Efficacy of early skin-to-skin contact on the rate of exclusive breastfeeding   in term neonates: a randomized controlled trial.

Amit Sharma
Detroit Medical Center, Neonatology

Abstract
Background: Despite multiple benefits of breast milk, the rates of exclusive breastfeeding in developing countries are low.

Objective: To evaluate the efficacy of early skin -to -skin contact (SSC) on the rate of exclusive breastfeeding (EBF) at 6 weeks
of age among term neonates born by vaginal delivery.

Methods: Term neonates born by vaginal delivery and did not require any resuscitation were randomized at birth to SSC (n=100) and control (n=100) group. Immediately after clamping the umbilical cord, SSC group neonates were placed on the  bare bosom of mother and control group neonates were placed under a radiant warmer for a period of 45 minutes each while  mothers underwent management of the third stage of labor and episiotomy repair. Pain experienced by mother during episiotomy repair was recorded using a numerical pain scale The primary outcome evaluated was the rate of exclusive breastfeeding  at 6 weeks of postnatal age.

Results:A significantly higher proportion of neonates were exclusively breastfeed at 6 weeks of age in the SSC group than in  the control group (72% vs. 57.6%, p=0.04, relative risk: 1.3, 95% confidence interval: 1.0 -1.6). The pain score during episiotomy  repair in mothers of the SSC group was significantly lower than the control group (4.74±0.85 versus 5.34±0.81; P <0.01).

Conclusions: Early SSC significantly improved the rate of exclusively breastfeeding at 6 weeks of age among healthy term neonates. An important additional effect was a decrease in the amount of pain that mothers in the SSC group experienced during
episiotomy repair.

Keywords:Early skin-to-skin contact, exclusive breastfeeding in term neonates, randomized controlled trial.