Abstract
ABSTRACT Objective: to verify the factors associated with the practice of skin-to-skin contact with breastfeeding in the first hour of life and its influence on exclusive breastfeeding in the first month. Method: a retrospective cross-sectional study with medical records from a breastfeeding outpatient clinic in São Paulo, Brazil. The sample included all the medical records of the mother-baby dyad who had been consulted by nurses between 2004 and 2010. Data were collected from the medical records between 2014 and 2015. Results: 1,030 medical records were identified, 71 were excluded and the final sample was 959. The prevalence of skin-to-skin contact with breastfeeding in the first hour was 37.2%. The Apgar score between 8 and 10 in the first minute of life and the higher birth weight of the newborn were protective factors of contact with early breastfeeding; lower maternal age and cesarean delivery and forceps were risk factors for this practice. Exclusive breastfeeding was statistically higher in the group of newborns who had contact with breastfeeding in the first hour; however, there was no association with duration of exclusive breastfeeding. Conclusion: good birth conditions were protective factors for breastfeeding followed by skin-to-skin contact in the first hour, while younger maternal age and surgical deliveries proved to be risk factors. Exclusive breastfeeding in the baby´s first month of life was not associated with skin-to-skin contact followed by breastfeeding in the first hour of life.
Highlights
Skin-to-skin contact (SSC) and breastfeeding in the first hour of life have been widespread practices in the humanization of care for women in childbirth, with the aim of promoting the quality of care in the delivery room and breastfeeding
The obstetric unit of the hospital cares for pregnant women and mostly high-risk parturients, who are hospitalized in rooming-in wards in the postpartum period and receive appointments to be seen in the outpatient clinic on their day of discharge
The prevalence of skin-to-skin contact (SSC) followed by breastfeeding in the first hour of life found in this study (37.2%) is below the national average identified in 2008 (67.7%),[10] it is close to the world average (43%) presented by UNICEF9 and to a recent publication which analyzed the rate of breastfeeding in the first hour of life (31-60%) between 2000 and 2013 in 57 countries.[13]
Summary
Skin-to-skin contact (SSC) and breastfeeding in the first hour of life have been widespread practices in the humanization of care for women in childbirth, with the aim of promoting the quality of care in the delivery room and breastfeeding. It is a recommendation set out in the fourth step of the “Ten Steps to Successful Breastfeeding” promoted by the World Health Organization (WHO) and the United Nations (UNICEF) since the creation of the Baby Friendly Hospital Initiative (BFH).[1]. In addition to SSC, breastfeeding in the first hour of life reflects a number of advantages such as decreased risk of postpartum hemorrhage,[5] lower risk of infections, and neonatal death.[6]
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