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Schlesinger E, Hatiel K, Hod N, Shinwell ES. Longer skin-to-skin contact after birth enhances breastfeeding quality and duration: A cohort study. Acta Paediatr 2024. [PMID: 39180237 DOI: 10.1111/apa.17388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/26/2024]
Abstract
AIM Skin-to-skin contact (SSC) immediately after birth may improve breastfeeding outcomes. This study explored the effect of the duration of SSC in the delivery room on breastfeeding quality and duration. METHODS In this prospective observational cohort study, mother-infant pairs practising SSC were categorised into two groups based on SSC duration (≤45 or >45 min). Outcomes included breastfeeding quality in the delivery room and at 24 h of age assessed by the Infant-Breastfeeding Assessment Tool (IBFAT) score, and long-term breastfeeding duration up to 6 months while accounting for potential confounding variables. RESULTS The study included 72 mother-infant pairs. SSC for more than 45 min was significantly correlated with longer immediate breastfeeding (65 vs. 19 min, p < 0.001) and higher breastfeeding quality scores immediately after birth (IBFAT score of 10 vs. 7, p < 0.001). Regarding the long-term effect, infants in the extended SSC group were breastfed longer (5.2 vs. 3.7 months, p = 0.005) and had exclusive breastfeeding (4.7 vs. 2.7 months, p > 0.001). No significant confounding variables were identified. CONCLUSION Extended SSC (>45 min) correlated with prolonged, higher-quality breastfeeding after birth and longer successful breastfeeding.
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Affiliation(s)
| | - Keren Hatiel
- Department of Neonatology, Ziv Medical Center, Safed, Israel
- Department of Obstetrics, Ziv Medical Center, Safed, Israel
| | - Neomi Hod
- Department of Neonatology, Ziv Medical Center, Safed, Israel
- Department of Obstetrics, Ziv Medical Center, Safed, Israel
| | - Eric S Shinwell
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
- Department of Neonatology, Ziv Medical Center, Safed, Israel
- Department of Obstetrics, Ziv Medical Center, Safed, Israel
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Lazarus MF, Marchman VA, Brignoni-Pérez E, Dubner S, Feldman HM, Scala M, Travis KE. Inpatient Skin-to-skin Care Predicts 12-Month Neurodevelopmental Outcomes in Very Preterm Infants. J Pediatr 2024; 274:114190. [PMID: 39004169 DOI: 10.1016/j.jpeds.2024.114190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/24/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To examine the relationship between inpatient skin-to-skin care rates and neurodevelopmental scores measured at 12 months in very preterm (VPT) infants. STUDY DESIGN From a retrospective review of medical records of 181 VPT infants (<32 weeks gestational age [GA] at birth), we derived skin-to-skin care rate, ie, total minutes of skin-to-skin care each infant received over the number of days of hospital stay. We used scores on the Capute Scales from routine follow-up assessments at 12 months to measure neurodevelopmental outcomes. RESULTS Families averaged approximately 17 minutes/day of skin-to-skin care (2 days/week, 70 minutes/session), although there was substantial variability. Variation in skin-to-skin rate was positively associated with outcomes at 12 months corrected age (r = 0.25, P < .001). Skin-to-skin rate significantly predicted 6.2% unique variance in 12-month neurodevelopmental outcomes, after adjusting for GA, socioeconomic status (SES), health acuity, and visitation frequency. A 20-minute increase in skin-to-skin care per day was associated with a 10-point increase (0.67 SDs) in neurodevelopmental outcomes at 12 months. GA and infant health acuity did not moderate these relations. CONCLUSION VPT infants who experienced more skin-to-skin care during hospitalization demonstrated higher scores on 12-month neurodevelopmental assessments. Results provide evidence that skin-to-skin care confers extended benefits to VPT infants through the first year of life. Skin-to-skin care offers promise as a family-centered intervention designed to promote positive developmental outcomes in at-risk infants.
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Affiliation(s)
- Molly F Lazarus
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA; Department of Pediatrics, Burke-Cornell Medical Research Institute, Weill Medical College, Cornell University, New York, NY
| | - Virginia A Marchman
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA; Department of Psychology, Stanford University, Stanford, CA
| | - Edith Brignoni-Pérez
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA; Department of Psychiatry, Stanford University, Stanford, CA
| | - Sarah Dubner
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA
| | - Heidi M Feldman
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA
| | - Melissa Scala
- Division of Neonatology, Department of Pediatrics, Stanford University, Stanford, CA
| | - Katherine E Travis
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA; Department of Pediatrics, Burke-Cornell Medical Research Institute, Weill Medical College, Cornell University, New York, NY.
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Packheiser J, Hartmann H, Fredriksen K, Gazzola V, Keysers C, Michon F. A systematic review and multivariate meta-analysis of the physical and mental health benefits of touch interventions. Nat Hum Behav 2024; 8:1088-1107. [PMID: 38589702 PMCID: PMC11199149 DOI: 10.1038/s41562-024-01841-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/29/2024] [Indexed: 04/10/2024]
Abstract
Receiving touch is of critical importance, as many studies have shown that touch promotes mental and physical well-being. We conducted a pre-registered (PROSPERO: CRD42022304281) systematic review and multilevel meta-analysis encompassing 137 studies in the meta-analysis and 75 additional studies in the systematic review (n = 12,966 individuals, search via Google Scholar, PubMed and Web of Science until 1 October 2022) to identify critical factors moderating touch intervention efficacy. Included studies always featured a touch versus no touch control intervention with diverse health outcomes as dependent variables. Risk of bias was assessed via small study, randomization, sequencing, performance and attrition bias. Touch interventions were especially effective in regulating cortisol levels (Hedges' g = 0.78, 95% confidence interval (CI) 0.24 to 1.31) and increasing weight (0.65, 95% CI 0.37 to 0.94) in newborns as well as in reducing pain (0.69, 95% CI 0.48 to 0.89), feelings of depression (0.59, 95% CI 0.40 to 0.78) and state (0.64, 95% CI 0.44 to 0.84) or trait anxiety (0.59, 95% CI 0.40 to 0.77) for adults. Comparing touch interventions involving objects or robots resulted in similar physical (0.56, 95% CI 0.24 to 0.88 versus 0.51, 95% CI 0.38 to 0.64) but lower mental health benefits (0.34, 95% CI 0.19 to 0.49 versus 0.58, 95% CI 0.43 to 0.73). Adult clinical cohorts profited more strongly in mental health domains compared with healthy individuals (0.63, 95% CI 0.46 to 0.80 versus 0.37, 95% CI 0.20 to 0.55). We found no difference in health benefits in adults when comparing touch applied by a familiar person or a health care professional (0.51, 95% CI 0.29 to 0.73 versus 0.50, 95% CI 0.38 to 0.61), but parental touch was more beneficial in newborns (0.69, 95% CI 0.50 to 0.88 versus 0.39, 95% CI 0.18 to 0.61). Small but significant small study bias and the impossibility to blind experimental conditions need to be considered. Leveraging factors that influence touch intervention efficacy will help maximize the benefits of future interventions and focus research in this field.
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Affiliation(s)
- Julian Packheiser
- Social Neuroscience, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany.
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands.
| | - Helena Hartmann
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
- Center for Translational and Behavioral Neuroscience, University Hospital Essen, Essen, Germany
- Clinical Neurosciences, Department for Neurology, University Hospital Essen, Essen, Germany
| | - Kelly Fredriksen
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
| | - Valeria Gazzola
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
| | - Christian Keysers
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
| | - Frédéric Michon
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
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Ramaiah R, Jothishanmugam A, Alshahrani SH, Innocent Rani V, Alshahrani BY, Rajagopal Sambasivan L, Xavier Dhas J. Kangaroo Mother Care Induced Serum Oxytocin Facilitates Prolactin and IL-10 Among Emergency Cesarean Mothers. J Multidiscip Healthc 2024; 17:2689-2699. [PMID: 38840703 PMCID: PMC11152167 DOI: 10.2147/jmdh.s444172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/18/2024] [Indexed: 06/07/2024] Open
Abstract
Background The rate of cesarean section is increasing from 15% to 40% in recent years. The type of delivery influences the hormonal, emotional and mental health of the mother, which correlates positively or negatively with the health benefits of the newborn. There have been many published studies on kangaroo mother care for mothers undergoing elective cesarean section, but there is still a lack of understanding about emergency cesarean section. Objective This study aimed to evaluate the benefits of KMC practice for mothers undergoing emergency cesarean section in terms of hormone levels such as oxytocin, cortisol, prolactin, interleukin-6 and interleukin-10. Methods This retrospective analysis used remnant serum (KMC group = 16; control group = 9), and clinical data such as KMC practice (15-30 minutes three or four times daily until discharge), breastfeeding initiation time, feeding time, crying time and hospital stay were extracted from the electronic database. All hormone and cytokine expressions were quantitatively determined by ELISA. Comparisons within and between groups were performed using appropriate statistical tests. Results In the KMC group, increased levels of the hormone oxytocin significantly reduced cortisol and IL-6 and negatively influenced prolactin and IL-10 levels. The elevated prolactin facilitates overall lactation behaviour, of which 64% reported breastfeeding directly at the breast. The cytokine analysis revealed a reduction in pro-inflammatory cytokines and thereby an improved wound healing was seen in the KMC group. Conclusion These quantitative results strongly encourage the use of KMC for mothers undergoing emergency cesarean section. These simple yet effective breastfeeding strategies promote maternal and infant health, which can reduce medication use.
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Affiliation(s)
- Ramasubbamma Ramaiah
- Medical and Surgical Department, College of Nursing, King Khalid University Abha, Khamis Mushait, Asir, Saudi Arabia
| | - Aruna Jothishanmugam
- Department of Nursing, University College at Aldair, Jazan University, Jazan, Saudi Arabia
| | - Shadia Hamoud Alshahrani
- Medical and Surgical Department, College of Nursing, King Khalid University Abha, Khamis Mushait, Asir, Saudi Arabia
| | - Vanitha Innocent Rani
- Psychiatric Nursing Department, Nursing College Mahayil, King Khalid University, Mahayil, Asir, Saudi Arabia
| | - Bader Yahya Alshahrani
- Supplies Warehouse Department, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | - Logapriya Rajagopal Sambasivan
- Biochemistry Department, Government Medical College, Thiruvallur, The TN Dr.MGR Medical University, Thiruvallur, TN, India
| | - Justin Xavier Dhas
- Artificial Intelligence and Data Science Department, Velammal Institute of Technology, Viraganur, Anna University, TN, India
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Díaz-Ogallar MA, Hernández-Martínez A, Linares-Abad M, Martínez-Galiano JM. Development of a Predictive Model for Skin-to-Skin Contact Immediately after Birth: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:577. [PMID: 38790572 PMCID: PMC11120315 DOI: 10.3390/children11050577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
The aim of this study was to develop and validate a predictive model for the establishment of skin-to-skin contact immediately after birth. A descriptive cross-sectional study was conducted during the last trimester of 2022 and the first trimester of 2023 with women who had given birth in Spain. A questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn, as well as the Bond and Attachment questionnaire (VAMF, for its name in Spanish) for the analysis of the mother-child bond and attachment, were administered. A multivariate analysis was performed, and areas under the ROC curve (AUC) with their 95% confidence intervals (CI) and the predictive characteristics of these models were estimated. In total, 1077 women participated. The prevalence of early skin-to-skin contact after delivery was 50.2% (468) in the derivation cohort and 49.8% (464) in the validation cohort. Multivariate analysis showed that prematurity, type of delivery, and birth experience were statistically significant, so they were included in the model (p ≤ 0.05). The predictive ability (AUC ROC) was good in both the derivation cohort, yielding 0.92 (95% CI: 0.89-0.95), and in the validation cohort, yielding 0.89 (95% CI: 0.85-0.93). This study developed a predictive model identifying factors facilitating early skin-to-skin contact between a mother and her newborn immediately after birth.
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Affiliation(s)
- María Antonia Díaz-Ogallar
- San Agustin Hospital, Andalusian Health Service, 23700 Linares, Spain;
- Nursing Department, University of Jaen, 23071 Jaen, Spain;
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | | | - Juan Miguel Martínez-Galiano
- Nursing Department, University of Jaen, 23071 Jaen, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Nitzan I, Philips R, White RD. Screening Recommendations and Treatments for Postpartum Depression. JAMA 2024; 331:1153-1154. [PMID: 38563841 DOI: 10.1001/jama.2024.1631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Itamar Nitzan
- Shaare Zedek Medical Center, Hebrew University School of Medicine, Jerusalem, Israel
| | - Raylene Philips
- Loma Linda University Children's Hospital, Loma Linda University School of Medicine, Loma Linda, California
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Ismail A, Mahdi A, Al-Nuaimi KM. Parents' Perception and Use of Skin-to-Skin Care in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e56734. [PMID: 38646219 PMCID: PMC11033043 DOI: 10.7759/cureus.56734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Skin-to-skin care (SSC) between newborns and their parents provides many positive outcomes for both newborns and their parents. However, there is a lack of research assessing the perception of parents, especially fathers, of SSC in Saudi Arabia. PURPOSE The aim of the study is to assess parents' perception of SSC in Saudi Arabia. METHODS This cross-sectional study used an online survey. Data were collected from a convenience sample of 140 parents of hospitalized neonates between January and June 2023. Data were collected from one private hospital (Dr. Soliman Fakeeh Hospital) and one public hospital (King Abdulla Medical Complex) in Jeddah, Saudi Arabia. The parents' perceptions of SSC were assessed using the Parents' Perceptions of SSC tool. An independent t-test was used to compare mothers and fathers in their perceptions of SSC. RESULTS One hundred and forty parents completed the online survey (70 females and 70 males). The majority of the parents did not use SSC with their babies (n=102, 73%), did not read or hear about the use and benefits of skin-to-skin care (n=100, 71%), and did not receive information or training on SSC from healthcare professionals (n=112, 80%). Mothers' perception of SSC was significantly higher than that of fathers (p ≤ 0.05). CONCLUSION Fathers' perception of SSC was lower than that of mothers. Awareness and training programs are needed to inform parents, especially fathers, regarding SSC and its benefits in Saudi Arabia.
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Affiliation(s)
- Ahmad Ismail
- Nursing, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Amnah Mahdi
- Nursing, Fakeeh College for Medical Sciences, Jeddah, SAU
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Costello S, Santillan D, Shelby A, Bowdler N. Skin-to-Skin Contact and Breastfeeding After Planned Cesarean Birth Before and During the COVID-19 Pandemic. Breastfeed Med 2024; 19:166-176. [PMID: 38416483 PMCID: PMC10951620 DOI: 10.1089/bfm.2023.0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Background: Benefits of early skin-to-skin contact (SSC) between mother and newborn are widely documented, including improved breastfeeding outcomes. While promoting immediate SSC is standard practice for vaginal birth, it happens less often after cesarean birth. It is not known how changes in hospital practices and staffing shortages during the COVID-19 pandemic have influenced the practice of SSC in the operating room (OR). This study aims to identify the relationship between SSC after cesarean birth and breastfeeding and compare SSC before and during the COVID-19 pandemic at a single institution. Materials and Methods: This was a retrospective cohort study of 244 subjects who had scheduled cesarean births during 2019 and 2020. The primary outcome was newborn feeding at hospital discharge. Secondary outcomes were time to initiate breastfeeding, newborn feeding at 4-8-weeks postpartum, and location of SSC initiation in 2019 versus 2020. Results: SSC within 3 days of birth was significantly associated with feeding type on discharge and/or 4-8 weeks postpartum. More subjects intending to exclusively breastfeed met this intention at discharge with SSC in the OR. Newborns who had SSC in the OR had significantly earlier initiation of breastfeeding. There was an increase in SSC in the OR between 2019 (27%) and 2020 (39%). Conclusion: SSC in the OR was associated with improved short-term breastfeeding outcomes in our study. If immediate SSC is not possible, SSC within 3 days of birth may have breastfeeding benefits. The increase in SSC in the OR during the COVID-19 pandemic indicates that SSC practices can be implemented, despite challenging circumstances.
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Affiliation(s)
- Sarah Costello
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Donna Santillan
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Alyssa Shelby
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Noelle Bowdler
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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Li X, Li Y, Qian L, Han P, Feng H, Jiang H. Mothers' experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence. BMC Pregnancy Childbirth 2024; 24:124. [PMID: 38341542 PMCID: PMC10858471 DOI: 10.1186/s12884-024-06323-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/06/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Mother-infant separation, which is occurring with an increasing incidence, is a barrier to direct breastfeeding. Owing to the importance of breast milk to hospitalized infants, mothers are actively encouraged to express milk during their infants' neonatal intensive care unit (NICU) stay. However, mothers are often faced with a number of challenges in this process. There is a need to understand such mothers' real-life experiences of breast milk expression to develop supportive strategies to reduce the burden on mothers and increase breastfeeding rates. METHODS A comprehensive search of 12 databases was conducted for relevant studies published from database construction to December 2022. All qualitative and mixed-method studies published in English and Chinese that reported on mothers' experiences of human milk expression during separation from their hospitalized infants were included. Two reviewers independently conducted screening, data extraction, and quality appraisal, with disagreements resolved by a third reviewer. The process of searching followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The JBI Qualitative Assessment and Review Instrument was used to assess study quality and the credibility of study findings. Meta-aggregation was performed to integrate the results. RESULTS This systematic review aggregated mothers' experiences of milk expression during separation from their hospitalized infants. Database search yielded 600 records, of which 19 full-text documents were screened. Finally, 13 studies of good quality were included with data from 332 mothers across seven countries. A total of 61 primary findings with illustrations were extracted from the 13 eligible studies, the findings were generalized into 16 categories, and further were concluded as four synthesized findings: purpose and motivation, physical and emotional experiences, barrier factors, and coping styles. CONCLUSION Mothers were driven by extrinsic motivation in their decision to express breast milk. They experienced physical exhaustion and many negative emotional feelings while expressing. This process was affected by numerous barriers. Social support was essential to the initiation and maintenance of milk expression. Medical staff and families should pay more attention to the mental health of mothers with infants in the NICU. Future research should incorporate strategies to cope with emotional responses and offer practical strategies for managing milk expression. SYSTEMATIC REVIEW REGISTRATION [ www.crd.york.ac.uk ], identifier [PROSPERO 2022 CRD42022383080].
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Affiliation(s)
- Xuemei Li
- Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Yongqi Li
- School of Nursing, Naval Medical University, Shanghai, 200433, China
| | - Lin Qian
- Nursing Department, Shanghai East Hospital, Tongji University, Shanghai, 200120, China
| | - Peng Han
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Haoxue Feng
- Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Hui Jiang
- Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China.
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Eckermann HA, Meijer J, Cooijmans K, Lahti L, de Weerth C. Daily skin-to-skin contact alters microbiota development in healthy full-term infants. Gut Microbes 2024; 16:2295403. [PMID: 38197254 PMCID: PMC10793693 DOI: 10.1080/19490976.2023.2295403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
The gut microbiota is vital for human body development and function. Its development in early life is influenced by various environmental factors. In this randomized controlled trial, the gut microbiota was obtained as a secondary outcome measure in a study on the effects of one hour of daily skin-to-skin contact (SSC) for five weeks in healthy full-term infants. Specifically, we studied the effects on alpha/beta diversity, volatility, microbiota maturation, and bacterial and gut-brain-axis-related functional abundances in microbiota assessed thrice in the first year. Pregnant Dutch women (n = 116) were randomly assigned to the SSC or care-as-usual groups. The SSC group participants engaged in one hour of daily SSC from birth to five weeks of age. Stool samples were collected at two, five, and 52 weeks and the V4 region was sequenced. We observed significant differences in the microbiota composition, bacterial abundances, and predicted functional pathways between the groups. The SSC group exhibited lower microbiota volatility during early infancy. Microbiota maturation was slower in the SSC group during the first year and our results suggested that breastfeeding duration may have partially mediated this relation. Our findings provide evidence that postpartum SSC may influence microbiota development. Replication is necessary to validate and generalize these results. Future studies should include direct stress measurements and extend microbiota sampling beyond the first year to investigate stress as a mechanism and research SSC's impact on long-term microbiota maturation trajectories.
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Affiliation(s)
- Henrik Andreas Eckermann
- Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, The Netherlands
| | - Jennifer Meijer
- Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, The Netherlands
| | - Kelly Cooijmans
- Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Leo Lahti
- Department of Computing, University of Turku, Turku, Finland
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Radboud university medical center, Nijmegen, The Netherlands
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11
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Wigglesworth H, Huddy V, Knowles R, Millings A. Evaluating the impact of sling provision and training upon maternal mental health, wellbeing and parenting: A randomised feasibility trial. PLoS One 2023; 18:e0293501. [PMID: 37948400 PMCID: PMC10637655 DOI: 10.1371/journal.pone.0293501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Close body contact interventions such as Kangaroo Mother Care have been shown to improve maternal mental health following birth. Infant carriers ('slings') facilitate hands-free close body contact. No studies have specifically examined whether sling use improves maternal mental health. A full-scale efficacy study is needed to examine whether sling use is beneficial to maternal mental health. The current study is a feasibility study designed to gather information to support the design of a future RCT, such as acceptability and study parameters, including recruitment rates, consent rate and attrition. METHOD Mothers of infants aged 0-6 weeks were randomised to one of two conditions: intervention (n = 35) vs. waitlist control (n = 32). Intervention participants received sling training, support, and free sling hire for 12 weeks. Participants completed self-report measures of mood, wellbeing and parenting at baseline (Time 1), and 6- (Time 2) and 12- (Time 3) weeks post-baseline. RESULTS Eligibility and consent rates met feasibility objectives, though there were some difficulties with retention of participants in the study. Preliminary effectiveness analyses showed a non-significant improvement with a small effect size in postnatal depression from T1 to T3, and a significant improvement with a medium effect size in maternal self-efficacy from T1 to T3. Qualitative feedback indicated acceptability of the intervention and study participation. Intervention participants attributed greater autonomy, bonding with their baby, and parental self-confidence, to the intervention. CONCLUSIONS These findings indicate a randomised study of the impact of a sling and related support intervention upon maternal mental health is feasible. These findings should be interpreted within the context of sampling bias (due to the use of volunteer sampling methods), an absence of feedback from those who discontinued participation in the study, and the study not being adequately powered. TRIAL REGISTRATION Registration number ISRCTN88575352.
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Affiliation(s)
| | - Vyv Huddy
- Clinical Psychology Unit, University of Sheffield, Sheffield, United Kingdom
| | - Rosie Knowles
- Sheffield Sling Surgery and Library, Carrying Matters, Sheffield, United Kingdom
| | - Abigail Millings
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, United Kingdom
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12
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Chávez-Tostado M, Chávez-Tostado KV, Cervantes-Guevara G, Cervantes-Cardona G, Hernandez-Corona DM, González-Heredia T, Méndez-Del Villar M, Corona-Meraz FI, Guzmán-Ornelas MO, Barbosa-Camacho FJ, Álvarez-Villaseñor AS, Cervantes-Pérez E, Fuentes-Orozco C, Barrera-López NG, López-Bernal NE, González-Ojeda A. Breastfeeding Practices and Postpartum Depression in Mexican Women during the COVID-19 Pandemic: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1330. [PMID: 37512141 PMCID: PMC10385480 DOI: 10.3390/medicina59071330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Background: Breastfeeding is a characteristic process of mammals that ensures delivery of an adequate nutritional supply to infants. It is the gold standard food source during an infant's first months of life. Since the onset of the COVID-19 pandemic in 2020, people in quarantine have experienced a wide range of feelings, which may make isolation challenging in terms of maternal health. This study focused on the prevalence of breastfeeding practices and postpartum depression (PPD) among Mexican women during the COVID-19 pandemic. Materials and Methods: This cross-sectional study included 586 postpartum women who completed an online survey 4-8 weeks after delivery from April to December 2020 in Guadalajara, Mexico. The aim was to identify potentially depressed mothers according to the Edinburgh Postnatal Depression Scale (EPDS) and describe their breastfeeding practices. Results: The mean maternal age was 30.4 ± 4.6 years, the mean EPDS score was 9.6 ± 5.0, and the PPD prevalence according EPDS scores was 27.1%. Exclusive breastfeeding (EBF) was reported by 32.3% of mothers in the first 48 h and by 70.3% of mothers 48 h after delivery. EBF was associated with a lower prevalence of PPD during the first 48 h (p = 0.015) and after the first 48 h (p = 0.001) after delivery. Skin-to-skin contact (SSC) was reported by 385 (65.7%) mothers. PPD was less frequent in mothers practicing SSC (20.3%) than it was in those not practicing SSC (40.3%) (p = 0.001). A higher percentage of mothers practiced SSC breastfed (66.9%) and used EBF (150, 79.4%) (p = 0.012 and 0.001, respectively). Conclusions: Results suggest that the pandemic emergency and restrictions imposed on the population significantly affected the well-being of mothers after birth, and that these effects may have posed risks to the mental health and emotional stability of postpartum mothers. Therefore, encouraging BF or EBF and SSC may improve or limit depressive symptoms in postpartum mothers.
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Affiliation(s)
- Mariana Chávez-Tostado
- Departamento de Reproducción, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44410, Mexico
| | | | - Gabino Cervantes-Guevara
- Departamento de Bienestar y Desarrollo Sustentable, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán 46200, Mexico
| | - Guillermo Cervantes-Cardona
- Departamento de Disciplinas Filosóficas, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44410, Mexico
| | - Diana Mercedes Hernandez-Corona
- Departamento de Ciencias Biomédicas, División de Ciencias de la Salud, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá 45425, Mexico
| | - Tonatiuh González-Heredia
- Departamento de Ciencias Biomédicas, División de Ciencias de la Salud, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá 45425, Mexico
| | - Miriam Méndez-Del Villar
- Departamento de Ciencias Biomédicas, División de Ciencias de la Salud, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá 45425, Mexico
| | - Fernanda Isadora Corona-Meraz
- Departamento de Ciencias Biomédicas, División de Ciencias de la Salud, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá 45425, Mexico
| | - Milton Omar Guzmán-Ornelas
- Departamento de Ciencias Biomédicas, División de Ciencias de la Salud, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá 45425, Mexico
| | | | | | - Enrique Cervantes-Pérez
- Departamento de Medicina Interna, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Clotilde Fuentes-Orozco
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico
| | - Natalia Guadalupe Barrera-López
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico
| | - Noelia Esthela López-Bernal
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico
| | - Alejandro González-Ojeda
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico
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Ulmer-Yaniv A, Yirmiya K, Peleg I, Zagoory-Sharon O, Feldman R. Developmental Cascades Link Maternal-Newborn Skin-to-Skin Contact with Young Adults' Psychological Symptoms, Oxytocin, and Immunity; Charting Mechanisms of Developmental Continuity from Birth to Adulthood. BIOLOGY 2023; 12:847. [PMID: 37372132 DOI: 10.3390/biology12060847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/04/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
Premature birth disrupts the continuity of maternal-newborn bodily contact, which underpins the development of physiological and behavioral support systems. Utilizing a unique cohort of mother-preterm dyads who received skin-to-skin contact (Kangaroo Care, KC) versus controls, and following them to adulthood, we examined how a touch-based neonatal intervention impacts three adult outcomes; anxiety/depressive symptoms, oxytocin, and secretory immunoglobulin A (s-IgA), a biomarker of the immune system. Consistent with dynamic systems' theory, we found that links from KC to adult outcomes were indirect, mediated by its effects on maternal mood, child attention and executive functions, and mother-child synchrony across development. These improvements shaped adult outcomes via three mechanisms; (a) "sensitive periods", where the infancy improvement directly links with an outcome, for instance, infant attention linked with higher oxytocin and lower s-IgA; (b) "step-by-step continuity", where the infancy improvement triggers iterative changes across development, gradually shaping an outcome; for instance, mother-infant synchrony was stable across development and predicted lower anxiety/depressive symptoms; and (c) "inclusive mutual-influences", describing cross-time associations between maternal, child, and dyadic factors; for instance, from maternal mood to child executive functions and back. Findings highlight the long-term impact of a birth intervention across development and provide valuable insights on the mechanisms of "developmental continuity", among the key topics in developmental research.
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Affiliation(s)
- Adi Ulmer-Yaniv
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Karen Yirmiya
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Itai Peleg
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Orna Zagoory-Sharon
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Ruth Feldman
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
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14
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Ball MK, Seabrook RB, Corbitt R, Stiver C, Nardell K, Medoro AK, Beer L, Brown A, Mollica J, Bapat R, Cosgrove T, Texter KT. Safety and Feasibility of Skin-to-Skin Contact in the Delivery Room for High-Risk Cardiac Neonates. Pediatr Cardiol 2023; 44:1023-1031. [PMID: 36971793 PMCID: PMC10040310 DOI: 10.1007/s00246-023-03149-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/12/2023] [Indexed: 03/28/2023]
Abstract
Early skin-to-skin contact (SSC), beginning in the delivery room, provides myriad health benefits for mother and baby. Early SSC in the delivery room is the standard of care for healthy neonates following both vaginal and cesarean delivery. However, there is little published evidence on the safety of this practice in infants with congenital anomalies requiring immediate postnatal evaluation, including critical congenital heart disease (CCHD). Currently, the standard practice following delivery of infants with CCHD in many delivery centers has been immediate separation of mother and baby for neonatal stabilization and transfer to a different hospital unit or a different hospital altogether. However, most neonates with prenatally diagnosed congenital heart disease, even those with ductal-dependent lesions, are clinically stable in the immediate newborn period. Therefore, we sought to increase the percentage of newborns with prenatally diagnosed CCHD who are born in our regional level II-III delivery hospitals who receive mother-baby SSC in the delivery room. Using quality improvement methodology, through a series of Plan-Do-Study-Act cycles we successfully increased mother-baby skin-to-skin contact in the delivery room for eligible cardiac patients born across our city-wide delivery hospitals from a baseline 15% to greater than 50%.
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Affiliation(s)
- Molly K Ball
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA.
| | - R B Seabrook
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - R Corbitt
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - C Stiver
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - K Nardell
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - A K Medoro
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
| | - L Beer
- Pediatrix Medical Group, Columbus, OH, USA
| | - A Brown
- Phoenix Children's Medical Group, Neonatology, Phoenix, AZ, USA
| | - J Mollica
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - R Bapat
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
| | - T Cosgrove
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - K T Texter
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
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15
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Liu H, Li J, Li X, Lu H. Dysphoric Milk Ejection Reflex: Report of Two Cases and Postulated Mechanisms and Treatment. Breastfeed Med 2023; 18:388-394. [PMID: 37022738 DOI: 10.1089/bfm.2022.0206] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Background: The symptoms of Dysphoric Milk Ejection Reflex (D-MER) occur just before milk release, last no more than a few minutes, and then subside spontaneously, which are characterized by a sudden and transient feeling of dysphoria, depression, sadness, or other negative emotions. These emotions may adversely affect the mother's lactation behavior and mental health, negatively influence the mother-child relationship, and even result in self-harm or suicidal tendencies in lactating women. Case Presentation: We reported two cases of breastfeeding mothers with D-MER who experienced unpleasant emotions during lactation. Severely affected by D-MER symptoms, the mother in the first case chose to wean prematurely after struggling for 6 months, and her symptoms disappeared after weaning. With the help of professional guidance, the mother with D-MER in the second case actively adjusted and persisted in breastfeeding until her daughter was 18 months old, after that her symptoms vanished. Discussion: Awareness and knowledge of D-MER are insufficient among the public and health care professionals. D-MER is not a psychological disorder but a physiological issue caused by hormones, which is different from postpartum depression. The severity of D-MER symptoms can be evaluated by the assessment tool of the D-MER spectrum. Lactating women can relieve their symptoms through self-regulation, lifestyle changes, and professional guidance and treatments. Conclusions: The two cases studies about Chinese women with D-MER will enrich the knowledge of D-MER, and it might suggest some directions to health care workers for exploring scientific guidance and treatments for lactating women. Because the literature and published empirical studies about D-MER are scarce, further researches on the theory and interventions of D-MER are necessary.
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Affiliation(s)
- Huan Liu
- Department of Nursing, Xi'an Jiaotong University City College, Xi'an, Shaanxi, China
| | - Jin Li
- Department of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaomei Li
- Department of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huapeng Lu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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16
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Skoog CM, Katzer JF, Wendt LH, Ituk U. The Association of Anesthesia Type and Neonatal Outcomes Following Category-1 Cesarean Delivery: A Retrospective Cohort Study. Cureus 2023; 15:e35910. [PMID: 37033505 PMCID: PMC10081886 DOI: 10.7759/cureus.35910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Objectives Neuraxial anesthesia is the preferred anesthesia technique for cesarean delivery due to a decreased risk of adverse events. However, general anesthesia is often employed during emergent cesarean deliveries to achieve a shorter decision-to-delivery interval. The objective of this study was to determine if the conversion of epidural labor analgesia to surgical anesthesia for a category-1 cesarean delivery is associated with significant neonatal morbidity. Study design This was a retrospective cohort study of all intrapartum category-1 cesarean deliveries performed at an academic tertiary care institution between August 2016 and July 2021. The primary outcome was neonatal morbidity, defined as a composite of neonatal umbilical artery pH < 7.10 and/or 5-min Apgar score < 7, and/or neonatal intensive care unit admission. A multivariate regression analysis was performed to control for the presence of covariates and examine the degree to which they influenced the outcome. Results A total of 185 mother-neonate pairs qualified for inclusion, of which 23 had cesarean delivery under general anesthesia and 162 under epidural anesthesia. There was no significant difference in adverse neonatal outcomes between category-1 cesarean deliveries done under general anesthesia compared to epidural anesthesia (47% vs 35%, p = 0.3). The incidence of umbilical arterial pH < 7.10 was higher in the general anesthesia group compared to the epidural anesthesia group (35% vs 12%, p = 0.018). The multivariate regression model showed that gestational age (OR = 0.63; 95% CI = 0.51-0.75, p = <0.001) and non-reassuring fetal heart trace (OR = 0.18; 95% CI = 0.05-0.58, p = 0.005) were significant predictors of adverse neonatal outcome. Conclusion Our results suggest that the conversion of epidural analgesia to surgical anesthesia for category-1 cesarean delivery in women with a functional labor epidural catheter is not associated with poorer neonatal outcomes.
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Affiliation(s)
- Carl M Skoog
- Carver College of Medicine, University of Iowa, Iowa City, USA
| | - Joel F Katzer
- Carver College of Medicine, University of Iowa, Iowa City, USA
| | - Linder H Wendt
- Institute of Clinical and Translational Research, University of Iowa, Iowa City, USA
| | - Unyime Ituk
- Department of Anesthesia, University of Iowa, Iowa CIty, USA
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17
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Persson C, Ericson J, Salari R, Eriksson MH, Flacking R. NICU parents' mental health: A comparative study with parents of term and healthy infants. Acta Paediatr 2023; 112:954-966. [PMID: 36853186 DOI: 10.1111/apa.16735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/30/2023] [Accepted: 02/27/2023] [Indexed: 03/01/2023]
Abstract
AIM To compare mental health in parents of preterm/ill infants and parents of term and healthy infants before birth and 1 month after hospital discharge. METHODS A comparative cohort design was used. In total 439 parents from six neonatal intensive care units (NICUs) and 484 parents from four maternity units (MUs) in Sweden answered a survey 1 month after discharge. RESULTS Parents in neonatal units experienced significantly more psychologically traumatic births and rated their health and the health of their infants less favourably the first week after delivery than parents in MUs. In the neonatal units, both parents had better possibilities to stay together with the infant during hospital stay. There was no difference between the NICU and MU groups in postpartum depressive symptoms 1 month after discharge. Experiencing a traumatic birth was not related to an increased risk of perinatal depressive symptoms (Edinburgh Postnatal Depression Scale ≥13) for mothers in NICUs. In contrast, the risk of depression increased for mothers in MUs. CONCLUSION Family togetherness, parent-infant closeness and emotional support at NICUs may contribute to the positive outcome. Further studies are needed to assess the long-term effects of how family togetherness and closeness influence families long term.
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Affiliation(s)
- Christine Persson
- School of Health and Welfare, Dalarna University, Falun, Sweden.,Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Jenny Ericson
- School of Health and Welfare, Dalarna University, Falun, Sweden.,Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Raziye Salari
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mats H Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Renée Flacking
- School of Health and Welfare, Dalarna University, Falun, Sweden
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18
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Moran C, Thomson G, Moran V, Fallon V. The content, experiences and outcomes of interventions designed to increase early skin-to-skin contact in high-income settings: A mixed-methods systematic review. Acta Paediatr 2023; 112:200-221. [PMID: 36260059 PMCID: PMC10100171 DOI: 10.1111/apa.16575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 01/13/2023]
Abstract
AIM To explore the content, experiences and outcomes of interventions designed to increase early skin-to-skin contact (SSC) in high-income settings. METHODS A mixed-methods systematic review was undertaken across six bibliographic databases. References of all included studies were hand-searched. All papers were quality appraised using a mixed-method appraisal tool. A narrative synthesis was used to synthesise both quantitative and qualitative findings. RESULTS Database searches generated 1221 hits, and two studies were identified via hand-searching. Ten studies were included; most (n = 7) were designed to improve SSC following a caesarean section, and half were of low/poor quality. Outcomes related to SSC prevalence and/or duration (n = 7), breastfeeding prevalence, (n = 4) and six explored mothers' and/or health professionals' experiences of the intervention. While the interventions had 'some' impact on the prevalence of SSC, the duration was often limited and not in line with WHO recommendations. Breastfeeding rates (exclusive/any) were found to improve but generally not to a significant extent. Mother and healthcare professionals were positive about the interventions, with barriers to implementation noted. Most interventions targeted healthcare professionals, rather than mothers. CONCLUSION High-quality interventions that increase SSC in line with WHO recommendations, and that target both health professionals and parents are needed.
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Affiliation(s)
- Chloe Moran
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Gill Thomson
- MAINN Research Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Victoria Moran
- Reader in Maternal & Child Nutrition, MAINN Research Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Victoria Fallon
- Department of Psychology, University of Liverpool, Liverpool, UK
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19
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Rheinheimer N, Beijers R, Bruinhof N, Cooijmans KHM, de Weerth C. Effects of daily full-term infant skin-to-skin contact on behavior and cognition at age three - secondary outcomes of a randomized controlled trial. J Child Psychol Psychiatry 2023; 64:136-144. [PMID: 35942886 PMCID: PMC10087794 DOI: 10.1111/jcpp.13679] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Daily skin-to-skin contact (SSC) during early infancy fosters the long-term development of children born preterm. This is the first randomized controlled trial assessing the potential beneficial effects of daily SSC on executive functioning and socio-emotional behavior of children born full-term. Whether children of mothers who experienced prenatal stress and anxiety benefitted more from SSC was also explored. METHODS Pregnant women (N = 116) were randomly assigned to a SSC or care-as-usual (CAU) condition. Women in the SSC condition were instructed to perform one hour of SSC daily from birth until postnatal week five. Prenatal stress was measured with questionnaires on general and pregnancy-specific stress and anxiety completed by the mothers in gestational week 37. At child age three, mothers filled in questionnaires on children's executive functioning, and externalizing and internalizing behavior. Analyses were performed in an intention-to-treat (ITT), per-protocol, and dose-response approach. Netherlands Trial Register: NL5591. RESULTS In the ITT approach, fewer internalizing (95% CI = 0.11-1.00, U = 2148.50, r = .24, p = .001) and externalizing (95% CI = 0.04-2.62, t = 2.04, d = 0.38, p = .04) problems were reported in the SSC condition compared to the CAU condition. Multivariate analyses of variance did not show group differences on executive functioning. Additional analyses of covariance showed no moderations by maternal prenatal stress. CONCLUSIONS Current findings indicate that early daily SSC in full-term infants may foster children's behavioral development. Future replications, including behavioral observations of child behavior to complement maternal reports, are warranted.
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Affiliation(s)
- Nicole Rheinheimer
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roseriet Beijers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Social Development, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Nina Bruinhof
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Social Development, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Kelly H M Cooijmans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Social Development, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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20
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Samsudin S, Chui PL, Ahmad Kamar A, Abdullah KL, Yu CW, Mohamed Z. The Impact of Structured Kangaroo Care Education on Premature Infants' Weight Gain, Breastfeeding and Length of Hospitalization in Malaysia. J Multidiscip Healthc 2023; 16:1023-1035. [PMID: 37077560 PMCID: PMC10106807 DOI: 10.2147/jmdh.s403206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/21/2023] [Indexed: 04/21/2023] Open
Abstract
Purpose Kangaroo care is a complementary humanistic intervention based on a family-centered care model. This study investigated the effects of a locally contextualized, structured kangaroo care education program on weight gain, breastfeeding rate and length of hospitalization for premature infants. Patients and Methods This longitudinal quasi-experimental study with pre- and post-intervention design involved 96 infants born between 28 and 37 weeks of gestation for three months, and was carried out at a neonatal intensive care unit in Malaysia. The experimental group received a structured education program and careful monitoring of their kangaroo care practices, while the control group received routine care without a structured education program. The institutional review board approved the study design and registered at ClinicalTrials.gov (NCT04926402). Results The kangaroo care hours performed by mothers at baseline in the experimental and control group was 4.12 and 0.55 hours per week, respectively. At three months post-discharge, the experimental group had significantly higher weight gain, higher breastfeeding rates and shorter lengths of hospitalization than the control group. Conclusion A locally contextualized and structured kangaroo care education program is effective in the performance of kangaroo care. One hour per day of kangaroo care is positively associated with an extended period of breastfeeding, improved weight gain and shorter hospitalization of premature infants.
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Affiliation(s)
- Sharmiza Samsudin
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Allied Health Professions, AIMST University, Bedong, Malaysia
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Correspondence: Ping Lei Chui, Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia, Tel +60127128893, Email
| | - Azanna Ahmad Kamar
- Department of Paediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing, School of Medical and Life Sciences, Sunway University, Subang Jaya, Malaysia
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Chye Wah Yu
- Faculty of Allied Health Professions, AIMST University, Bedong, Malaysia
| | - Zainah Mohamed
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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21
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Şimşek DC, Aydın M, Günay U. Does Kangaroo Care Have an Effect on Transition Time from Gavage Feeding to Full Oral Feeding in Premature Babies? KLINISCHE PADIATRIE 2022. [PMID: 36539196 DOI: 10.1055/a-1982-9599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Kangaroo care is a safe and effective alternative method to conventional neonatal care for newborn babies. The aim of this study was to evaluate the effect of kangaroo care on the transition time to full oral feeding in preterm infants fed by gavage. METHODS This is a randomized controlled trial. This study was conducted in a level III neonatal intensive care unit of a university hospital in eastern Turkey 50 premature babies with a birth weight of≥1000 g and a gestational age of 27-36 weeks, and their mothers were included in the study. The cases were randomly divided into two groups: kangaroo care, which would be applied up to five days a week, and standard care. Records of cases were kept regularly from their hospitalization until they reached full oral feeding. RESULTS Premature babies in the kangaroo care group reached full oral feeding at 29.20±8.06 days after birth, while babies in the standard care group reached full oral feeding at 44.60±21.90 days. The transition period from gavage feeding to reaching full oral feeding was 13.60±6.83 days in the kangaroo care group, and 22.10±7.38 days in the standard care group. The difference was statistically significant (p=0.007). CONCLUSION Kangaroo care is an effective method to reduce the transition time from gavage feeding to full oral feeding for premature babies.
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Affiliation(s)
| | - Mustafa Aydın
- School of Medicine, Firat Universitesi, Elazig, Turkey
| | - Ulviye Günay
- Faculty of Nursing, Inonu University, Malatya, Turkey
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Mirghafourvand M, Meedya S, Mohammadi E, Mohammad-Alizadeh-Charandabi S, Jafarabadi MA, Ghanbari-Homaie S. Iranian women's perception on the determinants of birth experience: a qualitative study. BMC Pregnancy Childbirth 2022; 22:751. [PMID: 36199065 PMCID: PMC9535943 DOI: 10.1186/s12884-022-05078-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of cesarean birth in Iran is very high. Having a negative childbirth experience is one of the reasons that primiparous women provide to prefer caesarean birth over a vaginal birth. This study is aimed to understand women's perspective on what determines a positive or negative birth experience for them. METHODS This qualitative study is a part a mixed method study that was conducted among primiparous women with a previous vaginal birth experience. The purpose of the main study was to develop a guideline based on Iranian primiparous women's birth experiences. The quantitative phase of the study was a cross-sectional study where women's childbirth experiences was measured in a survey via the Childbirth Experience Questionnaire-2. In the qualitative part of the study, women were invited for an in-depth interview via a random stratified sampling method based on their childbirth mean score (women with 10% of the upper bound score which indicated a positive birth experience and 10% of the lower bound indicating negative birth experience, n = 17). Conventional content analysis was used for data analysis. RESULTS We extracted three main themes: (a) "Internal control", (b) "External control", and (c) "Support". Possessing internal control, having a balanced external control to feel cared and feeling supported were the main reasons for women to feel positive about their birth experiences. Whereas, loss of internal control, imbalanced external control and unsupportive environment were related to their negative childbirth experiences. CONCLUSION Considering that women's sense of control, the care and support that they receive can influence their childbirth experiences, there is a need for changing maternity policies and practices to highlight the importance of a woman-centred care to create a pleasant, respectful and positive memory for primirparous women who experience normal vaginal births.
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Affiliation(s)
- Mojgan Mirghafourvand
- Social determinants of Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Shahla Meedya
- School of Nursing and Midwifery, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Eesa Mohammadi
- Department of Nursing, School of Medicine, Tarbiat Modares University, Tehran, Iran
| | | | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, 3144, Melbourne, VIC, Australia.,School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 3800, Melbourne, VIC, Australia.,Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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ÇELİK İ, KÖK G. Investigation of Nurses and Midwives' Knowledge and Attitudes towards Early Skin-to-Skin Contact Practice of Mother and Newborn. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.995636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Amaç: Bu araştırma, hemşire ve ebelerin anne ve yenidoğanın erken ten tene temas uygulamasına yönelik bilgileri ile tutumlarını incelemek amacıyla yapılmıştır.Yöntem: Bu tanımlayıcı araştırma, Ankara’da bir eğitim ve araştırma hastanesinde yürütülmüştür. Araştırmanın örneklemini Ekim 2020-Ocak 2021 tarihleri arasında araştırmayı kabul eden 117 hemşire ve ebe oluşturmuştur. Veriler, araştırmacı tarafından hazırlanan yapılandırılmış veri toplama formu ile “Anne-Yenidoğan Ten Tene Temas Ölçeği” aracılığıyla yüz yüze görüşme tekniği ve google forms üzerinden hazırlanan elektronik veri toplama formu kullanılarak toplanmıştır. Veriler, IBM SPSS Statistics 25.0 paket programı kullanılarak analiz edilmiştir. İstatistiksel olarak anlamlılık düzeyi p<0.05 olarak kabul edilmiştir.Bulgular: Katılımcıların Anne-Yenidoğan Ten Tene Temas Ölçeği’nden aldıkları toplam puan ortalaması 136.33±9.53’dür. Katılımcıların %95.7’sinin doğum sonrası dönemde anne ve yenidoğanın ten tene temas uygulamasını daha önceden duyduğu, %89.7’sinin anne ve yenidoğan ten tene temas becerisini doğru bir şekilde bildiği, %65.4’ünün anne ve yenidoğan ten tene temas uygulamasına yönelik bilgiyi hizmet içi eğitim programından aldığı belirlenmiştir. Katılımcıların %92.3’ünün doğum sonrası dönemde anne ve yenidoğanın ten tene temas becerisini uyguladığı belirlenmiştir. Katılımcıların yaş, meslek ve eğitim durumları açısından anne-yenidoğan ten tene temas ölçeğinden aldıkları puan ortancaları arasında anlamlı bir fark olmamasına rağmen ölçeğin bazı alt boyutları açısından katılımcıların eğitim düzeylerine ve çalıştıkları yerlere göre anneye sağlanan hizmet alt boyutu (p=0.002) ile etkinleştiren faktörler (p=0.03) alınan puanlar arasında istatistiksel olarak anlamlı bir farkın olduğu belirlenmiştir.Sonuç: Çalışmamıza katılan tüm ebe ve hemşirelerin anne ve yenidoğanın ten tene temas uygulaması ile ilgili olumlu tutumlarının olduğu, ebe ve hemşirelerin doğum sonu erken dönemde ten tene temasın anne ve yenidoğan sağlığı için bilgi ve farkındalık oluşturmalarının önemli olduğu değerlendirilmiştir.
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Affiliation(s)
| | - Gülşah KÖK
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, GÜLHANE SAĞLIK BİLİMLERİ FAKÜLTESİ
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Still-face redux: Infant responses to a classic and modified still-face paradigm in proximal and distal care cultures. Infant Behav Dev 2022; 68:101732. [PMID: 35760032 DOI: 10.1016/j.infbeh.2022.101732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022]
Abstract
Literature on infant emotion is dominated by research conducted in Western, industrialized societies where early socialization is characterized by face-to-face, vocal communication with caregivers. There is a dearth of knowledge of infant emotion in the context of social interaction outside of the visual and vocal modalities. In a three-population cross-cultural comparison, we used the still-face task to measure variation in behavior among infants from proximal care (practicing high levels of physical contact) communities in Bolivia and distal care (emphasizing vocal and visual interaction) communities in the U.S. and Fiji. In a modified version of the face-to-face still-face (FFSF), Study 1, infants in the U.S. and Fiji displayed the typical behavioral response to the still-face episode: increased negative affect and decreased social engagement, whereas infants in Bolivia showed no change. For tactile behavior, infants in Bolivia showed an increase in tactile self-stimulation from the interaction episode to the still-face episode, whereas U.S. infants showed no change. In Study 2, we created a novel body-to-body version of the still-face paradigm ("still-body") with infants in US and Bolivia, to mimic the near-constant physical contact Bolivian infants experience. The U.S. and Bolivian infant response was similar to Study 1: US infants showed decreased positive affect and increased negative affect and decreased social engagement from the interaction to the still-body episode and Bolivian infants showed no change. Notably, there were overall differences in infant behaviors between the two paradigms (FFSF and Still-Body). Infants in Bolivia and the U.S. showed increased positive facial affect during the FFSF paradigm in comparison with the Still-Body paradigm. Our results demonstrate the need for more globally representative developmental research and a broader approach to infant emotion and communication.
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Daily mother-infant skin-to-skin contact and maternal mental health and postpartum healing: a randomized controlled trial. Sci Rep 2022; 12:10225. [PMID: 35715486 PMCID: PMC9205929 DOI: 10.1038/s41598-022-14148-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/02/2022] [Indexed: 11/09/2022] Open
Abstract
This randomized controlled trial examined the effects of a daily hour of mother-infant skin-to-skin contact (SSC) during the first five postnatal weeks, compared to care-as-usual, on maternal depressive (primary outcome), anxiety, stress, fatigue, pain, and delivery-related post-traumatic stress symptoms (PTSS). Prenatal symptom severity and touch discomfort were examined as moderators. Mothers and full-term infants were randomly allocated to SSC or care-as-usual conditions and followed during the first postnatal year. For the total group (intention-to-treat analyses), care-as-usual mothers showed an increase of anxiety symptoms from week 2 to 12, while SSC mothers displayed a stability of anxiety symptoms. Also, care-as-usual mothers showed an initial decrease in fatigue followed by an increase, while SSC mothers showed a decrease from week 2 to 12. In per-protocol analyses, including only the SSC dyads who adhered to SSC guidelines, findings on anxiety, but not fatigue, were replicated. No SSC effects were found for depressive, stress, and pain symptoms. No moderator, dose-response, or 52-week follow-up effects were found. PTSS were low with little variation; consequently, analyses were discontinued. Daily SSC in healthy mother-infant dyads may reduce anxiety and fatigue symptoms, but not depressive, stress, and pain symptoms, during the early postpartum period. Replication studies are recommended.
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Barriers to Kangaroo Care in the NICU: A Qualitative Study Analyzing Parent Survey Responses. Adv Neonatal Care 2022; 22:261-269. [PMID: 34054009 DOI: 10.1097/anc.0000000000000907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite its benefits, parents in the neonatal intensive care unit (NICU) face significant barriers to kangaroo care (KC). Clinician-reported barriers to KC include staff education, environment, and equipment among others; however, parent-perceived barriers are underexplored. PURPOSE To examine parental understanding of KC, parental perception of experiences with KC, and parental views on the key factors that help or hinder KC. METHODS This is an observational, mixed-methods study that used an author-developed survey to assess parental feelings, perceived importance, and barriers to KC. Likert scale responses were analyzed using descriptive statistics. Free-text responses were analyzed using thematic analysis. A comparison of results was made between parents receiving and not receiving infant mental health services. RESULTS Fifty (N = 50) parents completed surveys. Eighty percent of parents stated they wanted more information on KC. Common barriers to KC were reported by parents, such as issues with space/environment. The most frequently reported barrier when asked openly was fear of hurting their infant. Ninety-six percent of parents believed that KC helped their emotional well-being. Parents receiving mental health services reported more fear but results did not reach significance. IMPLICATIONS FOR PRACTICE AND RESEARCH The frequency with which factors are reported as important to parents may allow a prioritization of barriers to KC, which may help focus quality improvement initiatives. The results of this study underscore the vital role nurses play in supporting KC. Additional attention needs to be given to the mental health of NICU parents and its impact on care practices.
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Gebeyehu NA, Gelaw KA, Azeze GA, Admass BA, Lake EA, Adela GA. Knowledge, attitude and practice towards kangaroo mother care among postnatal women in Ethiopia: Systematic review and meta-analysis. PLoS One 2022; 17:e0265411. [PMID: 35522657 PMCID: PMC9075620 DOI: 10.1371/journal.pone.0265411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/01/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Kangaroo mother care is a key procedure in reducing neonatal mortality and morbidity associated with preterm birth. In Ethiopia, neonatal death remains a serious problem, and this study aims to determine the prevalence of the knowledge, attitudes and practice of kangaroo mother care among Ethiopia women. METHODS PubMed, Web of Science, Google Scholar, EMBASE and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analysed using STATA statistical software (v. 11). Publication bias was checked by forest plot, Begg's rank test and Egger's regression test. To look for heterogeneity, I2 were computed and an overall estimated analysis carried out. Subgroup analysis was done by region, study setting, publication, gestational age, birth weight and component of kangaroo care. The Joanna Briggs Institute risk of bias assessment tool was used. We carried out a leave one out sensitivity analysis. RESULTS Out of 273 articles retrieved, 16 studies met the eligibility criteria and are thus included in this study. Those 16 studies had a total of 12,345 respondents who reported kangaroo mother practice, with five (comprising 1,232 participants combined) reporting that both knowledge and attitude were used to determine the overall estimation. The pooled estimates of good knowledge, positive attitude and poor practice of kangaroo mother care were found to be 64.62% (95% CI: 47.15%-82.09%; I2 = 97.8%), 61.55% (49.73%-73.38%; I2 = 94.8%) and 45.7% (95% CI: 37.23%-54.09%; I2 = 98.5%), respectively. This study is limited to postnatal women and does not take account their domestic partners or health providers. CONCLUSION The findings revealed significant gaps in the knowledge, attitudes and practice of kangaroo mother care in Ethiopia when compared with other developing countries. Therefore, kangaroo mother care training to women, along with further studies on domestic partners and health providers.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kelemu Abebe Gelaw
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Gedion Asnake Azeze
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, College of Health Science and Medicine, University of Gondar, Gondar, Ethiopia
| | - Eyasu Alem Lake
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adela
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Mothers' interoceptive sensibility mediates affective interaction between mother and infant. Sci Rep 2022; 12:6273. [PMID: 35428844 PMCID: PMC9011379 DOI: 10.1038/s41598-022-09988-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/31/2022] [Indexed: 12/01/2022] Open
Abstract
Interoceptive sensibility, which denotes the self-perceived sensitivity to inner-body sensations, has been associated with the emotional experiences and inferences of others’ emotional states. Focusing on the role of interoceptive sensibility in the emotional states and psychological well-being of mothers during caregiving, this study explores how physiological arousal and interoceptive sensibility mediate the association between mother–infant interaction and maternal well-being using an experience sampling method. Infant-directed-singing (IDS) with social touch was used to facilitate mother–infant interaction. Pairs of 2–8-month-old infants and their mothers participated. Mothers in an IDS group (N = 25) and a no-IDS group (N = 26) recorded their and the infant’s daily feelings and physiological states using a smartphone application for one month. All participants, including the control group (N = 78) who neither performed IDS nor used the application, answered the Multidimensional Assessment of Interoceptive Awareness questionnaire before and after the recording period. Results indicated that IDS improved mother–infant interactions and positive feelings, enhancing maternal physiological arousal. Increased interoceptive sensibility enhanced infants’ positive feelings in the IDS group, whereas in the no-IDS group, it weakened mother’s positive feelings, suggesting that maternal interoceptive sensibility mediated the effects of IDS on mother and infant well-being.
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Dudukcu FT, Aygor H, Karakoc H. Factors Affecting Breastfeeding within the First Hour After Birth. Niger J Clin Pract 2022; 25:62-68. [PMID: 35046197 DOI: 10.4103/njcp.njcp_703_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Every baby should start life with breastfeeding. However, some obstacles prevent babies from enjoying this right. Aim This study aimed to determine the factors affecting breastfeeding within the first hour after birth. Patients and Methods This study employed a comparison design. This was a comparative study of women who breastfeed their babies within 1 h of birth and those who did not. The research population consisted of 368 mothers who had babies aged 6-24 months. A semi-structured questionnaire, which consisted of 32 open- and closed-ended questions, was used to collect data. The number and proportions were used for the descriptive statistics, and Chi-square tests were used to compare data between groups. The level of statistical significance was accepted as P < 0.05. Results Of the 368 participants, 50.8% breastfed their babies within the first hour after birth, 49.2% did not breastfeed within the first hour, 51.6% exclusively breastfed in the first 6 months, 48.4% did not breastfeed exclusively in the first 6 months. Moreover, results revealed that a high-risk pregnancy status, mode of delivery, prelacteal food, and the mother's role in making decisions about baby feeding affects breastfeeding practices within the first hour after birth. Conclusions Initiatives should be increased to start breastfeeding within the first hour after birth in women who have high-risk pregnancy and those giving birth by cesarean section. Breast milk should be the baby's first food, and mothers should be the primary decision-makers in baby's nutrition.
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Affiliation(s)
- F T Dudukcu
- Department of Nursing, College of Health Science, KTO Karatay University, Akabe Neighborhood, Alaaddin Kap Street No: 130, Karatay, Turkey
| | - H Aygor
- Department of Nursing, Faculty of Nursing, Necmettin Erbakan University, Yunus Emre, Beyşehir St. No: 281 D: No: 281, Meram, Turkey
| | - H Karakoc
- Department of Midwifery, KTO Karatay University, Akabe Neighborhood, Alaaddin Kap St. No: 130 Karatay, Konya, Turkey
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Almutairi WM. Survey of Skin-to-Skin Contact with Obstetrics and Pediatric Nurses. NURSING REPORTS 2022; 12:13-21. [PMID: 35076611 PMCID: PMC8788535 DOI: 10.3390/nursrep12010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/28/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
Skin-to-skin, or chest-to-chest, contact (SSC) between newborns and their mothers is known as kangaroo mother care. The physiological and psychological benefits of SSC for infants and mothers are well established. The World Health Organization (WHO) recommends practicing SSC for term and preterm newborns. However, in Saudi Arabia, SSC is not practiced as widely as recommended. There is insufficient evidence of the nurses' knowledge and attitudes regarding SSC in Saudi Arabia. The aims of this study were to describe and determine relationships between knowledge, education, beliefs/attitudes, and the implementation of SSC in Jeddah, Saudi Arabia. Thank You for Your Time and Kind Suggestion Methods: Cross-sectional descriptive data were collected from 40 nurses using an English-language version of a knowledge, beliefs/attitudes, education, and implementation questionnaire used by others. Results: The mean age of the nurses was 42.4 years (SD = 3.2), with a mean experience of 12 years (SD = 2.1). The mean total score of SSC knowledge was 13.6 (SD = 2.3), the mean of total score of attitudes/beliefs was 12.3 (SD = 3.1), the SSC education mean score was 17.1 (SD = 3.4), and the SSC implementation mean score was 17.0 (SD = 4.1). In total, 55% of the nurses were not sure of the impact of SSC on brain development in neonates, 45% could not interpret infants' responses during SSC; 67% disagreed that it was the nurses' responsibility to facilitate SSC, 37.5% were not aware of SSC guidelines, and 47% of the nurses had not received any continuing education on SSC in their units. Pearson correlations revealed a significant association between SSC implementation and nurses' knowledge level (r = 0.297, p = 0.031), education (r = 0.85, p = 0.015), and beliefs (r = 0.31, p = 0.024). Conclusions: Once nurses have improved their knowledge, education, and beliefs/attitudes, SSC implementation may concomitantly increase. A continuing education program and clear guidelines are needed to promote SSC adoption in practice.
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Affiliation(s)
- Wedad M Almutairi
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
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31
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Eyeberu A, Getachew T, Debella A, Birhanu A, Alemu A, Dessie Y. Practicing Level and Determinants of Safe Cord Care and Skin-To-Skin Contact Among Post-partum Women in Public Hospitals of Eastern Ethiopia. Front Pediatr 2022; 10:883620. [PMID: 35722500 PMCID: PMC9201809 DOI: 10.3389/fped.2022.883620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/27/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Even though practicing levels of safe cord care and skin-to-skin contact among post-partum women are critical to reducing neonatal deaths, limited data revealed the low practice. Thus, the purpose of this study was to determine the level of practice and determinants of safe cord care and skin-to-skin contact among post-partum women in public hospitals of Eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted at the public hospitals of Harari reginal state, eastern Ethiopia. A random sample of 820 post-partum women was included in the study. A pre-tested and structured questionnaire was used to collect data through a face-to-face interview. STATA version 14 was used for data analysis. Bivariable and multivariable logistic regression analyses were employed to determine the association between independent and outcome variables. RESULTS The practicing level of safe cord care was 71.7% (95% Confidence Interval (CI): 64.5, 81.7). While the practicing level of Skin-To-Skin contact was 53.2% (95% CI: 43.6, 58.8). Being in age of 20-29 [adjusted odds ratio (AOR) = 2.93, 95% CI: 1.24, 6.96], attending tertiary education [AOR = 1.83, 95% CI (1.08, 3.13)], and having good knowledge about safe cord care [AOR = 11.3, 95% CI: (7.49, 17.18)] were determinants of safe cord care practice. While mothers aged 20-29, 30-39, and above 40 [(AOR = 11.17, 95% CI: 4.71, 26.5; AOR = 4.1, 95% CI: 1.77, 9.55, and AOR = 14.3, 95% CI: 7.2, 28.6), respectively], Being married [AOR = 3.70, 95% CI (1.58, 8.70)], being a merchant and self-employed ([AOR = 0.55, 95% CI: 0.34,0.87] and [AOR = 0.49, 95% CI: 0.27, 0.86], respectively), having good knowledge about SSC [AOR = 2.11, 95% CI: (1.53, 2.92)], giving birth at gestational age of 37-42 weeks [AOR = 1.82, 95% CI (1.31, 2.5)], and multigravidity (AOR = 2.83, 95% CI (1.90,4.21) were significantly associated with skin to skin contact. CONCLUSIONS The practicing level of safe cord care and skin-to-skin contact was high. In this study, the age of mothers, educational status, and knowledge of post-partum women on safe cord care were determinants of a safe cord care practice. While the age of mothers, marital status, occupational status, knowledge of mother, and gestational age at birth were significantly associated with skin-to-skin contact practice. Safe cord care should be strengthened and intensified to reduce neonatal mortality due to avoidable umbilical cord infections. Furthermore, skin-to-skin contact practice should be strengthened to enhance the survival of at-risk neonates.
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Affiliation(s)
- Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Medina J, De Guzman RM, Workman JL. Lactation is not required for maintaining maternal care and active coping responses in chronically stressed postpartum rats: Interactions between nursing demand and chronic variable stress. Horm Behav 2021; 136:105035. [PMID: 34488064 DOI: 10.1016/j.yhbeh.2021.105035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/11/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022]
Abstract
Women who do not breastfeed or discontinue breastfeeding early are more likely to develop postpartum depression (PPD) and stress is a significant risk factor for depression, including PPD. Using a rat model, we investigated whether the absence of nursing would increase the susceptibility to chronic stress-related behavioral and neural changes during the postpartum period. Adult female rats underwent thelectomy (thel; removal of teats), sham surgery, or no surgery (control) and were paired with males for breeding. All litters were rotated twice daily until postpartum day (PD) 26. Sham rats served as surrogates for thel litters, yielding a higher nursing demand for sham rats. Concurrently, rats received either no stress or chronic variable stress until PD 25. Rats were observed for maternal behaviors and tested in a series of tasks including open field, sucrose preference, and forced swim. We used immunohistochemistry (IHC) for doublecortin (DCX; to label immature neurons) or for mineralocorticoid receptor (MR). Contrary to our expectations, non-nursing thel rats were resistant to the effects of stress in all dependent measures. Our data indicate that even in chronic adverse conditions, nursing is not required for maintaining stable care to offspring or active coping responses in an acutely stressful task. We discuss the possible role of offspring contact and consider future directions for biomedical and clinical research. In rats with high nursing demand, however, chronic stress increased immobility, hippocampal neurogenesis, and MR expression (largely in opposition to the effects of stress in rats with typical nursing demand). We discuss these patterns in the context of energetics and allostatic load. This research highlights the complexity in relationships between stress, nursing, and neurobehavioral outcomes in the postpartum period and underscores the need for additional biomedical and clinical research geared toward optimizing treatments and interventions for women with PPD, regardless of breastfeeding status. SIGNIFICANCE STATEMENT: The goal of this research was to determine how the absence of nursing and higher nursing demand impact stress-coping behaviors and neural changes associated with chronic stress in order to disentangle the complex interplay of factors that contribute to psychological illness during the postpartum period.
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Affiliation(s)
- Joanna Medina
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Ave., Albany, NY 12222, United States of America
| | - Rose M De Guzman
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Ave., Albany, NY 12222, United States of America
| | - Joanna L Workman
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Ave., Albany, NY 12222, United States of America; Center for Neuroscience Research, University at Albany, State University of New York, 1400 Washington Ave., Albany, NY 12222, United States of America.
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Kirca N, Adibelli D. Effects of mother-infant skin-to-skin contact on postpartum depression: A systematic review. Perspect Psychiatr Care 2021; 57:2014-2023. [PMID: 33476428 DOI: 10.1111/ppc.12727] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 12/16/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The aim of this systematic review was to evaluate the effects of the skin-to-skin contact (SSC) method on postpartum depression. DESIGN AND METHODS A systematic review of the literature was performed. FINDINGS This review was completed with three studies meeting the research criteria. Two studies were randomized controlled studies and one study had a quasi-experimental design. PRACTICE IMPLICATIONS SSC is such a low-cost intervention that it would be accessible, simple, and feasible for most mothers in the first postpartum weeks. By reducing mothers' depressive symptoms and physiological stress, SSC facilitates mothers' wellbeing and ultimately affects infants' development by enhancing the mother/infant relationship.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Derya Adibelli
- Department of Public Health Nursing, Faculty of Health Sciences Kumluca, Akdeniz University, Antalya, Turkey
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Nakphong MK, Sacks E, Opot J, Sudhinaraset M. Association between newborn separation, maternal consent and health outcomes: findings from a longitudinal survey in Kenya. BMJ Open 2021; 11:e045907. [PMID: 34588231 PMCID: PMC8479975 DOI: 10.1136/bmjopen-2020-045907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Disrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors or associated outcomes. This study examined these experiences and associations with healthcare satisfaction, use and breast feeding. DESIGN Prospective cohort study. SETTING 3 public hospitals, 2 private hospitals, and 1 health centre/dispensary in Nairobi and Kiambu counties in Kenya. PARTICIPANTS Data were collected from women who delivered in health facilities between September 2019 and January 2020. The sample included 1014 women surveyed at baseline and at least one follow-up at 2-4 or 10 weeks post partum. PRIMARY AND SECONDARY OUTCOME MEASURES: (1) Outcomes related to satisfaction with care and care utilisation; (2) continuation of post-discharge newborn care practices such as breast feeding. RESULTS 17.6% of women reported newborn separation at the facility, of whom 71.9% were separated over 10 min. 44.9% felt separation was unnecessary and 8.4% reported not knowing the reason for separation. 59.9% reported consent was not obtained for procedures on their newborn. Women separated from their newborn (>10 min) were 44% less likely to be exclusively breast feeding at 2-4 weeks (adjusted OR (aOR)=0.56, 95% CI: 0.40 to 0.76). Obtaining consent for newborn procedures corresponded with 2.7 times greater likelihood of satisfaction with care (aOR=2.71, 95% CI: 1.67 to 4.41), 27% greater likelihood of postpartum visit attendance for self or newborn (aOR=1.27, 95% CI: 1.05 to 1.55), and 33% greater likelihood of exclusive breast feeding at 10 weeks (aOR=1.33, 95% CI: 1.10 to 1.62). CONCLUSIONS Newborns, mothers and families have a right to high-quality, respectful care, including the ability to stay together, be informed and properly consent for care. The implications of these experiences on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care.
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Affiliation(s)
- Michelle Kao Nakphong
- Department of Community Health Sciences, University of California Los Angeles, Los Angeles, California, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, California, USA
| | - Emma Sacks
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - James Opot
- Innovations for Poverty Action, Nairobi, Kenya
| | - May Sudhinaraset
- Department of Community Health Sciences, University of California Los Angeles, Los Angeles, California, USA
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Ünal Toprak F, Şentürk Erenel A. Impact of kangaroo care after caesarean section on paternal-infant attachment and involvement at 12 months: A longitudinal study in Turkey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1502-1510. [PMID: 33118268 DOI: 10.1111/hsc.13210] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
The mother's first meeting with the baby after the caesarean section is usually delayed due to the reasons arising from the mother and the baby in Turkey. Although there are many benefits of kangaroo care (KC) intervention between the mother and the newborn, there is a limited number of studies on the KC intervention between the newborn and the father after caesarean section in international literature, and there are none in Turkey. This study was carried out to determine the effect of fathers and infants who participated in KC, immediately after birth by caesarean section, on paternal-infant attachment and the fathers' involvement in infant care in the 12th month. The study was conducted as a longitudinal study with a control group. Initially, the sample consisted of 60 fathers. However, the study was completed with 48 fathers. KC intervention was practised to the couple of the father and the infant in the experimental group, while no practice was given to the control group. Fathers in the experimental group were told that they should continue to practice KC intervention at least two times a week until their baby will be 1-year-old. The data collection forms were given to fathers face-to-face in the first interview, and then through phone calls and emails after 12 months. The status of the fathers in the experimental group fathers' involvement in infant care of the baby (p = .005) was significantly higher than the control group. The mean score for the Postnatal Paternal-Infant Attachment Questionnaire (PPAQ), in fathers who participated in KC intervention, was higher than that of fathers who did not participate in the KC intervention (p < .005). The results of this study demonstrated that the paternal-infant attachment and the fathers' participation in infant care were more positive in fathers and babies who performed the KC intervention.
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Affiliation(s)
- Filiz Ünal Toprak
- Bolu Abant İzzet Baysal University Faculty of Health Sciences, Bolu, Turkey
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Immediate and Sustained Skin-to-Skin Contact for Healthy Late Preterm and Term Newborns After Birth: AWHONN Practice Brief Number 14. Nurs Womens Health 2021; 25:e9-e11. [PMID: 34462236 DOI: 10.1016/j.nwh.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Immediate and Sustained Skin-to-Skin Contact for Healthy Late Preterm and Term Newborns After Birth: AWHONN Practice Brief Number 14. J Obstet Gynecol Neonatal Nurs 2021; 50:e13-e15. [PMID: 34462182 DOI: 10.1016/j.jogn.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Aragona E, West D, Loyal J. Well-Newborn Unit Director Experiences During the COVID-19 Pandemic: A BORN Study. Hosp Pediatr 2021; 11:e170-e181. [PMID: 34376484 DOI: 10.1542/hpeds.2021-005862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND As coronavirus disease 2019 (COVID-19) spread across the country, well-newborn unit medical directors developed newborn care plans as guidelines and evidence evolved. We chose to examine approaches to newborn care during these early phases of the COVID-19 pandemic. METHODS An electronic survey was administered to well-newborn unit directors in a national network of US well-newborn units in May 2020. Respondents were asked about their approaches to testing, infection prevention, routine newborn care, discharge planning, breastfeeding, rounding, and teaching. RESULTS Of 107 sites, 65 (61%) respondents completed the survey. Respondents estimated a 1% positivity rate of 1198 newborns tested for COVID-19. Most sites (86%) performed universal maternal COVID-19 testing, and most (82%) tested newborns of COVID-19-positive mothers at 24 hours of life (75%). Infection prevention and visitation policies varied. Of respondents, in COVID-19-positive mothers, 28% permitted no visitors, 54% recommended rooming-in with the newborn, 55% encouraged breastfeeding at the breast, 38% deferred routine circumcisions of the newborn, 74% initiated immediate bathing of the newborn, 68% continued standard newborn screening, and 55% modified newborn follow-up plans. Medical directors reported adjustments to rounding and teaching workflow. Content analysis of free-text responses revealed themes related to challenges with changing recommendations, discomfort with mother-infant separation recommendations, innovations, and stress management. CONCLUSIONS Well-newborn units quickly adopted universal maternal testing and testing of exposed newborns. Despite guidelines, we identified variation in the care of newborns of COVID-19-positive mothers. Further investigation of these differences and newborn outcomes is warranted to develop best practices.
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Affiliation(s)
- Elena Aragona
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Dennis West
- Academic Pediatric Association, McLean, Virginia
| | - Jaspreet Loyal
- Department of Pediatrics, Yale University, New Haven, Connecticut
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Cong S, Wang R, Fan X, Song X, Sha L, Zhu Z, Zhou H, Liu Y, Zhang A. Skin-to-skin contact to improve premature mothers' anxiety and stress state: A meta-analysis. MATERNAL AND CHILD NUTRITION 2021; 17:e13245. [PMID: 34258864 PMCID: PMC8476413 DOI: 10.1111/mcn.13245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/02/2021] [Accepted: 06/27/2021] [Indexed: 01/16/2023]
Abstract
Premature mothers present more anxiety and stress after delivery, which may be caused by mother–infant separation while hospitalised. Skin‐to‐skin contact (SSC), a mitigating factor for mother–infant separation, can benefit infants and mothers in many ways, but few studies focused on its efficacy on maternal anxiety and stress states. Therefore, this review aims to evaluate the effect of SSC on anxiety and stress. Comprehensive research was conducted in nine databases. Meta‐analysis was conducted to investigate the effect of SSC, and subgroup analyses were performed to explain the sources of heterogeneity. Eight randomised controlled trials with 728 participants were included, and SSC significantly reduced the level of anxiety ([standardised mean difference, SMD] −0.72; 95% CI −1.08 to −0.35) and stress state ([SMD] −0.84; 95% CI −1.59 to −0.09). One subgroup analysis revealed that SSC can relieve anxiety if performing SSC no less than 1 h per day ([SMD] −0.94; 95% CI −1.34 to −0.53). Another subgroup analysis suggested that applying SSC repeatedly and lasting less than 1 week ([SMD] −1.49; 95% CI −2.31 to −0.66) or for 1 week to 2 weeks ([SMD] −1.04; 95% CI −1.29 to −0.79) can significantly reduce maternal anxiety level but no significance if lasting over 2 weeks ([SMD] −0.33; 95% CI −0.67 to 0.01). SSC can effectively improve anxiety and stress states among premature mothers after delivery, and not definitive finding presents that only SSC that was performed no less than 60 min could improve postpartum anxiety states, while SSC alone was not as effective when carried out over 2 weeks.
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Affiliation(s)
- Shengnan Cong
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Rui Wang
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Xuemei Fan
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Xiaowei Song
- Department of Neurosurgery, Sir Run Run Hospital, Nanjing Medical University, Jiangsu, China
| | | | - Zhu Zhu
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Hui Zhou
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Ying Liu
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Aixia Zhang
- School of Nursing, Nanjing Medical University, Jiangsu, China.,Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
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Cooijmans KHM, Beijers R, Brett BE, de Weerth C. Daily skin-to-skin contact in full-term infants and breastfeeding: Secondary outcomes from a randomized controlled trial. MATERNAL AND CHILD NUTRITION 2021; 18:e13241. [PMID: 34236131 PMCID: PMC8710110 DOI: 10.1111/mcn.13241] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 11/27/2022]
Abstract
This randomized controlled trial evaluated the effect of a 5-week daily skin-to-skin contact (SSC) intervention between mothers and their full-term infants, compared with care-as-usual, on exclusive and continued breastfeeding duration during the first post-natal year. Healthy pregnant women (n = 116) from a community sample were enrolled and randomly allocated to the SSC or care-as-usual condition. SSC mothers were requested to provide one daily hour of SSC for the first five post-natal weeks. Twelve months post-partum, mothers indicated the number of exclusive and continued breastfeeding months. Multiple regression analyses were conducted using intention-to-treat, per-protocol and exploratory dose-response frameworks. In intention-to-treat analyses, exclusive and continued breastfeeding duration was not different between groups (exclusive: 3.61 ± 1.99 vs. 3.16 ± 1.77 months; adjusted mean difference 0.28, 95% confidence interval [CI] -0.33 to 0.89; p = 0.36; continued: 7.98 ± 4.20 vs. 6.75 ± 4.06 months; adjusted mean difference 0.81, 95% CI -0.46 to 2.08; p = 0.21). In per-protocol analyses, exclusive and continued breastfeeding duration was longer for SSC than care-as-usual dyads (exclusive: 4.89 ± 1.26 vs. 3.25 ± 1.80 months; adjusted mean difference 1.28, 95% CI 0.31-2.24; p = 0.01; continued: 10.81 ± 1.97 vs. 6.98 ± 4.08 months; adjusted mean difference 2.33, 95% CI 0.13-4.54; p = 0.04). Exploratory dose-response effects indicated that more SSC hours predicted longer exclusive and continued breastfeeding duration. This study demonstrates that for the total group, the 5-week daily SSC intervention did not extend exclusive and continued breastfeeding duration. However, for mothers performing a regular daily hour of SSC, this simple and accessible intervention may extend exclusive and continued breastfeeding duration by months. Future studies are required to confirm these promising findings. Trial registration: Netherlands Trial Register (NTR5697).
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Affiliation(s)
- Kelly H M Cooijmans
- Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roseriet Beijers
- Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bonnie E Brett
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Nation H, Sanlorenzo L, Lebar K, Brandon D. A Quality Improvement Project to Increase Frequency of Skin-to-Skin Contact for Extreme Low-Birth-Weight Infants in the Neonatal Intensive Care Unit. J Perinat Neonatal Nurs 2021; 35:247-257. [PMID: 34330136 DOI: 10.1097/jpn.0000000000000556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Benefits of skin-to-skin contact (SSC) are documented but often delayed in the extremely preterm population due to medical complexity and staff misconceptions about safety. This quality improvement initiative was designed to increase SSC utilization among infants born before 29 weeks' gestation regardless of respiratory support by addressing nursing barriers inhibiting SSC. A pre-/postsurvey evaluated comfort level performing and perceived barriers to SSC utilization. Implementation consisted of an updated unit-specific SSC protocol and tailored education specific to identified barriers. Evaluation included SSC rates and maternal human milk usage in the first 30 days of life. In total, 81 patients (22-28 weeks, 370-1410 g) were included. SSC rates ranged from 3.3% to 17.7% at baseline and increased to 33.2% to 39.1% postintervention. Maternal human milk utilization increased above target (≥75%) postintervention for days 7 and 14, but declined towards baseline on days 21 and 30. A statistically significant increase was observed in nursing comfort level when performing SSC for intubated infants as well as infants with a peripherally inserted central catheter or umbilical venous catheter. SSC rates increased with infants younger than 29 weeks requiring intubation and central line management, possibly as a result of greater nursing comfort surrounding with SSC.
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Affiliation(s)
- Helen Nation
- Duke University, Durham, North Carolina, and Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee (Dr Nation); Division of Neonatology, Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee (Dr Sanlorenzo); Women's and Children's Service Line, Philadelphia, Pennsylvania (Dr Lebar); and Duke University School of Nursing, Durham, North Carolina (Dr Brandon)
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Machold CA, O'Rinn SE, McKellin WH, Ballantyne G, Barrett JFR. Women's experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study. CMAJ Open 2021; 9:E834-E840. [PMID: 34465580 PMCID: PMC8428890 DOI: 10.9778/cmajo.20200079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Skin-to-skin contact between mother and infant immediately after birth is recommended regardless of delivery method; however, it is less common after cesarean delivery. We aimed to describe and compare women's experiences of cesarean birth with and without skin-to-skin contact at an urban tertiary care hospital. METHODS In this hermeneutic phenomenologic study, we used semistructured telephone interviews from 2015 to 2018 to interview a convenience sample of women who delivered at term by scheduled skin-to-skin cesarean birth at an urban tertiary care hospital in Toronto, Ontario. Women were invited to participate if they had had a previous planned or unplanned cesarean birth and a scheduled skin-to-skin cesarean birth between 2013 and 2017. Participants were excluded if they had antenatally diagnosed conditions, they delivered before 37 weeks, they had general anesthesia, their condition was unstable at the time of surgery, a skin-to-skin cesarean birth was not possible or they declined skin-to-skin cesarean birth. Interviews were recorded, transcribed and analyzed by means of thematic analysis. RESULTS Ten women were interviewed 1-19 months postpartum. Four central themes emerged: support for skin-to-skin cesarean birth (women feeling supported by their families and health care providers); control (participants experiencing greater control during their skin-to-skin cesarean birth); connection with the infant, which enabled women to be active participants in their delivery, enhanced bonding and intimacy, facilitated breastfeeding and bolstered confidence during early parenthood; and logistic considerations, with participants recognizing that skin-to-skin cesarean birth required additional resources. INTERPRETATION These findings refine what is known about skin-to-skin cesarean birth and provide a critical perspective, that of mothers. They support the transformation of traditional operating room dynamics to a more patient-centred environment.
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Affiliation(s)
- Clea A Machold
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont.
| | - Susan E O'Rinn
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - William H McKellin
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Gillian Ballantyne
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Jon F R Barrett
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
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Tran HT, Murray JCS, Sobel HL, Mannava P, Huynh LT, Nguyen PTT, Giang HTN, Le TTM, Hoang TA, Nguyen VD, Li Z, Pham NTQ. Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study. BMJ Open Qual 2021; 10:e001089. [PMID: 34301731 PMCID: PMC8728344 DOI: 10.1136/bmjoq-2020-001089] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 06/20/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND To improve maternal and neonatal outcomes, Vietnam implemented early essential newborn care (EENC) using clinical coaching and quality improvement self-assessments in hospitals to introduce policy, practice and environmental changes. Da Nang Hospital for Women and Children began EENC with caesarean section births to inform development of national guidelines. This study compared newborn outcomes after caesarean sections pre/post-EENC introduction. METHODS Maternity records of all live in-born hospital caesarean births and separate case records of the subpopulation admitted to the neonatal intensive care unit (NICU) were reviewed pre-EENC (November 2013-October 2014) and post-EENC (November 2014-October 2015) implementation. NICU admissions and adverse outcomes on NICU admission were compared using descriptive statistics. FINDINGS A total of 16 927 newborns were delivered by caesarean section: 7928 (46.8%) pre-EENC and 8999 post-EENC (53.2%). Total NICU admissions decreased from 16.7% to 11.8% (relative risk 0.71; 95% CI 0.66 to 0.76) after introduction of EENC. Compared with the pre-EENC period, babies with hypothermia on admission to the NICU declined from 5.0% to 3.7% (relative risk 0.73; 95% CI 0.63 to 0.84) and cases of sepsis from 3.2% to 0.8% (relative risk 0.26; 95% CI 0.20 to 0.33) post-EENC implementation. While more than half of all newborns in the NICU were fed something other than breastmilk pre-EENC introduction, 85.8% were exclusively breast fed post-EENC (relative risk 1.86; 95% CI 1.75 to 1.98). Preterm newborns <2000 g receiving kangaroo mother care (KMC) increased from 50% to 67% (relative risk 1.33; 95% CI 1.12 to 1.59). CONCLUSION The EENC quality improvement approach with caesarean section births was associated with reduced NICU admissions, admissions with hypothermia and sepsis, and increased rates of exclusive breast feeding and KMC in the NICU.
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Affiliation(s)
- Hoang Thi Tran
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - John Charles Scott Murray
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Howard Lawrence Sobel
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Priya Mannava
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Le Thi Huynh
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - Phuong Thi Thu Nguyen
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - Hoang Thi Nam Giang
- School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - Tuyen Thi Mong Le
- General Obstetrics and Gynaecology, Da Nang Hospital for Women and Children, Da Nang, Vietnam
| | - Tuan Anh Hoang
- Maternal and Child Health Department, Ministry of Health of Vietnam, Ha Noi, Vietnam
| | - Vinh Duc Nguyen
- Maternal and Child Health Department, Ministry of Health of Vietnam, Ha Noi, Vietnam
| | - Zhao Li
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Nga Thi Quynh Pham
- Universal Health Coverage team, World Health Organization Representative Office in Vietnam, Ha Noi, Vietnam
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Cho H, Jeong IS. The relationship between mother-infant contact time and changes in postpartum depression and mother-infant attachment among mothers staying at postpartum care centers: An observational study. Nurs Health Sci 2021; 23:547-555. [PMID: 33914405 DOI: 10.1111/nhs.12847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/05/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
This observational study investigated the relationship between mother-infant contact time and changes in postpartum depression and mother-infant attachment. The study population consisted of 101 mothers staying for 14 days at two postpartum care centers in Busan, Republic of Korea. Data were collected from February to March 2018 using a self-administered questionnaire that covered postpartum depression, mother-infant attachment, and included a contact timesheet. Data were analyzed using descriptive statistics, including means and standard deviations, Kruskal-Wallis tests, and multiple linear regression with bootstrapping estimation. The mean daily contact time was 5.31 ± 1.80 h. The mean postpartum depression decreased from 8.76 ± 7.10 points at admission to 5.16 ± 3.35 points at discharge. By increasing daily kangaroo mother care time by 1 h, postpartum depression was decreased by 4.02 points. However, changes in mother-infant attachment were not related to contact time. Kangaroo mother care was effective in decreasing postpartum depression among the mothers at the postpartum care centers. Nurses working at the care centers should encourage mothers to participate in kangaroo mother care programs. Further studies considering various contacts, such as baby massage or bathing, are recommended.
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Affiliation(s)
- Heajin Cho
- Queen's Park Women Hospital, Busan, Korea
| | - Ihn Sook Jeong
- College of Nursing, Pusan National University, Yangsan, Republic of Korea
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Bosworth K, Mustafa Y, Aukland M, Bhat A, Kelly G. P.77 Skin-to-skin care during caesarean section in two obstetric units. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sinha B, Sommerfelt H, Ashorn P, Mazumder S, Taneja S, More D, Bahl R, Bhandari N. Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e216040. [PMID: 33885776 PMCID: PMC8063066 DOI: 10.1001/jamanetworkopen.2021.6040] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Approximately 1 in 5 women in low- and middle-income countries experience postpartum depression, and the risk is higher among mothers of low-birth-weight (LBW) infants. Kangaroo mother care (KMC) is effective in improving survival among LBW infants, but the benefits of KMC for mothers are not well described. OBJECTIVE To estimate the effects of community-initiated KMC (ciKMC) on maternal risk of moderate-to-severe postpartum depressive symptoms and on salivary cortisol concentration, a biomarker of stress. DESIGN, SETTING, AND PARTICIPANTS This was an unmasked, parallel-group, individually randomized clinical trial. Participants included 1950 mothers of stable LBW infants (weighing 1500-2250 g) in rural and semiurban low-income populations in North India enrolled between April 2017 and March 2018. Data analysis was performed from January to July 2020. INTERVENTIONS Eligible participants were randomly assigned to the intervention or control group by block randomization. The mothers in the intervention group were supported to practice ciKMC until 28 days after birth or until the infant wriggled out of the KMC position (ie, was no longer staying in the KMC position). The intervention included promotion and support of skin-to-skin contact and exclusive breastfeeding through home visits. MAIN OUTCOMES AND MEASURES Postpartum depressive symptoms at the end of the neonatal period were measured using the Patient Health Questionnaire-9, with a score of 10 or higher used to identify moderate-to-severe depressive symptoms. Salivary cortisol concentration was measured in a subsample of 550 mothers before and after breastfeeding on day 28 after birth. RESULTS Of the 1950 participants (mean [SD] age, 23 [3.5] years), outcome assessment was completed for 974 of 1047 participants (93%) in the intervention group and 852 of 903 participants (94%) in the control group. Sixty-four percent of participants (1175 of 1826 participants) belonged to the lowest 3 wealth quintiles. The proportion of mothers with moderate-to-severe postpartum depressive symptoms was 10.8% (95% CI, 8.9%-12.9%; 105 of 974 mothers) in the intervention group vs 13.6% (95% CI, 11.4%-16.1%; 116 of 852 mothers) in the control group. The adjusted relative risk of moderate-to-severe maternal postpartum depressive symptoms was 0.75 (95% CI, 0.59-0.96), or an efficacy of 25%. There was no difference in day-28 salivary cortisol concentration between the ciKMC and control group mothers before or after breastfeeding. The analysis estimated that supporting 36 mothers to perform KMC at home would prevent 1 mother from experiencing moderate-to-severe postpartum depressive symptoms. CONCLUSIONS AND RELEVANCE These findings suggest that ciKMC practice may substantially reduce the risk of moderate-to-severe maternal postpartum depressive symptoms. This evidence supports KMC as an intervention to be incorporated in essential newborn care programs in low- and middle-income settings. TRIAL REGISTRATION Clinical Trials Registry-India Identifier: CTRI/2017/04/008430.
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Affiliation(s)
- Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
- Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland
- DBT/Wellcome India Alliance, Hyderabad, India
| | - Halvor Sommerfelt
- Centre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Ashorn
- Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland
| | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Deepak More
- Clinical and Research Laboratories, Society for Applied Studies, New Delhi, India
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
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Coutts S, Woldring A, Pederson A, De Salaberry J, Osiovich H, Brotto LA. What is stopping us? An implementation science study of kangaroo care in British Columbia's neonatal intensive care units. BMC Pregnancy Childbirth 2021; 21:52. [PMID: 33435903 PMCID: PMC7805090 DOI: 10.1186/s12884-020-03488-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The goal of the Neonatal Intensive Care Unit (NICU) is to provide optimal care for preterm and sick infants while supporting their growth and development. The NICU environment can be stressful for preterm infants and often cannot adequately support their neurodevelopmental needs. Kangaroo Care (KC) is an evidence-based developmental care strategy that has been shown to be associated with improved short and long term neurodevelopmental outcomes for preterm infants. Despite evidence for best practice, uptake of the practice of KC in resource supported settings remains low. The aim of this study was to identify and describe healthcare providers' perspectives on the barriers and enablers of implementing KC. METHODS This qualitative study was set in 11 NICUs in British Columbia, Canada, ranging in size from 6 to 70 beds, with mixed levels of care from the less acute up to the most complex acute neonatal care. A total of 35 semi-structured healthcare provider interviews were conducted to understand their experiences providing KC in the NICU. Data were coded and emerging themes were identified. The Consolidated Framework for Implementation Research (CFIR) guided our research methods. RESULTS Four overarching themes were identified as barriers and enablers to KC by healthcare providers in their particular setting: 1) the NICU physical environment; 2) healthcare provider beliefs about KC; 3) clinical practice variation; and 4) parent presence. Depending on the specific features of a given site these factors functioned as an enabler or barrier to practicing KC. CONCLUSIONS A 'one size fits all' approach cannot be identified to guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers to its uptake. Support for improving parental presence, shifting healthcare provider beliefs, identifying creative solutions to NICU design and space constraints, and the development of a provincial guideline for KC in NICUs may together provide the impetus to change practice and reduce barriers to KC for healthcare providers, families, and administrators at local and system levels.
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Affiliation(s)
- Sarah Coutts
- Perinatal Services BC, 260 - 1770 W 7th Ave, Vancouver, BC, V6J 4Y6, Canada.
| | - Alix Woldring
- Perinatal Services BC, 260 - 1770 W 7th Ave, Vancouver, BC, V6J 4Y6, Canada
| | - Ann Pederson
- Perinatal Services BC, 260 - 1770 W 7th Ave, Vancouver, BC, V6J 4Y6, Canada
- BC Women's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | | | - Horacio Osiovich
- BC Women's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Lori A Brotto
- Women's Health Research Institute, H214 - 4500 Oak Street, Box 42B, Vancouver, BC, V6H 3N1, Canada
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
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Ghazi M, Zare M, Ramezani M, Heidarzadeh M, Behnam Vashani H. The Effect of Home Visit Program Based on the Continued Kangaroo Mother Care on Maternal Resiliency and Development of Premature Infant: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2021; 9:64-75. [PMID: 33521150 PMCID: PMC7829586 DOI: 10.30476/ijcbnm.2020.86141.1321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Premature birth is a crisis for mothers and affects resilience. Premature babies are at risk for developmental disorders. The Kangaroo Mother Care (KMC) can reduce maternal stress and improve the growth of the baby. This study aimed at assessing the effect of home visit based on the continued KMC on maternal resiliency and development of premature infant. METHODS This randomized controlled trial conducted on 50 pairs of mothers and premature babies with gestational age of 26-32 weeks who were admitted to Neonatal Intensive Care Unit of Om-al-Banin Hospital, Mashhad, Iran in 2019. The KMC is practiced routinely for all eligible newborns in this hospital. The experimental group continued the KMC one month after discharge at home and received two home visits. Resiliency of the mothers was assessed in admission, discharge, and one month after discharge with the Connor and Davison questionnaire and the development of the newborns was assessed in two months of adjusted age with Ages and Stages Questionnaire (ASQ). Data analysis was performed using SPSS software version 16 and t-test, Mann-Whitney, ANOVA, Friedman, Chi-square, Fishers exact. The significance level was set at P<0.05. RESULTS The resiliency score of the mothers one month after discharge was112.50±5.50 and 76.40±5.60 in the experimental and control groups, which was significantly different (P<0.001). The ASQ development score of the newborns in two months of adjusted age was also significantly higher in the experimental than the control group (280.40±15.60vs223.80±22.00) (P<0.001). CONCLUSION The results showed that the home visit program based on the continued KMC was effective in increasing maternal resilience and the development of premature infants. Trial Registration Number IRCT20181121041718N1.
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Affiliation(s)
- Marzieh Ghazi
- Department of Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Zare
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Heidarzadeh
- Department of Pediatric, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Behnam Vashani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Selman SB, Dilworth-Bart J, Selman HS, Cook JG, Duncan LG. Skin-to-skin contact and infant emotional and cognitive development in chronic perinatal distress. Early Hum Dev 2020; 151:105182. [PMID: 32977205 PMCID: PMC8536803 DOI: 10.1016/j.earlhumdev.2020.105182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined whether the timing of maternal-neonate skin-to-skin contact (SSC) predicts infant emotional and cognitive development in the context of chronic maternal perinatal stress and depressive symptoms. STUDY DESIGN This secondary analysis included data from a group-based prenatal care clinical trial for 37 pregnant women with low household income. Mothers completed the Perceived Stress Scale (PSS), and the Center for Epidemiologic Studies Depression Scale (CES-D) during the third trimester and postpartum. After birth, they reported timing of SSC, and completed the Infant Behavior Questionnaire-Revised Very Short Form (IBQ-R VSF) (M = 51.7 weeks, SD = 4.2). Increased PSS or CES-D score from the third trimester to post-birth indicates chronic maternal perinatal stress or depressive symptoms compared to a decrease or no change. Using hierarchical regression models, we examined if the timing of SSC makes a unique contribution in predicting infant outcomes in the context of chronic maternal perinatal stress and depressive symptoms. RESULTS Stress-exposed infants had less negative emotionality if SSC is provided immediately after delivery, less than 10 min after birth. The effect of SSC on effortful control in relation to chronic perinatal stress was not statistically significant. The impact of timing of SSC on negative emotionality or effortful control in relation to chronic perinatal depressive symptoms was not statistically significant. CONCLUSION This work implies that very early SSC may play a role in later infant emotion regulation process and could act as a protective factor in chronically stressed pregnant women.
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Affiliation(s)
- Saliha B. Selman
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Janean Dilworth-Bart
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - H. Sule Selman
- Department of Midwifery, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Joseph G. Cook
- Osher Center for Integrative Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Larissa G. Duncan
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Franco C, Mowers E, Lewis DL. Equitable Care for Pregnant Incarcerated Women: Infant Contact After Birth-A Human Right. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2020; 52:211-215. [PMID: 33369047 DOI: 10.1363/psrh.12166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Affiliation(s)
| | - Erika Mowers
- Department of Obstetrics and Gynecology, St. Joseph Mercy Hospital, Ann Arbor, MI
| | - Deborah Landis Lewis
- Department of Obstetrics and Gynecology, St. Joseph Mercy Hospital, Ann Arbor, MI
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