Skin-to-skin contact after elective caesarean section: Investigating the effect on breastfeeding rates
To determine whether kangaroo care (skin-to-skin contact) between mother and baby in the operating theatre can affect breastfeeding outcomes following an elective caesarean section.
A randomised controlled trial recruited 366 women (182 in study group, 187 in control) having an elective caesarean section at term (≥37 completed weeks of pregnancy) who chose to breastfeed their baby at birth. Babies in the study group had immediate skin-to-skin contact in the operating theatre. The control group had standard care (skin-to-skin following the operation).
There was a 5% increase in breastfeeding rates at 48 hours (88% vs 83%) and 7% at 6 weeks (53% vs 46%); however, these differences were not statistically significant (P = 0.25 and 0.44). There was a significant correlation between the length of time for which skin-to-skin was performed and continuing to breastfeed at 48 hours (P = 0.04).
Skin-to-skin contact in the operating theatre following an elective caesarean section is a simple intervention associated with a trend towards an increase in breastfeeding rates at 48 hours and 6 weeks. There is a correlation between length of time for which skin-to-skin is performed during the first 24 hours and the continuation of breastfeeding at 48 hours (P = 0.04).
Numerous policy documents from the Department of Health (2009a; 2009b; 2011; 2012a; 2012b; 2013) recognise that breastfeeding is associated with overwhelming health benefits and large potential cost savings. It has been identified as a national priority and a key area of focus for the NHS and local partners. UNICEF UK published a report in 2012 stating that, if the number of babies in the UK receiving any breast milk at all rose by just 1%, this alone could potentially reduce 10 000 hospital admissions annually for babies owing to gastroenteritis and respiratory illness, and save approximately £40 million a year for the NHS (Renfrew et al, 2012). It also stated that this could potentially lead to a small increase in IQ which, across the entire population, could result in gains of more than £278 million in economic productivity annually.
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