Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China

Abstract Background The implementation of early essential newborn care (EENC) is important to maternal and neonatal health. However, few studies have conducted a complete procedure of EENC in cesarean section. This study aimed to systematically evaluate the effects of EENC during and after cesarean...

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Main Authors: Min Zhou, Jin-Yi Guo, Tai-Yang Li, Chun-Hua Zhou, Xiao-Qin Zhang, Wei Wei, Jie Zhou, Sharon R. Redding, Yan-Qiong Ouyang, Hui-Jun Chen
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Reproductive Health
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Online Access:https://doi.org/10.1186/s12978-024-01932-9
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author Min Zhou
Jin-Yi Guo
Tai-Yang Li
Chun-Hua Zhou
Xiao-Qin Zhang
Wei Wei
Jie Zhou
Sharon R. Redding
Yan-Qiong Ouyang
Hui-Jun Chen
author_facet Min Zhou
Jin-Yi Guo
Tai-Yang Li
Chun-Hua Zhou
Xiao-Qin Zhang
Wei Wei
Jie Zhou
Sharon R. Redding
Yan-Qiong Ouyang
Hui-Jun Chen
author_sort Min Zhou
collection DOAJ
description Abstract Background The implementation of early essential newborn care (EENC) is important to maternal and neonatal health. However, few studies have conducted a complete procedure of EENC in cesarean section. This study aimed to systematically evaluate the effects of EENC during and after cesarean section. Methods A randomized controlled trial was conducted at a tertiary hospital in Wuhan, China. Full-term pregnant women who had no comorbidities and underwent elective cesarean section were recruited and received EENC intervention or routine health care. The Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), a questionnaire of the breastfeeding behavior, the Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) were used to collect data. The correlation between EENC implementation and breastfeeding, maternal-infant attachment, postpartum depression, and other maternal and neonatal outcomes was analyzed. Results Mother-newborn pairs (N = 157) were enrolled in this study, 78 in the EENC group and 79 in the control group. A total of 155 (98.8%) were followed up at 14 days, 144 (91.7%) at 42 days, and 123 (78.3%) at 3 months. For the primary outcomes, generalized linear mixed model analysis showed that implementing EENC during cesarean section was beneficial for initiating breastfeeding (OR = 0.021), shortening the breastfeeding initiation time (β = − 45.321), improving the IBFAT scores (β = 2.740), and enhancing breastfeeding self-efficacy (β = 4.880). These effects were not influenced by time interaction. However, no difference was observed in the rate of exclusive breastfeeding between these two groups (P > 0.05). Implementing EENC during cesarean section significantly improved maternal-infant attachment (β = 9.668). Moreover, univariate analysis showed benefits of EENC in improving postpartum depression (P < 0.001) and decreasing maternal perinatal blood loss (P < 0.05). Conclusions According to our small sample study, there is a trend of improvement in breastfeeding related behavior and maternal infant attachment in women who received EENC during cesarean deliveries. The effects of EENC on exclusive breastfeeding should be further explored in the future. Trial registration: Chinese Clinical Trial Register at www.chictr.org.cn , ChiCTR2300074760, retrospectively registration. Registration Date: August 15, 2023.
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spelling doaj-art-c5cf1e306ca6488fb73a57568449f4f02025-08-20T02:31:54ZengBMCReproductive Health1742-47552024-12-0121111310.1186/s12978-024-01932-9Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in ChinaMin Zhou0Jin-Yi Guo1Tai-Yang Li2Chun-Hua Zhou3Xiao-Qin Zhang4Wei Wei5Jie Zhou6Sharon R. Redding7Yan-Qiong Ouyang8Hui-Jun Chen9Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan UniversitySchool of Nursing, Wuhan UniversityDepartment of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan UniversityDepartment of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan UniversityDepartment of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan UniversityDepartment of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan UniversitySchool of Nursing, Wuhan UniversityGlobal Health of Project HOPESchool of Nursing, Wuhan UniversityDepartment of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan UniversityAbstract Background The implementation of early essential newborn care (EENC) is important to maternal and neonatal health. However, few studies have conducted a complete procedure of EENC in cesarean section. This study aimed to systematically evaluate the effects of EENC during and after cesarean section. Methods A randomized controlled trial was conducted at a tertiary hospital in Wuhan, China. Full-term pregnant women who had no comorbidities and underwent elective cesarean section were recruited and received EENC intervention or routine health care. The Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), a questionnaire of the breastfeeding behavior, the Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) were used to collect data. The correlation between EENC implementation and breastfeeding, maternal-infant attachment, postpartum depression, and other maternal and neonatal outcomes was analyzed. Results Mother-newborn pairs (N = 157) were enrolled in this study, 78 in the EENC group and 79 in the control group. A total of 155 (98.8%) were followed up at 14 days, 144 (91.7%) at 42 days, and 123 (78.3%) at 3 months. For the primary outcomes, generalized linear mixed model analysis showed that implementing EENC during cesarean section was beneficial for initiating breastfeeding (OR = 0.021), shortening the breastfeeding initiation time (β = − 45.321), improving the IBFAT scores (β = 2.740), and enhancing breastfeeding self-efficacy (β = 4.880). These effects were not influenced by time interaction. However, no difference was observed in the rate of exclusive breastfeeding between these two groups (P > 0.05). Implementing EENC during cesarean section significantly improved maternal-infant attachment (β = 9.668). Moreover, univariate analysis showed benefits of EENC in improving postpartum depression (P < 0.001) and decreasing maternal perinatal blood loss (P < 0.05). Conclusions According to our small sample study, there is a trend of improvement in breastfeeding related behavior and maternal infant attachment in women who received EENC during cesarean deliveries. The effects of EENC on exclusive breastfeeding should be further explored in the future. Trial registration: Chinese Clinical Trial Register at www.chictr.org.cn , ChiCTR2300074760, retrospectively registration. Registration Date: August 15, 2023.https://doi.org/10.1186/s12978-024-01932-9BreastfeedingCesarean sectionEarly essential newborn careHealth outcomesRandomized controlled trail
spellingShingle Min Zhou
Jin-Yi Guo
Tai-Yang Li
Chun-Hua Zhou
Xiao-Qin Zhang
Wei Wei
Jie Zhou
Sharon R. Redding
Yan-Qiong Ouyang
Hui-Jun Chen
Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China
Reproductive Health
Breastfeeding
Cesarean section
Early essential newborn care
Health outcomes
Randomized controlled trail
title Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China
title_full Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China
title_fullStr Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China
title_full_unstemmed Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China
title_short Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China
title_sort effect of early essential newborn care on breastfeeding and outcomes of mothers newborns post cesarean section a randomized controlled trial in china
topic Breastfeeding
Cesarean section
Early essential newborn care
Health outcomes
Randomized controlled trail
url https://doi.org/10.1186/s12978-024-01932-9
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