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J Pediatr. 2019 Nov 14. pii: S0022-3476(19)31305-8. doi: 10.1016/j.jpeds.2019.09.069. [Epub ahead of print]

Trends in Breastfeeding Interventions, Skin-to-Skin Care, and Sudden Infant Death in the First 6 Days after Birth.

Author information

1
Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA. Electronic address: mbartick@challiance.org.
2
College of Nursing, University of Massachusetts, Dartmouth, MA.
3
Department of Pediatrics, Boston University School of Medicine, Boston, MA.
4
Department of Pediatrics, Cooper Medical School of Rowan University, Camden, NJ.

Abstract

OBJECTIVE:

To determine if implementation of skin-to-skin care and the Baby-Friendly Hospital Initiative (BFHI) contributes to sudden unexpected infant death (SUID) and asphyxia in the first 6 days after birth.

STUDY DESIGN:

Survey data were used to determine a correlation between BFHI and deaths from SUID and asphyxia among infants <7 days in the US and Massachusetts. Using data from the Centers for Disease Control and Prevention, implementation of BFHI was tracked from 2004-2016 and skin-to-skin care was tracked from 2007-2015. Using data from Centers for Disease Control and Prevention WONDER and the Massachusetts Department of Public Health, SUID and asphyxia were tracked from 2004-2016.

RESULTS:

Nationally, births in Baby-Friendly facilities rose from 1.8% to 18.3% and the percentage of facilities in which most dyads experienced skin-to-skin care rose from 40% to 83%. SUID prevalence among infants <7 days was rare (0.72% of neonatal deaths) and decreased significantly from 2004-2009 compared with 2010-2016, from 0.033 per 1000 live births to 0.028, OR 0.85 (95% CI 0.77, 0.94). In Massachusetts, births in Baby-Friendly facilities rose from 2.8% to 13.9% and skin-to-skin care rose from 50% to 97.8%. SUID prevalence decreased from 2010-2016 compared with 2004-2009: OR 0.32 (95% CI 0.13, 0.82), with 0 asphyxia deaths during the 13-year period.

CONCLUSION:

Increasing rates of breastfeeding initiatives and skin-to-skin care are temporally associated with decreasing SUID prevalence in the first 6 days after birth in the US and Massachusetts.

KEYWORDS:

SUID; baby-friendly hospital initiative; infant mortality

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