Objective: 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. Method: 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). Results: 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). Conclusion: 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).

Objective: To compare the efficacy of Kangaroo care (skin-to-skin contact with mother) with standard care (next to the mother in a cot) for premature, low birth weight and babies of diabetic mothers in a transitional care ward setting. Method: This was a cohort study undertaken in a transitional care/postnatal ward of a UK district general hospital. The study involved 214 babies (107 in the study group, 107 in the control group) with a gestation 34-36+6 weeks, small for gestational age and babies of diabetic mothers. Babies in the study group had Kangaroo care following birth up to 6 weeks of age. Control group had standard care (in the cot next to the mother). The main outcome measure was the length of hospital stay. The secondary outcome measures were breastfeeding at discharge from hospital and at 6 weeks, admission to neonatal intensive care unit (NICU) and parent satisfaction. Results: There was a significant reduction in mean length of stay (4.33 vs. 5.01 days, P = 0.017, 95% CI 3.93-4.73 and 4.58-5.44) in the study group compared to the control. There was also an increase in exclusive breastfeeding rates on discharge from hospital in the study group (72% vs. 55% P = 0.01, OR 2.09, 95% CI 1.18-3.69). There were no differences in feeding outcomes at 6 weeks, or in admission to NICU. Conclusions: Kangaroo care is a simple intervention that reduces length of hospital stay and improves breastfeeding rates on discharge from hospital for babies cared for in a transitional care/postnatal ward setting. Parents rate Kangaroo care highly, especially in the first 2 weeks following birth.

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