Cochrane Database of Systematic Reviews Early skin-to-skin contact for mothers and their healthy newborn infants (Review) Moore ER, Bergman N, Anderson GC, Medley N Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD003519. DOI: 10.1002/14651858.CD003519.pub4. www.cochranelibrary.com Early skin-to-skin contact for mothers and their healthy newborn infants (Review) Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . ..... 4 BACKGROUND .................................... 7 OBJECTIVES ..................................... 9 METHODS ...................................... 9 RESULTS....................................... 14 Figure1. ..................................... 15 Figure2. ..................................... 16 Figure3. ..................................... 17 Figure4. ..................................... 21 DISCUSSION ..................................... 27 AUTHORS’CONCLUSIONS . 29 ACKNOWLEDGEMENTS . 30 REFERENCES ..................................... 30 CHARACTERISTICSOFSTUDIES . 42 DATAANDANALYSES. 112 Analysis 1.1. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 1 Breastfeeding 1 month to 4 months post birth. ......... 116 Analysis 1.2. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 2 Duration of breastfeeding in days. 117 Analysis 1.3. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 3 SCRIP scorefirst6hourspostbirth. 118 Analysis 1.4. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 4 Blood glucose mg/dL at 75-180 minutes post birth. ....... 119 Analysis 1.5. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 5 Infant axillary temperature 90 minutes to 2.5 hours post birth. ................ 120 Analysis 1.6. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 6 Exclusive breastfeeding at hospital discharge to 1 month post birth. ............... 121 Analysis 1.7. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 7 Exclusive breastfeeding 6 weeks to 6 months post birth. .............. 122 Analysis 1.8. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 8 Breastfeeding status day 28 to 1 month post birth. ............ 123 Analysis 1.9. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 9 Breastfeeding1yearpostbirth. 124 Analysis 1.10. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 10 Success of the first breastfeeding (IBFAT score). ........ 124 Analysis 1.11. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 11 Successful first breastfeeding (IBFAT score 10-12 or BAT score 8-12). .............. 125 Analysis 1.12. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 12 Suckled during the first 2 hours post birth. ........ 126 Analysis 1.13. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 13 Mean variation in maternal breast temp. 30-120 minutes post birth................ 126 Analysis 1.14. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 14 Breast engorgement - pain, tension, hardness 3 days post birth.................. 127 Analysis 1.15. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 15 Heart rate 75 minutes to 2 hours post birth. ........ 128 Analysis 1.16. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 16 Respiratory rate 75 minutes - 2 hours post birth. ............ 129 Early skin-to-skin contact for mothers and their healthy newborn infants (Review) i Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 1.17. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 17 Infant did not exceed parameters for stability. ............ 129 Analysis 1.18. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 18 Transferred to the neonatal intensive care unit. ............ 130 Analysis 1.19. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 19 Infant body weight change (grams) day 14 post birth. ........... 131 Analysis 1.20. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 20 Infant hospital length of stay in hours. ........ 131 Analysis 1.21. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 21 Not crying for > 1 minute during 90 minutes. 132 Analysis 1.22. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 22 Amount of crying in minutes during a 75-minute observation period. .............. 133 Analysis 1.23. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 23 PCERA Maternal positive affective involvement and responsiveness 12 months post birth. 133 Analysis 1.24. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 24 PCERA Dydadic mutuality and reciprocity 12 months post birth. ................ 134 Analysis 1.25. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 25 Mother’s most certain preference for same postdelivery care in thefuture. 134 Analysis 1.26. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 26 Maternal state anxiety 8 hours to 3 days post birth. ............. 135 Analysis 1.27. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 27 Maternal parenting confidence at 1 month post birth. ........... 136 Analysis 1.28. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 28 Breastfeeding 1 month to 4 months post birth: Sensitivity analysis. ............... 137 Analysis 1.29. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 29 Duration of breastfeeding in days: Sensitivity analysis. ................... 138 Analysis 1.30. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 30 Heart rate 75 minutes to 2 hrs post birth: Sensitivity analysis. ................. 139 Analysis 1.31. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 31 Respiratory rate 75 minutes to 2 hours post birth: Sensitivity analysis. 139 Analysis 1.32. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 32 Exclusive bf discharge - Marin 2010 sensitivity analysis. ................ 140 Analysis 1.33. Comparison 1 Immediate or Early skin-to-skin versus standard contact for healthy infants, Outcome 33 NICU admission - Marin 2010 sensitivity analysis. ............. 141 Analysis 2.1. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 1 Breastfeeding 1 month to 4 months post birth. ............ 141 Analysis 2.2. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 2 Exclusive breastfeeding at hospital discharge to 1 month post birth. 142 Analysis 2.3. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 3 Exclusive breastfeeding 6 weeks to 6 months post birth................ 143 Analysis 2.4. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 4 Success of the first breastfeeding (IBFAT score). ........... 143 Analysis 2.5. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 5 Respiratory rate 75 minutes - 2 hours post birth. .............. 144 Analysis 2.6. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 6 Maternal pain 4 hours post-cesarean birth. ........... 145 Analysis 2.7. Comparison 2 Immediate or Early skin-to-skin versus standard contact for healthy infants after cesarean birth, Outcome 7 Maternal state anxiety 8 hours to 3 days post birth. ................ 145 Analysis 3.1. Comparison 3 Skin-to-skin versus standard contact by time of initiation, Outcome 1 Breastfeeding 1 month to4monthspostbirth. 146 Analysis 3.2. Comparison 3 Skin-to-skin versus standard contact by time of initiation, Outcome 2 Duration of breastfeeding indays..................................... 147 Early skin-to-skin contact for mothers and their healthy newborn infants (Review) ii Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 3.3. Comparison 3 Skin-to-skin