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. 2020 Mar:218:11-15.
doi: 10.1016/j.jpeds.2019.09.069. Epub 2019 Nov 18.

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

Melissa Bartick  1 , Mary Ellen Boisvert  2 , Barbara L Philipp  3 , Lori Feldman-Winter  4
Affiliations

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

Melissa Bartick et al. J Pediatr. 2020 Mar.

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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Comment in

  • Breastfeeding, Baby-Friendly, and Safety: Getting the Balance Right.
    Steinhorn RH. Steinhorn RH. J Pediatr. 2020 Mar;218:7-8. doi: 10.1016/j.jpeds.2019.10.081. Epub 2019 Dec 4. J Pediatr. 2020. PMID: 31810631 No abstract available.
  • Late skin-to-skin care remains a safety concern.
    Bass JL, Gartley T, Kleinman R. Bass JL, et al. J Pediatr. 2020 Apr;219:281-283.e1. doi: 10.1016/j.jpeds.2019.12.067. Epub 2020 Jan 31. J Pediatr. 2020. PMID: 32008766 No abstract available.
  • Reply.
    Bartick M, Philipp BL, Feldman-Winter L. Bartick M, et al. J Pediatr. 2020 Apr;219:283-284.e1. doi: 10.1016/j.jpeds.2019.12.068. Epub 2020 Jan 31. J Pediatr. 2020. PMID: 32008768 No abstract available.
  • Sudden unexpected postnatal collapse during early breastfeeding and skin-to-skin care.
    Pearlman SA, Paul DA. Pearlman SA, et al. J Pediatr. 2020 May;220:269. doi: 10.1016/j.jpeds.2020.01.003. Epub 2020 Jan 31. J Pediatr. 2020. PMID: 32014283 No abstract available.
  • Reply.
    Bartick M, Philipp BL, Feldman-Winter L. Bartick M, et al. J Pediatr. 2020 May;220:269-270. doi: 10.1016/j.jpeds.2019.12.072. Epub 2020 Feb 14. J Pediatr. 2020. PMID: 32067782 No abstract available.