Skin-to-skin contact for culturally diverse women having breastfeeding difficulties during early postpartum.

BACKGROUND: Early breastfeeding (BF) cessation is more common in black women and women who experience BF difficulties during early postpartum. Skin-to-skin contact (SSC) during early postpartum promotes and sustains BF. The focus of this secondary analysis is on BF status and maternal race/ethnicity. METHODS: Data were collected in a prospective exploratory study with 48 healthy and culturally diverse mother-full-term infant dyads. These dyads were selected because they were experiencing BF difficulties postbirth (mean, 16.9 hours). Following informed consent, the SSC intervention was given with four BFs: the next three after enrollment plus one before hospital discharge. BF status (duration and exclusivity) was measured using a six-category instrument, the Index of Breastfeeding Status, at hospital discharge and by telephone interview 1 week and 1 month later. RESULTS: BF status was generally similar in this culturally diverse sample, except that at 1 month black mothers had lower exclusive BF (33%) and higher BF cessation (46.7%). These mothers were all high risk for poor BF outcomes, with black mothers at highest risk. Even so, BF outcomes exceeded those in studies that included all BF mothers whether or not they were having difficulties. CONCLUSIONS: Based on these findings, we propose that this SSC BF intervention, provided in hospital in a time-sensitive manner by a warm perceptive person, can transcend the likelihood of early BF cessation for most mothers regardless of race/ethnicity.

Newborn temperature during skin-to-skin breastfeeding in couples having breastfeeding difficulties.

BACKGROUND: Kangaroo (skin-to-skin contact) care facilitates the maintenance of safe temperatures in newborn infants. Concern persists that infants will become cold while breastfeeding, however, especially if in skin-to-skin contact with the mother. This concern might be especially realistic for infants experiencing breastfeeding difficulties. The objective was to measure temperature during a study of mothers and infants who were having breastfeeding difficulties during early postpartum and were given opportunities to experience skin-to-skin contact during breastfeeding. METHOD: Forty-eight full-term infants were investigated using a pretest-test-posttest study design. Temporal artery temperature was measured before, after, and once during 3 consecutive skin-to-skin breastfeeding interventions and 1 intervention 24 hours after the first intervention. RESULTS: During skin-to-skin contact, most infants reached and maintained temperatures between 36.5 and 37.6 degrees C, the thermoneutral range, with only rare exceptions. CONCLUSIONS: The temperatures of study infants reached and remained at the thermoneutral range during breastfeeding in skin-to-skin contact. The data suggest that mothers may have the ability to modulate their infant's temperature during skin-to-skin contact if given the opportunity. Hospital staff and parents can be reassured that, with respect to their temperature, healthy newborn infants, with or without breastfeeding difficulties, may safely breastfeed in skin-to-skin contact with their mothers.

Grief, anxiety, stillbirth, and perinatal problems: healing with kangaroo care.

A young, anxious mother's first pregnancy was eclamptic, her placenta was underperfused, and her son was stillborn. She carried grief, guilt, anxiety, and hypervigilance into her next preeclamptic pregnancy, birth (of her small-for-dates son), and early postpartum period. When breastfeeding difficulties developed, the authors intervened with three consecutive (skin-to-skin) breastfeedings. During the first skin-to-skin breastfeeding, the mother stopped crying, shared self-disparaging emotions, and then began relaxing and "taking-in" her new baby. Breastfeeding continues at 1 year.