Infant sleep location and breastfeeding initiation on the first postnatal night

Abstract

Hospitals making a commitment to the UNICEF Baby Friendly Initiative adopt a number of practices to help increase breastfeeding initiation rates. Allowing mothers and their infant's uninterrupted skin to skin contact for at least the first 30 minutes following delivery (Righard 1990) and keeping mothers and babies close are two of the practices that have been shown to encourage breastfeeding initiation (McKenna & Bernshaw 1995). Bedding-in is an obvious extension to skin-to-skin contact and a way of ensuring that mothers and their infants stay close. This randomised control trial investigates the effects of bedding-in compared to rooming-in on breastfeeding initiation, mother-infant contact and midwifery assistance required on the first post-natal night. In addition, a relatively new infant sleep condition (clip on crib) was assessed to determine whether infants and their mothers allocated to this condition behaved more like the bedding-in group or the rooming-in group in relation to breastfeeding initiation. Mothers were recruited via breast-feeding workshops held within the Royal Victoria Infirmary (RVI) when they were approximately 37 weeks gestation. Following vaginal delivery (without the use of intramuscular opiate analgesics) the behaviours and interaction of the mothers and their babies were recorded on the post-natal ward of the RVI using infra-red video equipment. Tapes were coded using the Noldus Observer 5.0 software according to an established taxonomy used in previous studies by the Parent-Infant Sleep Lab team. Data was analysed via Intention to Treat (ITT) and Treatment Received (TR) analysis using Kruskal-Wallis and Mann-Whitney บ tests. Results highlight the importance of prolonged close contact between mother and infant on breastfeeding initiation. Many mothers who were randomly allocated to rooming-in instinctively brought their infants into bed and mothers and infants who spent their first postnatal night in close contact initiated breastfeeding more successfully than those further apart. No significant difference was found in the amount of midwifery assistance with breastfeeding mothers requested or received between the three groups