Skin-to-skin contact and suckling in early postpartum : Effects on temperature, breastfeeding and mother-infant interaction
Author: Bystrova, Ksenia
Date: 2008-02-18
Location: Berzeliuslaboratoriet, Jacob Berzelius (fd sal Adam), KI Campus, Solna
Time: 13.00
Department: Institutionen för kvinnors och barns hälsa / Department of Women's and Children's Health
View/ Open:
thesis.pdf (1.361Mb)
Abstract
The overall aim of this thesis was to explore the role of closeness
versus separation on infant and maternal temperature adaptation,
breastfeeding outcome and mother-infant interaction. In addition, we
aimed to study a potential influence of swaddling on all outcomes
measured.
Material and design. A randomized factorial design and a longitudinal
approach were used. One hundred and seventy six (176) mother-infant pairs
from Maternity Home 13 in St. Petersburg were randomized into four
groups. Group I infants were placed skin-to-skin with their mothers after
birth, and had rooming-in two hours later. Group II infants were dressed
and placed in their mothers arms after birth, and had rooming-in two
hours later. Group III infants were kept in the nursery both after birth
and during the rest of maternity stay. Group IV infants were kept in the
nursery after birth, but roomed-in with their mothers two hours later.
Equal numbers of infants were either swaddled or dressed in baby clothes.
Methods included assessment of infant axillar, thigh, back and foot
temperature and maternal axillar and breast temperature, at 15-minute
intervals from 30 to 120 minutes after birth. A diary was filled in daily
by mothers with their estimation of feeling low/blue (Visual Analogue
Scale), perception of physiological breast engorgement, and number of
breastfeeds. In addition, on day 4 time of breastfeeds, milk amount
ingested and extra food given to the infants were registered. Recovery of
the neonatal weight loss was calculated. The duration of nearly
exclusive breastfeeding was noted. At the age of one year infants were
video-filmed with their mothers and interaction scored according to the
Parent-Child Early Relational Assessment (PCERA) method.
Results. Maternal axillar and breast temperature exhibited a small but
significant rise after delivery in all groups. In contrast, the variation
in maternal breast temperature increased by close contact and suckling.
Infant skin temperature, except for foot temperature in the Nursery
group, rose in all groups and was the highest in infants with
skin-to-skin contact. The rise of foot temperature was most pronounced in
the Skin-toskin group, and it remained high during the maternity stay.
Furthermore, in unseparated mother-infant dyads maternal axillar
temperature was positively related to the infant foot temperature at 120
minutes postpartum. Infant foot temperature rose about 2 units per unit
of change in the maternal axillar temperature.
Breastfeeding. Infants who stayed in the nursery and had standardized
breastfeeding frequency (7 times per 24 hours) ingested less breast-milk,
suckled for a shorter time and received more supplements day 4, than
rooming-in infants. Supplementation was one of the main factors reducing
milk production/ingestion. Swaddling did not affect these breastfeeding
parameters. In contrast, swaddled infants separated in the nursery, who
were in addition supplemented by formula, had significantly less weight
gain. Milk production/ingestion on day 4 postpartum in primiparas was
positively correlated with early suckling, with the level of perception
of breast engorgement and with the suckling frequency of the previous
day. It was negatively correlated with high levels of feeling low/blue.
Milk production/ingestion in multiparas was related to early suckling
and rooming-in. The duration of nearly exclusive breastfeeding was
related to amount of breast-milk produced/ingested on day 4 after birth.
Maternal-infant interaction. Skin-to-skin contact between the mother and
infant during the first two hours after birth significantly influenced
the level of maternal sensitivity, infant ability to regulate behavior
(selfregulation), and mutuality and reciprocity in the dyad when the
infant was one year old. In the absence of skin-to-skin contact, early
suckling induced these effects. Swaddling of the infant decreased the
mother s ability for positive affective involvement in the infant and
also mutuality and reciprocity in the dyad. These results were revealed
using the PCERA.
Conclusions. The data suggest that regulation of skin temperature and of
milk production seems to be mediated by different and independent
physiological mechanisms. In addition, the data show that early skinto-
skin contact influences the development of maternal-infant interaction
recorded at the age of one year, suggesting the existence of an early
sensitive period.
List of papers:
I. Bystrova K, Matthiesen AS, Vorontsov I, Widström AM, Ransjö-Arvidson AB, Uvnäs-Moberg K (2007). "Maternal axillar and breast temperature after giving birth: effects of delivery ward practices and relation to infant temperature." Birth 34(4): 291-300
Pubmed
II. Bystrova K, Widström AM, Matthiesen AS, Ransjö-Arvidson AB, Welles-Nyström B, Wassberg C, Vorontsov I, Uvnäs-Moberg K (2003). "Skin-to-skin contact may reduce negative consequences of "the stress of being born": a study on temperature in newborn infants, subjected to different ward routines in St. Petersburg." Acta Paediatr 92(3): 320-6
Pubmed
III. Bystrova K, Matthiesen AS, Widström AM, Ransjö-Arvidson AB, Welles-Nyström B, Vorontsov I, Uvnäs-Moberg K (2007). "The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling." Early Hum Dev 83(1): 29-39. Epub 2006 May 22
Pubmed
IV. Bystrova K, Widström AM, Matthiesen AS, Ransjö-Arvidson AB, Welles-Nyström B, Vorontsov I, Uvnäs-Moberg K (2007). "Early lactation performance in primiparous and multiparous women in relation to different maternity home practices. A randomised trial in St. Petersburg." Int Breastfeed J 2: 9
Pubmed
V. Bystrova K, Ivanova V, Edhborg M, Lundh W, Matthiesen AS, Ransjö-Arvidson AB, Welles-Nyström B, Vorontsov I, Mukhamedrakhimov R, Uvnäs-Moberg K, Widström AM (2008). "Effect of clseness versus separation after birth and influence of swaddling on mother-infant interaction one year later: a study in St. Petersburg." (Submitted)
I. Bystrova K, Matthiesen AS, Vorontsov I, Widström AM, Ransjö-Arvidson AB, Uvnäs-Moberg K (2007). "Maternal axillar and breast temperature after giving birth: effects of delivery ward practices and relation to infant temperature." Birth 34(4): 291-300
Pubmed
II. Bystrova K, Widström AM, Matthiesen AS, Ransjö-Arvidson AB, Welles-Nyström B, Wassberg C, Vorontsov I, Uvnäs-Moberg K (2003). "Skin-to-skin contact may reduce negative consequences of "the stress of being born": a study on temperature in newborn infants, subjected to different ward routines in St. Petersburg." Acta Paediatr 92(3): 320-6
Pubmed
III. Bystrova K, Matthiesen AS, Widström AM, Ransjö-Arvidson AB, Welles-Nyström B, Vorontsov I, Uvnäs-Moberg K (2007). "The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling." Early Hum Dev 83(1): 29-39. Epub 2006 May 22
Pubmed
IV. Bystrova K, Widström AM, Matthiesen AS, Ransjö-Arvidson AB, Welles-Nyström B, Vorontsov I, Uvnäs-Moberg K (2007). "Early lactation performance in primiparous and multiparous women in relation to different maternity home practices. A randomised trial in St. Petersburg." Int Breastfeed J 2: 9
Pubmed
V. Bystrova K, Ivanova V, Edhborg M, Lundh W, Matthiesen AS, Ransjö-Arvidson AB, Welles-Nyström B, Vorontsov I, Mukhamedrakhimov R, Uvnäs-Moberg K, Widström AM (2008). "Effect of clseness versus separation after birth and influence of swaddling on mother-infant interaction one year later: a study in St. Petersburg." (Submitted)
Issue date: 2008-01-28
Rights:
Publication year: 2008
ISBN: 978-91-7357-167-8
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