A randomised controlled trial in the north of England examining the effects of skin-to-skin care on breast feeding.

OBJECTIVE

to examine the effect of early skin-to-skin contact between mothers and their healthy full-term babies on initiation and duration of breast feeding.

DESIGN

a randomised controlled trial comparing skin-to-skin with routine care.

SETTING

Warrington Hospital, Cheshire, UK.

PARTICIPANTS

204 mother and baby pairs; 102 randomised to each group.

OUTCOME MEASURES: success of first breast feed, maternal satisfaction with skin-to-skin care and preference for future post-delivery care, baby-body temperature 1 hr after birth, partial or exclusive breast feeding at 4 months.

FINDINGS: in the skin-to-skin group, 89 out of 98 (91%) babies had a successful first feed compared with 82 out of 89 (83%) in the routine care group. The difference in the success rate was 8%, 95% confidence interval (CI) (-1.6%, 17.6%); chi(2)=2.7; df=1; P=0.10. Forty-two out of 97 (43%) babies given skin-to-skin were partially or exclusively breast feeding at 4 months compared with 40 out of 100 (40%) of babies in the routine care group. The difference in breast-feeding rate at 4 months was 3.3%, 95% CI (-10.3%, 16.7% ); chi(2)=0.22; df=1; P=0.64. The mean temperature 1 hr after birth was higher with skin-to-skin than routine care. The difference in means was 0.15 degrees C; 95% CI (0.03, 0.28); P=0.02. A larger proportion of mothers (87/97 [90%]) were very satisfied with skin-to-skin care, compared with 60 out of 102 (59%) in the control group; 83 out of 97 (86%) of the mothers in the intervention group said that they would prefer to receive the same care in the future compared with 31 out of 102 (30%) mothers in the control group.

CONCLUSIONS

the difference between the groups in the success rate for the first breast feed and rates at 4 months was not statistically significant. However, mothers who had skin-to-skin contact enjoyed the experience, and most reported that they would choose to have skin-to skin care in the future. In this, the largest trial to date, previous concerns about baby-body temperature after skin-to-skin care were dispelled.