Effective suckling in relation to naked maternal-infant body contact in the first hour of life: an observation study

Abstract

BackgroundBest practice guidelines to promote breastfeeding suggest that (i) mothers hold their babies in naked body contact immediately after birth, (ii) babies remain undisturbed for at least one hour and (iii) breastfeeding assistance be offered during this period. Few studies have closely observed the implementation of these guidelines in practice. We sought to evaluate these practices on suckling achievement within the first hour after birth.MethodsObservations of seventy-eight mother-baby dyads recorded newborn feeding behaviours, the help received by mothers and birthing room practices each minute, for sixty minutes.ResultsDuration of naked body contact between mothers and their newborn babies varied widely from 1 to 60 minutes, as did commencement of suckling (range = 10 to 60 minutes). Naked maternal-infant body contact immediately after birth, uninterrupted for at least thirty minutes did not predict effective suckling within the first hour of birth. Newborns were four times more likely to sustain deep rhythmical suckling when their chin made contact with their mother’s breast as they approached the nipple (OR 3.8; CI 1.03 - 14) and if their mothers had given birth previously (OR 6.7; CI 1.35 - 33). Infants who had any naso-oropharyngeal suctioning administered at birth were six times less likely to suckle effectively (OR .176; CI .04 - .9).ConclusionEffective suckling within the first hour of life was associated with a collection of practices including infants positioned so their chin can instinctively nudge the underside of their mother’s breast as they approach to grasp the nipple and attach to suckle. The best type of assistance provided in the birthing room that enables newborns to sustain an effective latch was paying attention to newborn feeding behaviours and not administering naso-oropharyngeal suction routinely.

An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth

“…Robson's criteria applied to the Japanese data set mothers indicates that, of the five mothers in this category, three are primiparas who were not induced and did not have exposure to epidural, one is a multipara who was not induced and did not have exposure to epidural, and one was a multipara who was induced but did not have exposure to epidural. (Cantrill, Creedy, Cooke, & Dykes, 2014). One speculation is that the use of iodine during the birthing process, which has a strong and distinct odour, may be interfering with the instinctive behaviour of the newborn to smell the amniotic fluid and the colostrum/Montgomery gland scents as a directive to the breast (Porter, 2004;Porter & Winberg, 1999).…”

“…The algorithm highlighted an area of research that could be proving a barrier to the otherwise implemented advantages of immediate, continuous, uninterrupted SSC. For example, infants who had naso‐oropharyngeal suctioning at birth were six times less likely to suckle effectively during the first hour after birth (Cantrill, Creedy, Cooke, & Dykes, ). One speculation is that the use of iodine during the birthing process, which has a strong and distinct odour, may be interfering with the instinctive behaviour of the newborn to smell the amniotic fluid and the colostrum/Montgomery gland scents as a directive to the breast (Porter, ; Porter & Winberg, ).…”

Effect of early maternal/newborn skin-to-skin contact after birth on the duration of third stage of labor and initiation of breastfeeding

“…The advantages of this method immediately following birth are many: first it makes the infant's transition to extrauterine life much easier; it improves mother's ability to care for her child; it shortens the time takes to deliver placenta; it reduces stress of mother and newborn; it has a long term positive impact on attachment behaviors. [18,19] In addition: it regulates heartbeat, body temperature and breathing of the newborn; shortens interval between delivery, and initiation of breastfeeding; calms sleep; elongates breastfeeding period and enhances success of continued breastfeeding. [20,21] Public agencies, NGOs, UNICEF and WHO recommend that breast feeding should begin in the first hour after giving birth and advocate it as the only feeding method for the first 6 months of life.…”

Contato pele a pele entre mãe e recém-nascido e amamentação na primeira hora de vida

“…Aproximadamente 68% dos RN começaram a sugar na primeira hora após nascer, sendo 38 ± 14,5 minutos o tempo médio de vida deles ao iniciar a sucção, com mediana de 37 minutos (mín: 24,5; máx: 31) 2 . Tais resultados estão próximos dos encontrados neste estudo, em que 58 RN (52%) sugaram ao seio, apresentando tempo de vida médio de 29±11 minutos ao iniciar a mamada e mediana de 27 minutos (mín: 15; máx: 45) 2 .…”

“…O contato pele a pele (CPP) consiste na colocação do RN despido no colo também despido de sua mãe 1,2 . Estudos demonstram que recém-nascidos (RN) em boas condições de vitalidade ao nascer, quando colocados imediatamente no colo materno, têm uma melhor transição da vida fetal para o meio extrauterino.…”