dear breastfeeding experts,
do you know if anyone is working on updates to
the early 2003 cochrane library reviews of
randomized controlled trials of kangaroo care and
skin-to-skin contact (see below)?
there have been several good studies published since these reviews were done.
thanks for your help,
tina
GC Anderson, E Moore, J Hepworth and N Bergman
(2003). Early skin-to-skin contact for mothers
and their healthy newborn infants. Cochrane
Database Syst Rev, 2005(2), CD003519.
Early skin-to-skin contact involves placing the
naked baby prone on the mother's bare chest at
birth or soon afterwards (< 24 hour). This could
represent a 'sensitive period' for priming
mothers and infants to develop a synchronous,
reciprocal, interaction pattern, provided they
are together and in intimate contact. Routine
separation shortly after hospital birth is a
uniquely Western cultural phenomenon that may be
associated with harmful effects including
discouragement of successful breastfeeding.
Seventeen studies, involving 806 participants
(mothers and babies), were included in this
review. We found statistically significant and
positive effects of early skin-to-skin contact on
breastfeeding at one to three months postbirth,
and breastfeeding duration measured at one year.
There was some evidence of improved summary
scores for maternal affectionate love/touch
during observed breastfeeding within the first
few days postbirth and maternal attachment
behaviour with early skin-to-skin contact.
Reviewers' conclusions: Limitations included the
methodological quality of the studies, variations
in the implementation of the intervention and
outcome variability. Early skin-to-skin contact
appears to have some clinical benefit especially
regarding breastfeeding outcomes and infant
crying and has no apparent short or long-term
negative effects.
A Conde-Agudelo, JL Diaz-Rossello and JM Belizan
(2003). Kangaroo mother care to reduce morbidity
and mortality in low birthweight infants.
Cochrane Database Syst Rev, 2005(2), CD002771.
Three studies, involving 1362 infants, were
included in our review. All the trials were
conducted in developing countries. KMC was
associated with the following reduced risks:
nosocomial infection at 41 weeks' corrected
gestational age, severe illness, lower
respiratory tract disease at 6 months follow-up,
not exclusively breastfeeding at discharge, and
maternal dissatisfaction with method of care. KMC
infants had gained more weight per day by
discharge. Scores on mother's sense of competence
according to infant stay in hospital and
admission to NICU were better in KMC than in
control group. Scores on mother's perception of
social support according to infant stay in NICU
were worse in KMC group than in control group.
Psychomotor development at 12 months' corrected
age was similar in the two groups. There was no
evidence of a difference in infant mortality.
However, serious concerns about the
methodological quality of the included trials
weaken credibility in these findings.
»@«*´`*»@«*´`*»@«*´`*´¯`·.¸¸ ¸¸.·´¯`*´`*»@«*´`*»@«*´`*»@«
Tina Kimmel, MSW, MPH
PhD Program, UC Berkeley School of Social Welfare
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