Duration Of Skin-to-skin Contact Research Articles

Longer skin-to-skin contact after birth enhances breastfeeding quality and duration: A cohort study.

Skin-to-skin contact (SSC) immediately after birth may improve breastfeeding outcomes. This study explored the effect of the duration of SSC in the delivery room on breastfeeding quality and duration. In this prospective observational cohort study, mother-infant pairs practising SSC were categorised into two groups based on SSC duration (≤45 or >45 min). Outcomes included breastfeeding quality in the delivery room and at 24 h of age assessed by the Infant-Breastfeeding Assessment Tool (IBFAT) score, and long-term breastfeeding duration up to 6 months while accounting for potential confounding variables. The study included 72 mother-infant pairs. SSC for more than 45 min was significantly correlated with longer immediate breastfeeding (65 vs. 19 min, p < 0.001) and higher breastfeeding quality scores immediately after birth (IBFAT score of 10 vs. 7, p < 0.001). Regarding the long-term effect, infants in the extended SSC group were breastfed longer (5.2 vs. 3.7 months, p = 0.005) and had exclusive breastfeeding (4.7 vs. 2.7 months, p > 0.001). No significant confounding variables were identified. Extended SSC (>45 min) correlated with prolonged, higher-quality breastfeeding after birth and longer successful breastfeeding.

Investigating the Start time and duration of skin-to-skin contact in the delivery or operating room in the hospitals of Khorasan Razavi Province, Iran

Background. Skin-to-skin contact (SSC) plays a significant role in the initiation and continuation of breastfeeding and maintaining and improving the health of infants. The goal of this research was to study the start time and duration of SSC in the labor rooms or operating rooms of the hospitals in Khorasan Razavi province. Methods. This descriptive study has been done on 714 newborn babies in labor rooms and ORs of governmental hospitals in Khorasan Razavi province from 1399 to 1401 through convenience sampling method. A midwife who did not have any role in the delivery process kept a record of the time of the SSC and its duration after the delivery. In the next stage, probable reasons for not having SSC, the connection of the start time of SSC and its duration with the start time and duration of breastfeeding were studied. Results. Based on the results of the study, 65% of the cases had SSC after the delivery in labor rooms under study . The mean start time of the SSC was 5.06±12.30 minutes, and the mean duration of the SSC after the birth was 9.28±13.66 minutes. Non-cooperation of the mother (61.38%), the fear of non-sterile environment (8.62%) and hastening the delivery process by the professionals involved (3.79%) were the most common reasons for not having SSC. Conclusion. In 35% of cases, there was no SSC after birth. Starting the contact early after birth can increase the success rate of breastfeeding. Practical Implications. According to the results of our study, skin-to-skin contact in our maternity hospitals is not done in one-third of the cases, which is necessary after the birth of babies. Babies who received skin-to-skin contact started breastfeeding earlier and held the breast longer, indicating that skin-to-skin contact facilitates the initiation of breastfeeding and increases its duration. The non-cooperation of the mother is the most common reason for not having skin-to-skin contact. Therefore, providing the necessary information and training to mothers about the importance of skin-to-skin contact in maintaining the health of babies, facilitating the initiation of breastfeeding, and changing the attitudes and behaviors of mothers seems necessary.

Factors associated with feeding behavior in the early neonatal period focusing on early skin-to-skin contact and epidural analgesia: A prospective observational study at a single hospital in Japan

BackgroundThe feeding behavior of newborns is influenced by the conditions of both the mother and newborn before and after birth. AimsThis study aimed to investigate the factors associated with newborn feeding behavior, focusing on skin-to-skin contact (SSC) as a promoting factor and epidural analgesia as an inhibiting factor, using the Japanese version of the Infant Breastfeeding Assessment Tool (IBFAT). Study DesignProspective observational study conducted in Japan. ParticipantsA total of 176 pairs of healthy mothers and their healthy full-term newborns. Outcome MeasuresThe primary outcome was newborn feeding behaviors measured using the Japanese version of IBFAT within about one day of birth. Stepwise multiple regression analysis was performed to explore the relationship between IBFAT scores and variables that might influence newborn feeding behavior. ResultsMultiple regression analysis revealed that lower IBFAT scores were associated with a higher dose of epidural fentanyl (β = −0.40), and higher IBFAT scores were associated with a longer duration of SSC (β = 0.26), even after adjusting for gestational weeks and Apgar scores. The dose and duration of synthetic oxytocin administration were not associated with IBFAT scores in the multivariate analysis. ConclusionsOur study showed a dose-dependent relationship between fentanyl and SSC, suggesting that consistently implementing SSC for the maximum duration possible may enhance newborn feeding behaviors, which are reduced by fentanyl administration.

Implementing the practice of early skin-to-skin contact among infants ≥35 weeks gestation born vaginally: a quality improvement study

BackgroundEarly skin-to-skin contact (SSC) at birth has been shown to improve neonatal outcomes due to enhanced cardiorespiratory stability, thermoregulation and breastfeeding success.Local problemThe practice of early SSC was virtually non-existent...

Contato pele a pele e sepse tardia em recém-nascidos com peso até 1.800g: estudo de coorte

Abstract Objectives: to evaluate the association between the time to initiate the first skin-to-skin contact (SSC) and the daily practice time with the rates of late-onset sepsis in newborns ≤1,800g. Methods: a multicentric cohort study was carried out at the neonatal units located in three Brazilian geographic regions. The SSC time was recorded in individual files by the hospital staff and the newborn’s parents. Maternal and neonatal data were obtained from medical records and through questionnaires applied to the mothers. Data analysis was carried out using a tree algorithm classification, which divided the data set into mutually exclusive subsets that best described the variable response. Results: 405 newborns participated in the study, with an average of 31.3 ± 2.7 weeks and 1,412g (QR=1,164-1,605g) as a median birth weight. The first SSC was carried out within 137 hours of life (≤5.7 days) was associated with a lower rate of late sepsis (p=0.02) for newborns who underwent daily SSC of 112.5 to 174.7 min/day (1.9 to 2.9h/day), with a reduction in the sepsis rate from 39.3% to 27.5%. Furthermore, the duration of SSC &gt;174.7min/day (&gt;2.9h/day) was relevant (p&lt;0.001) for newborns who weighed &gt;1,344g, with a reduction in this rate from 24.1% to 6%. Conclusions: SSP has been proven to be significant in reducing late-onset sepsis rates in preterm newborns, especially when carried out in a timely manner (≤5.7 days) and prolonged (&gt;2.9h/day).

Association of duration of skin-to-skin contact after cesarean delivery in China: a superiority, multicentric randomized controlled trial

In China, rates of early initiation and exclusive breastfeeding are low. The high cesarean section rates further contribute to low breastfeeding outcomes. Skin-to-skin contact (SSC), a key component of Early Essential Newborn Care, is known to be associated with improved breastfeeding initiation and exclusivity; however, the necessary duration has not been subjected to an RCT. To determine the association of duration of SSC after cesarean section on breastfeeding outcomes and maternal and neonatal health outcomes in China. A multi-centric RCT was conducted at four hospitals in China. 720 participants ≥37 gestational weeks with singleton pregnancy receiving elective cesarean section, using epidural anesthesia or spinal anesthesia or combined spinal-epidural anesthesia were randomly divided into 4 groups at the ratio of 1:1:1:1. The control group received routine care. Intervention group 1 (G1), 2 (G2) and 3 (G3) received 30, 60 and 90 minutes of SSC immediately after cesarean section, respectively. Between January 3 and October 14, 2021, 659 participants were recruited, including 173 in control group, 176 in G1, 146 in G2, and 164 in G3. Among G1, G2 and G3, the rate of early initiation of breastfeeding within 60 minutes of birth was 56%, 71% and 72%, compared to 22% in control group (p<0.001). The exclusive breastfeeding rate at discharge were 69%, 62% and 71%, compared to 57% in control group (p=0.003). EENC practices were associated with reduction in postpartum blood loss and NICU or neonatal ward admission (p< 0.001, p=0.022) . Our findings highlight that prolonged SSC after cesarean section was associated with higher initiation and exclusive breastfeeding at discharge. It also found associations with reduced postpartum blood loss and NICU or neonatal ward admission.

Skin-to-skin contact in the delivery room for very preterm infants: a randomised clinical trial

ObjectiveEvaluating safety, feasibility and effects on physiological parameters of skin-to-skin contact (SSC) from birth between mothers and very preterm infants in a high-income setting.DesignOpen-label randomised controlled trial.SettingThree Norwegian neonatal units.PatientsPreterm...

Association between Skin-to-Skin Contact Duration after Caesarean Section and Breastfeeding Outcomes.

We aimed to explore the association between skin-to-skin contact (SSC) duration after caesarean sections (CSs) and breastfeeding outcomes. A prospective study was conducted in four hospitals in China during January and August 2021. A total of 679 participants with singleton pregnancy who delivered by elective CS after 37 gestational weeks using epidural or spinal anesthesia were included. Logistic regression was applied to assess the association between SSC duration and early initiation of breastfeeding (EIBF), as well as the promoting factors for exclusive breastfeeding (EBF) at hospital discharge. Immediate SSC after CSs was strongly associated with higher rates of EIBF (p &lt; 0.001) and EBF at hospital discharge (p = 0.002). The EIBF rates increased with longer duration of SSC, with the at least 90 min SSC group having the highest EIBF rate (74.5%). Skin-to-skin contact durations of at least 90 min, 60-89 min and 30-59 min were significantly associated with 8.53 times (OR = 8.53, 95%CI: 4.94-14.72, Padj &lt; 0.001), 8.04 times (95%CI: 4.68-13.80, Padj &lt; 0.001) and 6.28 times (95%CI: 3.75-10.51, Padj &lt; 0.001), respectively, higher EIBF rates compared to those without immediate SSC. After multiple-testing correction, the rates of EBF at hospital discharge were found to be independent of the duration of SSC (Padj = 0.12). Early initiation of breastfeeding was not a significant predictor of EBF. Our results suggested that SSC is important for EIBF in Chinese baby-friendly hospitals. Skin-to-skin contact should be practiced after CS to promote breastfeeding and providing SSC with longer duration is encouraged to obtain the full benefit; if it is not feasible, a minimum of 30 min SSC could achieve improved EIBF and EBF at discharge.

Prevalence of early skin-to-skin contact and its impact on exclusive breastfeeding during the maternity hospitalization

BackgroundEarly essential newborn care has been implemented in countries regardless high or low neonatal mortality. This study aims to investigate the current practice of skin-to-skin contact (SSC) and its effect on exclusive breastfeeding during the hospital stay.MethodsThis is a cross-sectional study of 1812 Vietnamese mothers in multicenter. A questionnaire answered by the mothers was used to assess the duration of both SSC and breastfeeding practices. Multivariable logistic regression was used to identify a dose–response relationship between early SSC and prevalence of exclusive breastfeeding in hospital.ResultsThere were 88.7% of mothers experiencing SSC with their infants right after birth and the highest prevalence of SSC was found in district hospitals. Among those experiencing SSC, 18.8% of the infants received more than 90 min of SSC and completed the first breastfeeding during SSC time. Prevalence of exclusive breastfeeding during maternity hospital stay was 46.7%. We found a significant dose–response relation between the duration of SSC and exclusive breastfeeding in hospital. Compared with infants without SSC, the prevalence of exclusive breastfeeding was higher in infants who experienced SSC for 15–90 min (adjusted odds ratio [aOR], 95% confidence interval [95%-CI]: 2.62 [1.61–4.27]) and more than 90 min (aOR [95%-CI]: 5.98 [3.48–10.28]). Completed first breastfeeding during SSC time (aOR [95%-CI]: 4.24 [3.28–5.47]) and being born in district hospitals (aOR [95%-CI]: 2.35 [1.79–3.09]) were associated with increased prevalence of exclusive breastfeeding during hospital stay. On the other hand, mother education level as high school/intermediate (aOR [95%-CI]: 0.58 [0.42–0.82]) and place of residence classified as rural decreased odds of exclusive breastfeeding in hospital (aOR [95%-CI]: 0.78 [0.61–0.99]).ConclusionOur results demonstrate a strong dose–response relationship between duration of SSC and exclusive breastfeeding in hospital. Interventions that support exclusive breastfeeding during hospital stay, especially achieving prolonged uninterrupted SSC, could improve the duration of breastfeeding.

The Effectiveness of Duration Skin to Skin Contact and Telelactation in Exclusive Breastfeeding for Postpartum Mothers in Tangerang

Skin to Skin Contact (SSC) immediately after birth (SSC) , proved could initiate breastfeeding for the first time . Sustaining breastfeeding could stop because the mother cannot be fencing their problems, and the end to stop to breastfeed their baby. the telelaction was a solution for mothers with difficulties during lactation with support during pandemics. The aim analysis the characteristic (age, education level, type of birth, and parity), duration of SSC, and telelactation to exclusive breastfeeding during two weeks at home. Method quasi-experimental design , one group posttest-only. Analysis independent T-test, and regression logistic binary among102 respondents with accidental sampling. The results are the majority of mothers age 20-35 (85.3%), Have the highest level of education (93.1%), spontaneous delivery (65.7%), and multipara (69.6%). Duration SSC 31-60 minutes (64.7%) active telelactation (83.3%) at least twice during two weeks and (72.5%) have breastfeeding exclusively. SSC less than 30 minutes positively 16 times and SSC 30 minutes have 26.7 times to exclusive breastfeeding. Parity, duration SSC, and telelactation significant to Exclusive breastfeeding ( p less than 0.05). Regression logistics was found parity (pvalue 0.036), duration SSC?30 minutes (pvalue 0.005) and telelactation (pvalue 0.014). SSC less than 30 minutes 4 times, parity 3 times, and telelactation 4 times influence mothers to exclusive breastfeeding during two weeks at home. The competency of the health professional should be increased and the telelactation was one of the alternative to apply a continuum of care for postpartum mothers who want to breastfeed, with health protocol during the pandemic.

Skin-to-skin contact and deaths in newborns weighing up to 1800 grams: a cohort study

ObjectiveTo evaluate the association between dose of skin-to-skin contact (SSC) per day and initiation time with the occurrence of deaths in newborns with weight up to 1800g. MethodMulticentric cohort in five Brazilian neonatal units, including newborns with a birth weight of ≤1800g. The time of SSC was registered in individual file, by the team or family during the hospitalization. Maternal and newborn data were obtained through questionnaires applied to mothers and in medical records. Classification Tree was used for data analysis. ResultsThe performance of the first SSC after 206h was significantly associated with death (p = 0.02). Although there was no association between SSC/day and death (p = 0.09), the number of deaths among those who performed more than 146.9 minutes/day was lower (3;1.5%) than among those who performed this practice for a shorter time (13;6.4%), a fact considered of great clinical importance. Early and late infections present statistically significant associations with the outcome. The chance of death was equal to zero when there was no early infection in the group with the longest duration of SSC. This probability was also equal to zero in the absence of late sepsis for the group with less than 146.9 minutes/day of SSC. ConclusionsThe first SSC before 206 hours of life is recommended in order to observe a reduction in the risk of neonatal death. Staying in SSC for more than 146.9 min/day seems to be clinically beneficial for these neonates mostly when it was associated with the absence of infection.

193 Prevalence and predictors of mother-infant skin-to-skin contact at birth

Immediate skin-to-skin contact (SSC) has well-established benefits for both mother and baby, yet its implementation varies widely, with limited data on predictors. This study aims to quantify the prevalence and duration of immediate SSC for vaginal deliveries and to determine how maternal and newborn health affect SSC occurrence and duration. We conducted a retrospective cohort study of vaginal deliveries over six months at an academic medical center. Demographic and clinical predictor variables were abstracted from medical records. We determined associations with SSC occurrence and duration using multivariate logistic and linear regression, respectively. The prevalence of any SSC was 74%, with steady reduction as duration increased. The mean duration of SSC was 30.5 minutes. The presence of maternal delivery complications decreased SSC occurrence (aOR 0.41, 95%CI: 0.18-0.94), but maternal comorbidities did not. Maternal higher education increased odds of any SSC (aOR 2.06, 95%CI: 1.20-3.53). Compared to infants with 1-minute Apgar scores of 8-10, those with scores of 0-3 were about 4 times less likely to receive any SSC (aOR 0.24, 95%CI: 0.09-0.68). Other neonatal factors that decreased odds of any SSC were multiple gestation (aOR 0.06, 95%CI: 0.02-0.18), prematurity (aOR 0.39, 95%CI: 0.20-0.78), NICU admission (aOR 0.13, 95%CI: 0.06-0.28), and exclusive formula-feeding at discharge (aOR 0.49, 95%CI: 0.24-0.99). Low Apgar score, multiple gestation, prematurity, NICU admission, and feeding method at discharge also significantly decreased SSC duration. Maternal comorbidities, delivery complications, and higher education were not associated with SSC duration. The practice of immediate SSC after vaginal delivery occurs less often and with shorter duration than recommended. This practice is further decreased in the setting of maternal and neonatal complications, despite documented benefits extending to those scenarios. Interventions to increase SSC should include education on benefits and safety for patients and providers to improve maternal and neonatal care.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Association between early essential newborn care and breastfeeding outcomes in eight countries in Asia and the Pacific: a cross-sectional observational -study

ObjectiveTo explore the association between early essential newborn care (EENC) policy, practice and environmental interventions and breastfeeding outcomes.DesignCross-sectional observational study.Setting150 national, provincial and district hospitals implementing EENC in eight countries...

The Effect of Short Duration Skin to Skin Contact on Premature Infants' Physiological and Behavioral Outcomes: A Quasi-Experimental Study

PurposeThis study aimed at assessing the effect of short duration Skin to skin contact (SSC) (5 days) on premature infants' short-term physiological and behavioral outcomes. Design and methodsA quasi-experimental control group design was utilized. 89 stable premature infants were allocated to either an interventional or control group. ResultsResults showed that in comparison to the control group, newborns in the SSC group demonstrated higher weight gain (g/day) from day 3–5 of practicing SSC (53.7 g Vs. 32.6 g; P < .05), experienced significantly fewer numbers of apneas (48% Vs. 33.3%; P = .001), and were less likely to use formula feeding (60% Vs. 90%) and more likely to use mixed feeding (formula and breastfeeding) at discharge (33.3% Vs. 10%). Significant differences were also found in the crying, and sleeping patterns of the infants; infants of mothers who practiced SSC were less likely to cry in a continuous pattern and more likely to experience good sleep than infants in the control group. ConclusionsThe study highlights the importance of the early and short duration of SSC for premature infants. Practice implicationsThe initiation of SSC in the first few days of life may have a significant influence on the newborn's short-term outcomes.

Worldwide prevalence of mother-infant skin-to-skin contact after vaginal birth: A systematic review.

BackgroundDespite the World Health Organization’s (WHO) recommendation for immediate skin-to-skin contact (SSC) after birth, separation of mothers and infants seems to be common practice in many hospitals. It is unknown how common the practice of SSC is worldwide. Therefore, we aimed to determine the reported prevalence of SSC for healthy mothers and infants immediately after normal birth.MethodsWe systematically searched CINAHL, Medline, ProQuest Central, PubMed and the Cochrane Library for articles published between January 2007 and October 2017 using the keywords "kangaroo care" or "skin to skin contact" or "breastfeeding initiation" or "breast crawl" or "maternal infant contact" or "maternal newborn contact" or "baby friendly hospital initiative" or "ten steps for successful breastfeeding”.ResultsAfter an initial screening of 5266 records, 84 full text articles were assessed for eligibility, and 35 of these met the inclusion criteria. The studies were from 28 countries representing all six WHO world regions. There was a wide range in the practice of SSC for mother-infant dyads around the world: from 1% to 98%. Only 15 studies clearly defined SSC. Most of the studies were from high-income countries, and these reported higher rates of SSC than studies from low and middle-income countries.ConclusionThere was a great heterogeneity in the definition of SSC as well as study designs, which makes cross-county comparison difficult. National studies reporting SSC rates are lacking. Future studies and guidelines to enhance SSC practice should include a standardised set of indicators and measurement tools that document SSC starting time and duration of SSC.

The Positive Association Between Duration of Skin-to-Skin Contact and Blood Glucose Level in Full-Term Infants.

The aim of this study was to evaluate the contribution of the duration of skin-to-skin contact (SSC) on blood glucose levels at 2 hours after birth in healthy full-term infants. This observational study was done at one of the baby-friendly hospitals located in Aichi, Japan in 2009. Sixty newborn infants who were born vaginally from uncomplicated pregnancies were participated. All infants were held SSC within 5 minutes. All data regarding neonatal information, blood glucose levels at 2 hours of age, and maternal information were obtained from their medical history. Multiple linear regression analysis was performed to identify the independent contribution of the duration of SSC. The mean duration of SSC was 59.6 ± 13.6 minutes (range: 11.0-97.0 minutes) and the infant blood glucose level was 53.1 ± 9.5 (range: 30.0-80.0 mg/dL) mg/dL. The duration of SSC (β [95% confidence interval] = .282 [range: 0.037-0.357], standardized β = .282, P < .017) was significantly and positively associated with infant blood glucose levels independent of gestational age, birth weight, sex, length of second-stage labor, and mode of delivery. Thus, the longer early SSC was associated with higher blood glucose level at 2 hours of age in healthy full-term infants.

An Observational Cohort Study Examining the Effect of the Duration of Skin-to-Skin Contact on the Physiological Parameters of the Neonate in a Neonatal Intensive Special Care Unit.

Focus on skin-to-skin contact (SSC) as a family-centered care intervention in Neonatal Intensive Special Care (NISC) Units continues to increase. Previously, SSC has been shown to improve neonatal physiological stability, support brain development, and promote bonding and attachment. Limited research exists investigating SSC duration and neonatal physiological responses. This study examined the relationship between SSC duration and the neonate's oxygen saturation, heart rate (HR), respiratory rate (RR), and temperature. An observational cohort study was conducted at The Royal Women's Hospital NISC Unit in Melbourne, Australia. For each neonate participant, 1 SSC with their parent was studied (parent convenience) and neonatal physiological parameters recorded, with a bivariate correlation used to explore the relationship between the duration of SSC and the percentage of time during SSC that the neonate's physiological variables remained within a target range. No correlation existed between the duration of SSC and the neonatal physiological variables of oxygen saturation, HR, RR, and temperature. However, neonatal oxygen requirement was more often reduced across the duration of SSC. Due to previously documented benefits to neonates physiologically from SSC, and our supportive finding that SSC reduces neonatal oxygen requirement, we believe that this study adds to the evidence to support promotion of SSC in NISC Units. The duration of SSC does not appear to negatively impact the physiological effects to the neonate. Thus, SSC should be encouraged in all NISC Units to be conducted for the length of time the parent is able. This study should be repeated with a larger sample size.

Observation study showed that the continuity of skin-to-skin contact with low-birthweight infants in Uganda was suboptimal.

AimKangaroo mother care (KMC) is a safe and effective method of reducing neonatal mortality in resource‐limited settings, but there has been a lack of data on the duration of skin‐to‐skin contact (SSC) in busy, low‐resource newborn units. Previous studies of intermittent KMC suggest the duration of SSC ranged from 10 minutes to 17 hours per day.MethodsThis was an observational study of newborn infants born weighing less than 2000 g, which collected quantitative data on SSC over the first week after birth. The study took place in July 2016 in the newborn unit of a low‐resource facility in Uganda.ResultsThe mean daily duration of SSC over the first week after birth was three hours. This differed significantly from the World Health Organization recommendation of at least 20 hours of SSC per day. SSC was provided by mothers most of the time (73.5%), but other family members also took part, especially on the day of birth.ConclusionOur study found a disappointingly low daily duration of SSC in this Ugandan newborn unit. However, advocacy and community education of SSC may help to decrease the stigma of KMC, improve overall acceptance and reduce the age at SSC initiation.

The effect of skin-to-skin contact at birth, early versus immediate, on the duration of exclusive human lactancy in full-term newborns treated at the Clínica Universidad de La Sabana: study protocol for a randomized clinical trial.

BackgroundHuman lactancy is a simple and cost-effective strategy that influences infant and maternal mortality rates. Skin-to-skin contact (SSC) is an immediate postpartum period strategy that has proven to benefit the initiation and continuation of human lactation and to decrease hospitalization during the first week of life. This study aims to determine the effect of SSC initiation at birth (immediate versus early) in healthy, full-term newborns treated at the Universidad de La Sabana Clinic on the duration of exclusive human lactation.Methods/designA randomized, blind clinical trial will be performed with full-term healthy newborns born at the Universidad de La Sabana Clinic. The blind trial participants will be those persons measuring the results and analyzing the data. The sample size will be calculated for a type I error of 5 %, a two-tailed type II error of 20 %, and an estimated percentage loss of 30 %; 150 infants will be included in each group. Randomization will be performed using permuted, size-6 blocks. Descriptive analysis will be conducted using central tendency and dispersion measurements. A bivariate analysis will be performed to determine which variables are associated with exclusive lactancy at 6 months. For continuous variables, Student’s t test will be used for independent samples, and the Wilcoxon rank sum test will be used if the assumptions of normality for the t tests are not fulfilled. The assumption of normality will be evaluated using the Shapiro-Wilk and Kolmogorov-Smirnov tests. Categorical variables in contingency tables will be constructed to assess the independence between variables using the chi-square test, or Fisher’s exact test when the assumption of the number of cases is not met by the values in the contingency tables multiplied by two. This will be calculated as a measurement of the effect of relative risk (RR) with confidence intervals; the adjusted measurements will be calculated using a multivariate regression Poisson model. Variables with significant results will be used in the bivariate analysis, and those with biological plausibility will be used for the adjustment. The analysis will be carried out for a two-tailed type I error level of 5 %. The Stata 11 program will be used for data analysis. An interim analysis will be performed upon the submission of half the expected events (106), setting limits for the early termination of the trial according to the method proposed by Pampallona and Tsiatis (1994). Intervention: There will be two SSC randomization groups: early versus immediate. After completing the neonatal adaptation process and based on the group assignment, the mother will be left with her newborn child in hospital accommodation. Prior to discharge, the Infant Breast-Feeding Assessment Tool (IBFAT) will be applied. Monitoring will initially be performed with a face-to-face assessment between 3 and 10 days of life, followed by monthly telephone calls for 6 months to verify lactation status.DiscussionSSC at birth has shown benefits in the short and long term for both the mother and the full-term newborn. Although the meta-analysis that have been done have shown the benefits of this technique, multiple differences in the SSC interventions have been identified because criteria such as the initiation or duration of SSC (dose) have not been unified. Colombia has a malnutrition risk of 11,4 % in the total population for the period 2012-2014, so it is necessary to promote strategies that generate a positive impact on the duration of human lactation, providing support from the clinical setting of humanized delivery which is included in the IAMI strategy (Instituciones Amigas de la Mujer y la Infancia – Friends of Women and Children Institution). Therefore, we propose that the initiation time of SSC in full-term new-borns is related to the duration of exclusive human lactation.Trial registrationRegistered ClinicalTrials.gov Identifier: NCT 02687685. Registered on 2 February 2016. This study is not yet open for participant recruitment.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1587-7) contains supplementary material, which is available to authorized users.

Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants.

This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored. A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28 + 0 to 33 + 6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records, and follow-up questionnaires were filled in by parents. The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35 + 0 (32 + 1 to 37 + 5) weeks of postmenstrual age, and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p < 0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding. A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.