Abstract
BackgroundInfants with latch-on problems cause stress for parents and staff, often resulting in early termination of breastfeeding. Healthy newborns experiencing skin-to-skin contact at birth are pre-programmed to find the mother’s breast. This study investigates if skin-to-skin contact between mothers with older infants having severe latching on problems would resolve the problem.MethodsMother-infant pairs with severe latch-on problems, that were not resolved during screening procedures at two maternity hospitals in Stockholm 1998–2004, were randomly assigned to skin-to-skin contact (experimental group) or not (control group) during breastfeeding. Breastfeeding counseling was given to both groups according to a standard model. Participants were unaware of their treatment group. Objectives were to compare treatment groups concerning the proportion of infants regularly latching on, the time from intervention to regular latching on and maternal emotions and pain before and during breastfeeding.ResultsOn hundred and three mother-infant pairs with severe latch-on problems 1–16 weeks postpartum were randomly assigned and analyzed. There was no significant difference between the groups in the proportion of infants starting regular latching-on (75% experimental group, vs. 86% control group). Experimental group infants, who latched on, had a significantly shorter median time from start of intervention to regular latching on than control infants, 2.0 weeks (Q1 = 1.0, Q3 = 3.7) vs. 4.7 weeks (Q1 = 2.0, Q3 = 8.0), (p-value = 0.020). However, more infants in the experimental group (94%), with a history of “strong reaction” during “hands-on latch intervention”, latched-on within 3 weeks compared to 33% in the control infants (Fisher Exact test p-value = 0.0001). Mothers in the experimental group (n = 53) had a more positive breastfeeding experience according to the Breastfeeding Emotional Scale during the intervention than mothers in the control group (n = 50) (p-value = 0.022).ConclusionsSkin-to-skin contact during breastfeeding seems to immediately enhance maternal positive feelings and shorten the time it takes to resolve severe latch-on problems in the infants who started to latch. An underlying mechanism may be that skin-to-skin contact with the mother during breastfeeding may calm infants with earlier strong reaction to “hands on latch intervention” and relieve the stress which may have blocked the infant’s inborn biological program to find the breast and latch on.Trial registrationKarolinska Clinical Trial Registration number CT20100055
Highlights
Infants with latch-on problems cause stress for parents and staff, often resulting in early termination of breastfeeding
Background data There were no significant differences between the two groups in terms of background variables (Table 3), delivery and postnatal ward experiences (Table 4), mother’s experience and description of the infant’s reaction to “hands-on latch intervention” (Tables 5 and 6), infant age at trial entry, nutrition and way of giving breast milk /supplements, use of pacifier, nipple shield and maternal feeding intentions (Table 7)
Skin-to-skin contact seems to have added a positive effect on the infants potential to latch-on and may be beneficial to infants with a history of having reacted strongly when “helped” by staff to be attached to the breast with “hands-on latch intervention.”
Summary
Infants with latch-on problems cause stress for parents and staff, often resulting in early termination of breastfeeding. Previous research shows that when a full term newborn is placed skin-to-skin on the mother immediately after birth, the newborn exhibits a pre-programmed biological behavior to approach the breast and start suckling without help [1,2] During this first hour when the infant starts seeking the breast, the rooting reflex becomes successively more mature and distinct. Prior to this rooting-tongue reflex [3], the baby makes licking movements, which are probably a program aimed at shaping the areola and nipple for easy attachment as well as to transmit taste from the breast to the baby’s mouth This “familiarization” behavior can take up to 15 minutes before the baby attaches to the breast [4]. This rise in maternal oxytocin is suggested to support milk ejection and maternal bonding [5]
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