Early Skin-to-Skin Contact and Breast-Feeding Behavior in Term Neonates: A Randomized Controlled Trial

Aim: To evaluate if early skin-to-skin contact (SSC) improves breast-feeding (BF) behavior and exclusive BF (EBF) rates in term infants at 48 h of age. Methods: Term infants born by normal delivery were randomized at birth to either early SSC (n = 20) or conventional care (controls; n = 21). SSC was continued for at least 2 h after birth. Subsequently, one BF session of the infants was video recorded at about 48 h of life. The primary outcome, infants’ BF behavior at 48 h of life, was assessed using the modified infant Breast-Feeding Assessment Tool (BAT; a score consisting of infant’s readiness to feed, sucking, rooting and latching, each item scored from 0 to 3) by three independent masked observers. The secondary outcomes were EBF rates at 48 h and 6 weeks of age and salivary cortisol level of infants at 6 h of age. Results: Baseline characteristics including birth weight and gestation were comparable between the two groups. There was no significant difference in the BAT scores between the groups [median: 8, interquartile range (IQR) 5–10 vs. median 9, IQR 5–10; p = 0.6]. EBF rates at 48 h and at 6 weeks were, however, significantly higher in the early-SSC group than in the control group [95.0 vs. 38.1%; relative risk (RR): 2.5, 95% confidence interval (95% CI): 1.4–4.3 and 90 vs. 28.6%; RR: 3.2, 95% CI: 1.6–6.3]. Interpretation: Early SSC did not improve BF behavior at discharge but significantly improved the EBF rates of term neonates.