The role of skin-to-skin contact in exclusive breastfeeding: a cohort study

Marivanda Julia Furtado Goudard; Zeni Carvalho  Lamy; Sérgio Tadeu Martins  Marba; Geisy Maria de Souza Lima; Alcione Miranda dos  Santos; Marynea Silva do  Vale; Talyta Garcia da Silva Ribeiro; Roberta Costa; Vivian Mara Gonçalves de Oliveira Azevedo; Fernando Lamy-Filho

doi:10.11606/s1518-8787.2022056004063

Authors

Marivanda Julia Furtado Goudard Universidade Federal do Maranhão . Departamento de Saúde Pública . Programa de Pós-Graduação em Saúde Coletiva . São Luís , MA , Brasil https://orcid.org/0000-0003-3231-7793
Zeni Carvalho Lamy Universidade Federal do Maranhão . Departamento de Saúde Pública . Programa de Pós-Graduação em Saúde Coletiva . São Luís , MA , Brasil https://orcid.org/0000-0002-9332-0542
Sérgio Tadeu Martins Marba Universidade Estadual de Campinas . Departamento de Pediatria da Faculdade de Ciências Médicas . Campinas , SP , Brasil https://orcid.org/0000-0003-2903-6915
Geisy Maria de Souza Lima Instituto de Medicina Integral Professor Fernando Figueira . Departamento de Neonatologia . Recife , PE , Brasil https://orcid.org/0000-0002-8656-205X
Alcione Miranda dos Santos Universidade Federal do Maranhão . Departamento de Saúde Pública . Programa de Pós-Graduação em Saúde Coletiva . São Luís , MA , Brasil https://orcid.org/0000-0001-9711-0182
Marynea Silva do Vale Hospital Universitário da Universidade Federal do Maranhão . Departamento de Neonatologia . São Luís , MA , Brasil https://orcid.org/0000-0002-1544-5470
Talyta Garcia da Silva Ribeiro Universidade Federal do Maranhão . Faculdade de Medicina . São Luís , MA , Brasil https://orcid.org/0000-0002-5254-3408
Roberta Costa Universidade Federal de Santa Catarina . Departamento de Enfermagem . Florianópolis , SC , Brasil https://orcid.org/0000-0001-6816-2047
Vivian Mara Gonçalves de Oliveira Azevedo Universidade Federal de Uberlândia . Faculdade de Educação Física e Fisioterapia . Uberlândia , MG , Brasil https://orcid.org/0000-0002-7514-1508
Fernando Lamy-Filho Universidade Federal do Maranhão . Departamento de Saúde Pública . Programa de Pós-Graduação em Saúde Coletiva . São Luís , MA , Brasil https://orcid.org/0000-0002-7858-4195

DOI:

https://doi.org/10.11606/s1518-8787.2022056004063

Keywords:

Infant, Low Birth Weight, Premature Birth, Breast Feeding, Kangaroo-Mother Care Method, Intensive Care, Neonatal

Abstract

OBJETIVE To understand the role of exposure to skin-to-skin contact and its minimum duration in determining exclusive breastfeeding at hospital discharge in infants weighing up to 1,800g at birth. METHODS A multicenter cohort study was carried out in five Brazilian neonatal units. Infants weighing ≤ 1,800g at birth were eligible. Skin-to-skin contact time was recorded by the health care team and parents on an individual chart. Maternal and infant data was obtained from maternal questionnaires and medical records. The Classification Tree, a machine learning method, was used for data analysis; the tree growth algorithm, using statistical tests, partitions the dataset into mutually exclusive subsets that best describe the response variable and calculates appropriate cut-off points for continuous variables, thus generating an efficient explanatory model for the outcome under study. RESULTS A total of 388 infants participated in the study, with a median of 31.6 (IQR = 29–31.8) weeks of gestation age and birth weight of 1,429g (IQR = 1,202–1,610). The exclusive breastfeeding rate at discharge was 61.6%. For infant’s weighting between 1,125g and 1,655g, exposed to skin-to-skin contact was strongly associated with exclusive breastfeeding. Moreover, infants who made an average > 149.6 min/day of skin-to-skin contact had higher chances in this outcome (74% versus 46%). In this group, those who received a severity score (SNAPPE-II) equal to zero increased their chances of breastfeeding (83% versus 63%). CONCLUSION Skin-to-skin contact proved to be of great relevance in maintaining exclusive breastfeeding at hospital discharge for preterm infants weighing 1,125g–1,655g at birth, especially in those with lower severity scores.

References

Mayerl CJ, Gould FDH, Bond LE, Stricklen BM, Buddington RK, German RZ. Preterm birth disrupts the development of feeding and breathing coordination. J Appl Physiol. 2019;126(6):1681-6. https://doi.org/10.1152/japplphysiol.00101.2019

Wang Y, Briere CE, Xu W, Cong X. Factors affecting breastfeeding outcomes at six months in preterm infants. J Hum Lact. 2019;35(1):80-9. https://doi.org/10.1177/0890334418771307

Karimi FZ, Miri HH, Khadivzadeh T, Maleki-Saghooni N. The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: a systematic review and meta-analysis. J Turk Ger Gynecol Assoc. 2020;21(1):46-56. https://doi.org/10.4274/jtgga.galenos.2019.2018.0138

World Health Organization. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva (CH): WHO; 2017.

Lau C. Breastfeeding challenges and the preterm mother-infant dyad: a conceptual model. Breastfeed Med. 2018;13(1):8-17. https://doi.org/10.1089/bfm.2016.0206

Moore ER, Bergman N, Anderson GC, Medley N. Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016:(11):CD003519. https://doi.org/10.1002/14651858.CD003519.pub4

Tharashree CD, Shravani MR, Srinivasa S. The effect of Kangaroo Mother Care (KMC) on breast feeding at the time of NICU discharge. Int J Contemp Pediatr. 2018;5(3):1068-71. https://doi.org/10.18203/2349-3291.ijcp20181544

Jayaraman D, Mukhopadhyay K, Bhalla AK, Dhaliwal LK. Randomized controlled trial on effect of intermittent early versus late Mother Kangaroo Care on human milk feeding in low-birth-weight neonates. J Hum Lact. 2017;33(3):533-9. https://doi.org/10.1177/0890334416685072

Casper C, Sarapuk I, Pavlyshyn H. Regular and prolonged skin-to-skin contact improves short-term outcomes for very preterm infants: a dose-dependent intervention. Arch Pediatr. 2018;25(8):469-75. https://doi.org/10.1016/j.arcped.2018.09.008

Pike M, Kritzinger A, Krüger E. Breastfeeding characteristics of late-preterm infants in a kangaroo mother care unit. Breastfeed Med. 2017;12(10):637-44. https://doi.org/10.1089/bfm.2017.0055

Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mothercare to reduce morbidity and mortality in lowbirthweight infants. Cochrane Database Syst Rev. 2011;(3):CD002771. https://doi.org/10.1002/14651858.CD002771.pub2

Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, et al. Kangaroo mother care and neonatal outcomes: a meta-analysis. Pediatrics. 2016;137(1):e20152238. https://doi.org/10.1542/peds.2015-2238

Akbari E, Binnoon-Erez N, Rodrigues M, Ricci A, Schneider J, Madigan S, et al. Kangaroo mother care and infant biopsychosocial outcomes in the first year: a meta-analysis. Early Hum Dev. 2018;122:22-31. https://doi.org/10.1016/j.earlhumdev.2018.05.004

World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes. Geneva (CH): WHO; 2015.

Ghojazadeh M, Hajebrahimi S, Pournaghi-Azar F, Mohseni M, Derakhshani N, Azami-Aghdash S. Effect of Kangaroo Mother Care on successful breastfeeding: a systematic review and meta-analysis of randomised controlled trials. Rev Recent Clin Trials. 2019;14(1):31-40. https://doi.org/10.2174/1574887113666180924165844

Oxford University. Intergrowth-21st. Oxford (UK): Oxford University; 2020 [cited 2020 Aug 10]. Available from: http://intergrowth21.ndog.ox.ac.uk/pt

Muktan D, Singh RR, Bhatta NK Shah D. A neonatal mortality risk assessment using SNAPPE - II score in a neonatal intensive care unit. BMC Pediatr. 2019;19(1):279. https://doi.org/10.1186/s12887-019-1660-y

Bertsimas D, Dunn J. Optimal classificatioin trees. Mach Learn. 2017;106(7):1039-82. https://doi.org/10.1007/s10994-017-5633-9

Abdar M, Zomorodi-Moghadam M, Das R, Ting IH. Performance analysis of classification algorithms on early detection of liver disease. Expert Syst Appl. 2017;67:239-51. https://doi.org/10.1016/j.eswa.2016.08.065

Pandya D, Kartikeswar GAP, Patwardhan G, Kadam S, Pandit A, Patole S. Effect of early kangaroo mother care on time to full feeds in preterm infants: a prospective cohort study. Early Hum Dev. 2021;154:105312. https://doi.org/10.1016/j.earlhumdev.2021.105312

Mekonnen AG, Yehualashet SS, Bayleyegn AD. The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies. Int Breastfeed J. 2019;14:12. https://doi.org/10.1186/s13006-019-0206-0

Mazumder S, Taneja S, Dube B, Bathia K, Ghosh R, Shekhar M, et al. Effect of community-initiated kangaroo mother care on survival of infants with low birthweight: a randomised controlled trial. Lancet. 2019;394(10210):1724-36. https://doi.org/10.1016/S0140-6736(19)32223-8

Wilson E, Bonamy AKE, Bonet M, Toome L, Rodrigues C, Howell EA, et al; EPICE Research Group. Room for improvement in breast milk feeding after very preterm birth in Europe: results from the EPICE cohort. Matern Child Nutr. 2018;14(1):e12485. https://doi.org/10.1111/mcn.12485

Flackin R, Ewald U, Wallin L. Positive effect ok Kangaroo Mother Care on long-term breastfeeding in very preterm infants. J Obstet Gynecol Neonatal Nurs. 2011;40(2):190-7. https://doi.org/10.1111/j.1552-6909.2011.01226.x

Bonamy AKE, Zeitlin J, Piedvache A, Maier RF, Heijst A, Varendi H, et al. Wide variation in severe neonatal morbidity among very preterm infants in European regions. Arch Dis Child Fetal Neonatal Ed. 2019;104(1):F36-45. https://doi.org/10.1136/archdischild-2017-313697

Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. https://doi.org/10.1016/S0140-6736(15)01024-7

The role of skin-to-skin contact in exclusive breastfeeding: a cohort study

Authors

DOI:

Keywords:

Abstract

References

Downloads

Published

Issue

Section

License

How to Cite

Funding data

Language