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Subject:
From:
Tina Kimmel <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 19 May 2005 15:17:17 -0700
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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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