The benefits of breastfeeding are well known. The Surgeon General's Call to Action to Support Breastfeeding highlighted the impact of maternity care practices on the establishment of exclusive breastfeeding. The Centers for Disease Control identified placing the newborn skin-to-skin with the mother after birth as a breastfeeding supportive practice. Our healthcare system reviewed the maternity care practices at our hospitals and decided to implement skin-to-skin contact at birth. Would skin-to-skin contact at birth really make a difference in the exclusive breastfeeding rates at discharge?
An education program on the importance of skin-to-skin contact after birth was given to the nursing staff. Education included definitions and benefits of skin-to-skin contact and a description of its role in successful breastfeeding. The nursing staff was instructed to offer skin-to-skin at every vaginal delivery.
A sample of convenience of women giving birth at Atlantic Health hospitals in northwestern New Jersey. Morristown Medical Center is a regional perinatal center with approximately 4,000 births annually. Overlook Medical Center is a perinatal intensive hospital with approximately 2,400 births annually.
Breastfeeding women who gave birth vaginally to a term singleton infant. We excluded cesarean and preterm birth, multiple gestations, and teen mothers. A sample size of 148 was required at each hospital for the skin-to-skin group and the control group for a 95% confidence interval.
Retrospective closed chart review comparing the exclusive breastfeeding rates at discharge of women who did not have skin-to-skin contact prior to implementation of skin-to-skin and women who did have skin-to-skin contact with their infants. Exclusive breastfeeding was defined as no other liquid or solid fed to the infant except for medication.
Data were compared using paired t tests. A p-value of less than .05 was considered significant. At Morristown Medical Center the exclusive breastfeeding rate prior to the implementation of skin-to-skin was 54%. The exclusive breastfeeding rate for women with skin-to-skin at birth was 74%. This resulted in a p-value of .0003, which was statistically significant. At Overlook Medical Center the exclusive breastfeeding rate prior to the implementation of skin-to-skin was 51%. The exclusive breastfeeding rate for women with skin-to-skin contact at birth was 63%. The resultant p-value was .0196, which was also statistically significant.
Conclusion/Implications for Nursing Practice
Skin-to-skin contact at birth increased the exclusive breastfeeding rates at discharge for these participants. There may be increased nurse and patient satisfaction. Further research is needed.