Early Skin-to-Skin After Cesarean to Improve Breastfeeding
Abstract
In Brief This article describes a quality improvement project in which early skin-to-skin (STS) contact, in the operating room (OR) and during recovery, was used as an intervention to increase the success of breastfeeding initiation among healthy infants after cesarean, at a large, urban, acute care teaching hospital. The nursing role is key for the intervention, but the program involves the entire perinatal team, including the obstetricians, pediatricians, and anesthesiologists. During the first 3 months of our intervention, the rate of early STS among healthy babies born by cesarean increased from 20% to 68%. The rate of infants who did not get STS contact within 4 hours of birth decreased from 40% to 9%. Nine months after the initiation of the intervention, 60% of healthy cesarean births utilized STS in the OR, and 70% involved STS within 90 minutes of birth. Healthy infants born by cesarean who experienced STS in the OR had lower rates of formula supplementation in the hospital (33%), compared to infants who experienced STS within 90 minutes but not in the OR (42%), and those who did not experience STS in the first 90 minutes of life (74%). We concluded that STS contact was feasible after cesarean and could be provided for healthy mothers and infants immediately after cesarean birth. Perinatal and neonatal nurses should be leaders in changing practice to incorporate early STS contact into routine care after cesarean birth. Nurses have been in the forefront of studying family-centered methods of newborn care which not only promote attachment, but also improve health markers. In this QI project, nurses show how skin-to-skin care improves rates of one more important marker: breastfeeding after cesarean birth.
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The authors concluded that skin-to-skin contact after cesarean delivery is feasible and could be offered to healthy women and their infants immediately after birth.
“The authors concluded that skin-to-skin contact after cesarean delivery is feasible and could be offered to healthy women and their infants immediately after birth.”
From Women’s experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study (2021) · cites this paper as [8]
Healthy infants born by cesarean delivery who experienced skin-to-skin contact in the operating room had lower rates of formula supplementation in hospital (33%) than infants who experienced skin-to-skin contact within 90 minutes but not in the operating room (42%) and those who did not experience skin-to-skin contact within 90 minutes (74%).
“Healthy infants born by cesarean delivery who experienced skin-to-skin contact in the operating room had lower rates of formula supplementation in hospital (33%) than infants who experienced skin-to-skin contact within 90 minutes but not in the operating room (42%) and those who did not experience skin-to-skin contact within 90 minutes (74%).8”
From Women’s experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study (2021) · cites this paper as [8]
The 4 predominant themes that emerged were consistent with those in previous studies exploring the role of skin-to-skin cesarean birth, which also showed positive outcomes.
“the 4 predominant themes that emerged were consistent with those in previous studies exploring the role of skin-to-skin cesarean birth, which also showed positive outcomes.8,46,47”
From Women’s experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study (2021) · cites this paper as [8]
Early skin-to-skin contact in the operating room and during recovery can be used as an intervention to increase the success of breastfeeding initiation in healthy infants after cesarean birth.
“early skin-to-skin contact in the operating room and during recovery can be used as an intervention to increase the success of breastfeeding initiation in healthy infants after cesarean birth.8,46”
From Women’s experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study (2021) · cites this paper as [8]
Cited by
Sorted by citations
Bollag, L., Lim, G., Sultan, P., Habib, A. S., Landau, R., Zakowski, M., Tiouririne, M., Bhambhani, S., & Carvalho, B. (2021) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000005257 · Cited by 378 · see citing works
Machold, C. A., O’Rinn, S. E., McKellin, W. H., Ballantyne, G., & Barrett, J. F. R. (2021) · CMAJ Open · doi:10.9778/cmajo.20200079 · Cited by 10 · see citing works
- Authors
- Hung, K. J., & Berg, O.
- Affiliations
- San Francisco General Hospital (US)
- Venue
- MCN: The American Journal of Maternal/Child Nursing
- Published
- 2011-09
- Volume
- 36
- Issue
- 5
- Pages
- 318-324
- ISSN
- 0361-929X (ISSN-L)
- OpenAlex
- W2035360591
- Cited by
- 118
- References
- 0
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 10 · 2019: 7 · 2018: 11 · 2017: 11 · 2016: 13 · 2015: 12 · 2014: 15 · 2013: 4 · 2012: 2
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- MCN The American Journal of Maternal/Child Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- skin-to-skin contact, cesarean section, breastfeeding initiation, early postpartum care, formula supplementation, perinatal nursing, quality improvement, neonatal nursing
- MeSH terms
- Breast Feeding, Cesarean Section, Female, Humans, Infant, Newborn, Mother-Child Relations, Obstetric Nursing, Postoperative Period, Touch
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