To investigate the effect of mother–infant skin-to-skin contact (SSC) on the maintenance of breastfeeding over the first 3 months and the effect of breastfeeding on mother–infant interaction.
Home visits in eastern Nova Scotia.
Seventy-seven full-term infants and their mothers were seen in their homes at 1 week, 1 month, 2 months, and 3 months.
Mothers in an SSC group were requested to provide SSC, no request for SSC was made to control group mothers. All mothers kept daily records of the SSC they provided. The SSC group mothers provided approximately 5 hours/day of SSC in the infants’ first week and then more than 2 hours/day until the infants were 1 month old. Control group mothers provided little or no SSC. At each home visit, mothers reported whether they provided exclusive breastfeeding, partial breastfeeding, or no breastfeeding. Mother–infant interactions were assessed at each visit using the Nursing Child Assessment Feeding Scale (NSAFS).
The SSC group mothers provided more SSC than control group mothers (week 1: SSC, M = 4.92 hours/day, control M = 0.48 hours/day; weeks 2-4 SSC, M = 2.77 hours/day, control M = 0.19 hours/day). At 1 week, the percentage of breastfeeding dyads was similar in both groups (exclusive: SSC = 77%, control = 69%; exclusive + partial: SSC = 81%, control = 75%). The percentage of breastfeeding dyads (exclusive + partial) declined in the control group as the infants aged but remained stable in the SSC group. Breastfeeding dyads had significantly higher scores on the NCAFS Caregiver Scale, indicating more positive maternal interactions at 1 week, 2 months, and 3 months.
Conclusion/Implications for Nursing Practice
Though numerous studies have shown SSC to benefit newborns’ physiological adjustment, few studies have investigated the effect of SSC on breastfeeding duration beyond the newborn period. In this study, SSC facilitated the maintenance of breastfeeding during the infants’ early months, and breastfeeding was associated with increased positive maternal interactions. The findings imply the importance of the promotion of SSC to help mothers maintain the decision to breastfeed to the benefits of infants, mothers, and the developing mother–infant relationship. As providers of postpartum care, nurses are uniquely positioned to educate and support mothers in SSC and to influence broader public health policy about maternal–child health.