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Early skin-to-skin contact for mothers and their healthy newborn infants

  1. Elizabeth R Moore1,*,
  2. Gene C Anderson2,
  3. Nils Bergman3

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 18 JUL 2007

Assessed as up-to-date: 2 APR 2007

DOI: 10.1002/14651858.CD003519.pub2


How to Cite

Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003519. DOI: 10.1002/14651858.CD003519.pub2.

Author Information

  1. 1

    Vanderbilt University, School of Nursing, Nashville, Tennessee, USA

  2. 2

    Professor Emerita, University of Florida, Case Western Reserve University, Gainesville, FL, USA

  3. 3

    Medical Research Council of South Africa (affiliate), Pinelands, South Africa

*Elizabeth R Moore, School of Nursing, Vanderbilt University, 525 Godchaux Hall, 21st Avenue South, Nashville, Tennessee, 37240-0008, USA. elizabeth.moore@vanderbilt.edu .

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 JUL 2007

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Mother-infant separation postbirth is common in Western culture. Early skin-to-skin contact (SSC) begins ideally at birth and involves placing the naked baby, covered across the back with a warm blanket, prone on the mother's bare chest. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neurobehaviors ensuring fulfillment of basic biological needs. This time may represent a psychophysiologically 'sensitive period' for programming future behavior.

Objectives

To assess the effects of early SSC on breastfeeding, behavior, and physiological adaptation in healthy mother-newborn dyads.

Search methods

Cochrane Pregnancy and Childbirth Group's and Neonatal Group's Trials Registers (August 2006), Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 2), MEDLINE (1976 to 2006).

Selection criteria

Randomized and quasi-randomized clinical trials comparing early SSC with usual hospital care.

Data collection and analysis

We independently assessed trial quality and extracted data. Study authors were contacted for additional information.

Main results

Thirty studies involving 1925 participants (mother-infant dyads), were included. Data from more than two trials were available for only 8-of-64 outcome measures. We found statistically significant and positive effects of early SSC on breastfeeding at one to four months postbirth (10 trials; 552 participants) (odds ratio (OR) 1.82, 95% confidence interval (CI) 1.08 to 3.07), and breastfeeding duration (seven trials; 324 participants) (weighted mean difference (WMD) 42.55, 95% CI -1.69 to 86.79). Trends were found for improved summary scores for maternal affectionate love/touch during observed breastfeeding (four trials; 314 participants) (standardized mean difference (SMD) 0.52, 95% CI 0.07 to 0.98) and maternal attachment behavior (six trials; 396 participants) (SMD 0.52, 95% CI 0.31 to 0.72) with early SSC. SSC infants cried for a shorter length of time (one trial; 44 participants) (WMD -8.01, 95% CI -8.98 to -7.04). Late preterm infants had better cardio-respiratory stability with early SSC (one trial; 35 participants) (WMD 2.88, 95% CI 0.53 to 5.23). No adverse effects were found.

Authors' conclusions

Limitations included methodological quality, variations in intervention implementation, and outcome variability. The intervention may benefit breastfeeding outcomes, early mother-infant attachment, infant crying and cardio-respiratory stability, and has no apparent short or long-term negative effects. Further investigation is recommended. To facilitate meta-analysis, future research should be done using outcome measures consistent with those in the studies included here. Published reports should clearly indicate if the intervention was SSC and include means, standard deviations, exact probability values, and data to measure intervention dose.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Early skin-to-skin contact for mothers and their healthy newborn infants

Skin-to-skin contact between mother and baby at birth reduces crying, improves mother-baby interaction, keeps the baby warmer, and helps women breastfeed successfully.

In many cultures, babies are generally cradled naked on their mother's bare chest at birth. Historically, this was necessary for the baby's survival. In recent times, in some societies as more babies are born in hospital, babies are separated or dressed before being given to their mothers. It has been suggested that in industrialized societies, hospital routines may significantly disrupt early mother-infant interactions and have harmful effects. The review was done to see if there was any impact of early skin-to-skin contact between the mother and her newborn baby on infant health, behavior and breastfeeding. The review included 30 studies involving 1925 mothers and their babies. It showed that babies interacted more with their mothers, stayed warmer, and cried less. Babies were more likely to be breastfed, and to breastfeed for longer, if they had early skin-to-skin contact. Babies were also, possibly, more likely to have a good early relationship with their mothers, but this was difficult to measure.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

提早讓母親和她的健康新生兒進行肌膚接觸

西方國家中,讓母親和嬰兒在產後分開是常見的情況。理想的話,提早肌膚接觸(skintoskin contact (SSC))是在生產後將裸體胎兒直接放在母親裸露胸口,上面再以溫暖毛毯覆蓋。根據哺乳動物神經科學,在此處(棲息地)的親密接觸可喚起神經行為而確保滿足基本的生物需求。此時機可能代表編程後續行為(programming future behavior)的一種生理心理性的敏感期

目標

評估提早肌膚接觸對於健康的母親和新生兒兩者間的哺餵母乳、行為、及生理適應的效果

搜尋策略

Cochrane Pregnancy和Childbirth Group's與Neonatal Group's Trials Registers (2006年8月)、Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 2)、MEDLINE (1976年2006年)

選擇標準

隨機與半隨機臨床試驗比較提早肌膚接觸和一般醫院照護

資料收集與分析

我們獨立評估試驗品質和摘錄資料,聯絡研究作者以獲得更多資訊

主要結論

納入30篇研究、1925對參與者(母嬰)。64種測量結果中,有2篇以上試驗只有其中8種資料。我們發現提早肌膚接觸對於產後1 – 4個月的哺餵母乳(10篇研究、552對參與者 OR為1.82, 95% CI為1.08 – 3.07),和哺餵母乳時間之長短(7篇研究、324對參與者 加權平均差(weighted mean difference (WMD))為42.55, 95% CI為 −1.69至86.79)有統計顯著的正面效果。提早肌膚接觸傾向於改善整體的分數包括:(1)母親在哺餵母乳時溫柔撫摸嬰兒(4篇研究、314對參與者 標準平均差(standardized mean difference (SMD))為0.52, 95% CI為0.07 – 0.98)、(2)母親的情感行為(6篇研究、396對參與者 SMD為0.52, 95% CI為0.31 – 0.72)與提早肌膚接觸,提早肌膚接觸之嬰兒的哭泣時間較短(1篇研究、44對參與者 WMD為 −8.01,95% CI為 −8.98至 −7.04)。讓接近足月出生之嬰兒(Late preterm infants)提早肌膚接觸可以有較佳的心肺穩定度(1篇研究、35對參與者 WMD為2.88, 95% CI為0.53 −5.23)。沒有發現有任何副作用

作者結論

本文獻回顧之限制包括方法學之品質、介入方式之差異、及評估之預後不同。此種介入對於哺餵母乳、提早母嬰情感建立、嬰兒哭泣和心肺穩定度等有幫助,且沒有短期或長期負面影響。建議進行後續評估。為了有助於後統合分析,後續研究應使用和本文獻回顧之研究有一致性的預後測量。發表的報告應清楚地(1)指出介入方式是否為提早肌膚接觸、(2)納入平均值、標準差、實際機率值、測量介入值的資料等

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

提早讓母親和她的健康新生兒進行肌膚接觸。 生產後母嬰肌膚接觸可以減少哭泣、改善母嬰互動、保持嬰兒溫暖、幫助母親成功哺餵母乳。在一些地區的文化中,嬰兒一般會在出生時以裸體直接和母親裸露的胸膛接觸。在歷史上,這是嬰兒存活所必須。在近代,因為有越來越多嬰兒在醫院出生,嬰兒被分開或在穿上衣服後交給母親。一般認為在工業化社會中,住院慣例會顯著影響到母嬰早期互動而有負面影響。本回顧將探討母親和新生兒提早肌膚接觸對於嬰兒健康、行為和哺乳的影響。回顧包括了30篇研究、1925對母親和嬰兒。分析顯示嬰兒和母親互動越多,則比較溫暖且較少哭泣。如果嬰兒比較早肌膚接觸,比較可能被餵母乳且母乳哺餵期間會比較久,嬰兒也比較可能和母親有好的早期關係,但是這難以測量