Assessing Breastfeeding Behaviour in Indonesia: Does Early Skin-to-Skin Contact Affect Mothers’ Breastfeeding Performance and Confidence?

Abstract

Background and Objective: The skin-to-skin contact after birth is known as the first step in a feeding practice that helps mother and infant in establishing the breastfeeding bond and increases mothersʼ confidence in nurturing their infants. Despite the benefits, the absence of this contact commonly occurs in maternity practice, which seems to affect mothersʼ breastfeeding behaviour after discharge. This study aimed to analyse the effect of skin-to-skin contact on mothersʼ breastfeeding performance and self-efficacy. Methodology: This study involved 239 pregnant women who were selected based on cluster random sampling and data were collected from June 2014 to January 2015 in the coastal region of South Sulawesi, Indonesia. Mothers were followed and observed several times: first, during the birth process until 2 h after; second, at 7-10 days postpartum; and third, four weeks postpartum to evaluate skin-to-skin contact, breastfeeding performance and breastfeeding self-efficacy. Subjects were divided into two groups with immediate and delayed skin-to-skin contact. Differences between the two groups were measured by independent t-test. Result: Mothers with immediate skin-to-skin contact were more able to breastfeed effectively (p = 0.001, 95% CI 2.04-5.52) and were more confident (p = 0.001, 95% CI 9.71-16.55) compared to those in the delayed group. Immediate skin-to-skin contact shows significant differences in breastfeeding performance and maternal confidence. Conclusion: Immediate skin-to-skin contact remarkably impacted motherʼs ability to adapt to breastfeeding. It also eliminated anxiety and lower self-esteem in the beginning of the postpartum period. Later, these mothers were able to cope with and overcome severe breastfeeding problems. This raised their breastfeeding quality to a greater level.