Implementing Maternal-Newborn Intraoperative Skin-to-Skin Contact to Increase Exclusive Breastfeeding Rates in the C-Section Population

Abstract

Skin-to-skin contact (SSC) is a low-cost, evidence-based practice intervention demonstrated to increase exclusive breastfeeding and provide numerous other maternal and newborn benefits. Including SSC for mothers requiring cesarean sections (C-sections) can be challenging yet important to enhance their care and birth experience. A Doctor of Nursing Practice (DNP) project integrated intraoperative SSC for patients undergoing C-sections to evaluate the impact on exclusive breastfeeding at a suburban, healthcare facility. Exclusive breastfeeding was defined as the newborn consuming only breastmilk with no supplementation of formula during the postpartum stay. Anderson’s mother-newborn mutual caregiving framework guided the project as it asserts that mothers and newborns are mutually dependent as they create a physiological and emotional caregiving experience beginning at birth. The Model for Evidence-Based Practice Change guided the development of an interprofessional implementation team and the integration. The initiation and duration of SSC and the exclusive breastfeeding rate for stable, consenting patients receiving C-sections (n=31) were obtained from chart reviews. This data was compared to a pre-implementation sample of C-section maternal-newborn couplets (n=31) to evaluate project outcomes. The z-test compared the two groups’ exclusive breastfeeding rates while the t-test and Chi-square test provided correlational analysis. Since SSC was not previously utilized, intraoperative SSC rates increased by 62% with 31 of 50 eligible patients participating and 58% (n=18) experiencing the recommended 15-minute duration. Exclusive breastfeeding rates increased by 9.7% to 41.9% with SSC; however, the impact was not statistically significant (p=0.214). Project findings demonstrated clinical significance and supported continuation of the intervention as maternal and newborn outcomes improved, and SSC was readily accepted by the healthcare team and mothers involved.