23 January 2020

Following a premature birth it is important that the parents and the infant quickly establish a good relationship. Researchers at Linköping University have studied the relationship between mothers and infants who have continuous skin-to-skin contact during the entire period from birth to discharge from the hospital. The results show that continuous skin-to-skin contact does not lead to better interaction between the mother and the infant. The study is published in the scientific journal Advances in Neonatal Care.

Premature child
Kangaroo mother care is a method of care of preterm infants. Photographer: IvanJekic

Every year some 15 million infants worldwide are born prematurely. Because the infants often require intensive care, it is common that they are separated from their parents, which can negatively affect the attachment between mother and infant.

For the parents, this separation can result in guilt and a sense of emptiness at not being able to be close to their newborn child. For the infant, losing closeness to the parents is one of the largest stress factors in early life. But skin-to-skin care against the parent’s chest, instead of care in an incubator, can reduce stress.

“Skin-to-skin contact between parent and infant has proved to have positive effects for the infant’s development – but there are no clear results regarding the effect on the interaction between mother and infant. Which is why we wanted to study this”, says Charlotte Sahlén Helmer, doctoral student at Linköping University, Sweden.

In the study, the researchers investigated the interaction between mothers and infants born prematurely – between weeks 32 and 36. The study was carried out at two Swedish hospitals, where the parents are able to be with their infant around the clock. Thirty-one families took part. The families were split into two groups: one where the mother was to give the infant continuous skin-to-skin care from birth until discharge, and one where the mother was to give the infant as much or as little skin-to-skin care as she wanted to, or was able to.Barn som fötts för tidigt. Premature birth affects opportunities for interaction between infants and mothers. Photo credit Pablo Muños

After four months, the researchers followed up how the mothers interacted with their preterm infants. They found no significant differences in interaction between the continuous and the intermittent skin-to-skin contact groups. As regards the mother’s attachment to the infant, the researchers could not see that skin-to-skin contact had any effect in terms of e.g. the mother’s acceptance of or sensitivity to the infant. Nor was there a correlation between the number of hours of skin-to-skin contact and the quality of the interaction.

“Some people say that skin-to-skin contact automatically results in good attachment between mother and infant. Our study shows that this may not be the case. It may be a relief for the parents who are not able to keep their infant against their skin around the clock, to know that they can still have good interaction. But these results must be followed up with further studies”, says Charlotte Sahlén Helmer.

The study is part of a larger project investigating the effects of skin-to-skin contact in preterm infants.

The hospitals that took part in the study are Linköping University Hospital and Sachs’ Children’s and Youth Hospital, which is part of Stockholm South General Hospital in Stockholm.

Contact:
Charlotte Sahlén Helmer, doctoral student, charlotte.sahlen.helmer@liu.se , tel: 010-1031115

The study:
A Randomized Trial of Continuous Versus Intermittent Skin-to-Skin Contact After Premature Birth and the Effects on Mother–Infant Interaction, Sahlén Helmer, Charlotte; Birberg Thornberg, Ulrika; Frostell, Anneli; Örtenstrand, Annica; Mörelius, Evalotte Less, Advances in Neonatal Care. doi: 10.1097/ANC.0000000000000675

Link: https://journals.lww.com/advancesinneonatalcare/Abstract/publishahead/A_Randomized_Trial_of_Continuous_Versus.99713.aspx

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