K.a · Paul V.K.a
aDivision of Neonatology, Department of Pediatrics, WHO Collaborating Center for Training and Research in Newborn Care, and bDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India Neonatology 2012;102:114–119 (DOI:10.1159/000337839)


Aim: To evaluate if early skin-to-skin contact (SSC) improves breast-feeding (BF) behavior and exclusive BF (EBF) rates in term infants at 48 h of age. Methods: Term infants born by normal delivery were randomized at birth to either early SSC (n = 20) or conventional care (controls; n = 21). SSC was continued for at least 2 h after birth. Subsequently, one BF session of the infants was video recorded at about 48 h of life. The primary outcome, infants’ BF behavior at 48 h of life, was assessed using the modified infant Breast-Feeding Assessment Tool (BAT; a score consisting of infant’s readiness to feed, sucking, rooting and latching, each item scored from 0 to 3) by three independent masked observers. The secondary outcomes were EBF rates at 48 h and 6 weeks of age and salivary cortisol level of infants at 6 h of age. Results: Baseline characteristics including birth weight and gestation were comparable between the two groups. There was no significant difference in the BAT scores between the groups [median: 8, interquartile range (IQR) 5–10 vs. median 9, IQR 5–10; p = 0.6]. EBF rates at 48 h and at 6 weeks were, however, significantly higher in the early-SSC group than in the control group [95.0 vs. 38.1%; relative risk (RR): 2.5, 95% confidence interval (95% CI): 1.4–4.3 and 90 vs. 28.6%; RR: 3.2, 95% CI: 1.6–6.3]. Interpretation: Early SSC did not improve BF behavior at discharge but significantly improved the EBF rates of term neonates.


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