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Background: As an essential part of Early Essential Newborn Care, 90 minutes of mother-infant skin-to-skin contact is significant in improving maternal and infant outcomes. However, due to human resource constraints and the consideration of maternal and infant safety, it is difficult to achieve continuous uninterrupted skin-to-skin contact for at least 90 minutes during and after cesarean delivery. The aim of this study was to investigate the efficacy and safety of the continuous uninterrupted skin-to-skin contact for at least 90 minutes during and after cesarean section for exclusive breastfeeding rate during hospitalization and maternal and infant health indicators during and after cesarean delivery.

Methods: This is a single-center, prospective randomized controlled trial conducted in one tertiary care hospital in China. We selected 280 cases of elective cesarean delivery in a tertiary maternal and child specialty hospital in Zhejiang Province from September 2018 to August 2022, which were randomly divided into two groups: in the conventional group, doulas performed at least 30 minutes for early continuous SSC within 10-30 minutes during and after cesarean delivery. In the EENC group, with immediate continuous SSC within 5-10 minutes of neonatal delivery until surgery is completed and continued SSC after returning to the ward. Exclusive breastfeeding rate during hospitalization and maternal and infant health indicators were compared between the groups.

Results: A total of 258 cases were analyzed. Compared with the control group, the EENC group had earlier first breastfeeding initiation (13.7 ± 3.6 vs 62.8 ± 6.5 minutes, P < 0.001), longer duration of first breastfeeding (42.6 ± 9.0 vs 17.9 ± 7.5 minutes, P < 0.001), earlier onset of lactogenesis II (73.7 ± 3.6 vs 82.5 ± 7.4 hours, P < 0.001), higher breastfeeding self-efficacy score (128.6 ± 8.9 vs 104.4 ± 8.5, P < 0.001), higher Exclusive breastfeeding rate during hospitalization (88% vs 81%, P = 0.018), higher maternal satisfaction scores (18.9 ± 1.1 vs 14.0 ± 2.7, P < 0.001). Meanwhile the EENC group showed lower incidence of neonatal hypothermia (0% vs 4.6%, P = 0.014), lower neonatal hypoglycemia (0% vs 5.4%, P = 0.007) and less cumulative blood loss within 24 hours postpartum (254.2 ± 43.6 vs 282.8 ± 63.8 ml, P < 0.001).

Conclusion: The implementation of EENC up to 90 minutes by caesarean doula company nurses is feasible and beneficial to maternal and infant health.

Trial Registration: ChiCTR1800018195(2018-09-04).

Titel:	Implementation of early essential neonatal care for newborns delivered by cesarean section in Jiaxing: a single-center prospective randomized controlled trial.
Autor/in / Beteiligte Person:	Xu, J ; Zhang, M ; Li, Y ; Gu, S
Zeitschrift:	International breastfeeding journal, Jg. 19 (2024-05-03), Heft 1, S. 31
Veröffentlichung:	[London] : BioMed Central, 2006-, 2024
Medientyp:	academicJournal
ISSN:	1746-4358 (electronic)
DOI:	10.1186/s13006-024-00635-y
Schlagwort:	Humans Infant, Newborn Female Prospective Studies Adult China Pregnancy Kangaroo-Mother Care Method Male Infant Care Mother-Child Relations Cesarean Section Breast Feeding statistics & numerical data
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Language: English [Int Breastfeed J] 2024 May 03; Vol. 19 (1), pp. 31. <i>Date of Electronic Publication: </i>2024 May 03. MeSH Terms: Cesarean Section* ; Breast Feeding* / statistics & numerical data ; Humans ; Infant, Newborn ; Female ; Prospective Studies ; Adult ; China ; Pregnancy ; Kangaroo-Mother Care Method ; Male ; Infant Care ; Mother-Child Relations References: Midwifery. 2021 Oct;101:103063. (PMID: 34157585) ; Eur J Clin Nutr. 2018 Dec;72(12):1644-1654. (PMID: 29670258) ; MCN Am J Matern Child Nurs. 2019 May/Jun;44(3):137-143. (PMID: 31033584) ; Int J Environ Res Public Health. 2021 Oct 30;18(21):. (PMID: 34769946) ; BMC Pediatr. 2022 Mar 11;22(1):127. (PMID: 35277144) ; Cochrane Database Syst Rev. 2017 Jul 06;7:CD003766. (PMID: 28681500) ; J Midwifery Womens Health. 2019 Jan;64(1):112-117. (PMID: 30548422) ; Midwifery. 2015 Jan;31(1):132-7. (PMID: 25061006) ; BMJ Open Qual. 2021 Jul;10(3):. (PMID: 34301731) ; BMJ Open. 2020 Dec 22;10(12):e041829. (PMID: 33371038) ; BMJ Glob Health. 2020 Aug;5(8):. (PMID: 32764149) ; Trials. 2022 Aug 19;23(1):696. (PMID: 35986372) ; BMJ Open. 2021 Jun 23;11(6):e043802. (PMID: 34162635) ; Am Fam Physician. 2015 Feb 1;91(3):178-84. (PMID: 25822271) ; BMC Pregnancy Childbirth. 2021 Oct 22;21(1):709. (PMID: 34686143) ; Lancet. 2021 Jul;398 Suppl 1:S2. (PMID: 34227951) ; Midwifery. 2020 Dec;91:102834. (PMID: 32956984) ; BMC Pediatr. 2022 Jul 7;22(1):395. (PMID: 35799125) Contributed Indexing: Keywords: Breastfeeding; Cesarean section; Doula company; Early essential neonatal care; Maternal and child care Entry Date(s): Date Created: 20240503 Date Completed: 20240503 Latest Revision: 20240507 Update Code: 20240507 PubMed Central ID: PMC11069207

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Implementation of early essential neonatal care for newborns delivered by cesarean section in Jiaxing: a single-center prospective randomized controlled trial.