Topics: Breastfeeding, Infant, Evidence-based medicine Pages: 17 (5088 words) Published: May 16, 2013
A Literature review of randomised controlled trials evaluating
the effect of mother/baby skin-to-skin care on successful breast-feeding


Review: A critical literature review of the evidence about the effects of mothers and newborns early Skin-to-Skin contact on breast-feeding behavior.

Background: The World Health Organization (WHO), in 2003 recommended that babies should be fed exclusively on breast milk until six months of age. Several studies support that early (within the first hour after birth) and frequent breastfeeding it is ideal for both, mother and baby and that this mothers will breastfeed for longer duration (Ekströn et al. 2003, Palmer, 2009, Riordan, 2005). Objectives: To asses current research for early skin to skin effects on successful breastfeeding.

Search methods: The following databases were used: The Cochrane Library: CINAHL, MEDLINE, EMBASE, MIDIRS, Cochrane Pregnancy and Childbirth Group’s Trials Register. Selection Criteria: Randomised or quasi-randomised controlled trials in which early skin-to-skin contact between mothers and their healthy full term babies was compared to late after birth contact. Data Collection and Analysis: The author critically reviewed the articles using Offredy & Vickers (2010) critique Model Main Results: Once the literature search was completed, 4 Randomised Controlled Trials were eligible to answer the research question and write the review.

Author Conclusions: the findings of this literature review fail to support the evidence of the effects of SSC on breastfeeding success and duration. The review highlights the need for further primary research to assess the effect of skin-to-skin contact on the breast-feeding experience. No unfavorable consequences were found.


The National Institute for Health and Clinical Excellence (NICE) currently recommend that women should be encouraged to have skin-to-skin contact (placing the naked baby on the mother’s bare chest) with their babies right after birth, and initiation of breastfeeding should be commenced as soon as possible (NICE 2006). The WHO (1990) considers that skin-to-skin contact (SSC) is a critical component for successful breastfeeding initiation (Puig & Squassero, 2007). One of the recommended steps from the “Ten Steps to Successful Breastfeeding” (WHO/UNICEF, 1992) is to help mothers to initiate breastfeeding within half an hour of birth. Lasting benefits of immediate skin-to-skin contact and suckling within the first hour of life includes a longer duration of breastfeeding (Vaidya et al. 2005). Observational studies performed by Widstrom et al (1990) and Righard & Alade (1990) discovered that a newborn baby has an instinctive behavior to find the mother’s breast and start suckling within one hour of age when left in SSC on the mother’s torso. According to Christenson et al. (1992) uninterrupted skin-to-skin contact after birth also meets the new-borns physical needs, providing efficient temperature regulation and easy access to mothers breast.

In the mother, the skin-to-skin contact and sensory stimuli such as touch, heat and smell, is a powerful stimulant that, among other effects, causes oxytocin release (Winberg, 2005). Oxytocin causes an increase of the skin temperature of the breast of the mother, which provides heat to the infant. Oxytocin also reduces maternal anxiety and increases tranquillity and social responsiveness (Klaus et al., 1972). During the first hours after birth, oxytocin may also stimulate breeding behaviour and the results of skin to skin contact for mothers indicate better attachment, a greater sense of control and self-improvement, and therefore greater confidence (Affonso DD, Wahlberg, & Persson, 1989). According to Dennis, the sense of control and confidence are relevant because results predict breastfeeding duration (Dennis, 1999) it is have been identifying how women with little confidence in breastfeeding have three...
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