Document Type : Original Article
Authors
1 MSc of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat‑e Heydariyeh
2 MSc of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
Abstract
BACKGROUND: Early skin‑to‑skin maternal–neonate contact during the 1st h following birth prepares
both mother and baby to establish a two‑way, interactive pattern of interaction. There are few studies
on the use of kangaroo care method in term infants and maternal postpartum behavior.
OBJECTIVE: The present study aimed to compare abdominal and kangaroo skin contact on maternal
attachment behaviors.
SETTINGS AND DESIGN: This single‑blind randomized clinical trial was performed on 68 eligible
pregnant women in Torbat Heydariyeh in 2015.
MATERIALS AND METHODS: Individuals were randomly divided into experimental groups
(kangaroo skin contact) and control group (abdominal skin contact). Maternal attachment behaviors
were observed for 15 min during 1 h postpartum. Each minute was divided into two 30 s, during
the first and second 30 s of which the maternal behavior was observed and recorded using a
checklist of behavior. Attachment behaviors were assessed using an attachment behavior checklist
(including three types of emotional, proximity‑seeking, and caring behaviors).
STATISTICAL ANALYSIS USED: After data coding, the analysis was performed using Kruskal–Wallis
test, Chi‑square test, t‑test, and Mann–Whitney test in SPSS ver. 14. P < 0.05 was considered the
significant level.
RESULTS: Among emotional, proximity‑seeking, and caring behaviors 1 h and 2 months’
postpartum in the two groups, only proximity‑seeking behaviors were significantly different 2 months’
postpartum (P = 0.033). The attachment behavior of 1 h (0.134) and 2 months’ postpartum (0.051)
did not differ significantly between the two groups.
CONCLUSIONS: Kangaroo skin contact has an effect, similar to the abdominal skin contact, on the
maternal attachment behaviors and has a positive effect on proximity‑seeking behaviors and some
components of emotional behaviors compared to abdominal skin contact.
Keywords
maternal attachment behaviors in the first encounter with the
infant in a hospital affiliated to Shahid Beheshti University of
Medical Sciences and Health Services. J Fac Nurs Midwifery
Shahid Beheshti 2006;15:31‑39.
2. Nemat Bakhsh F, Kordi M, Sahebi A. The effect of skin contact
between mother and baby on maternal attachment. J Mental
Health 2009;8:25‑32.
3. Ludington‑Hoe SM, Anderson GC, Simpson S, Hollingsead A,
ArgoteLA, Rey H, et al. Birth‑related fatigue in 34‑36‑week preterm
neonates: Rapid recovery with very early kangaroo (skin‑to‑skin)
care. J Obstet Gynecol Neonatal Nurs 1999;28:94‑103.
4. Anderson GC, Moore E, Hepworth J, Bergman N. Early
skin‑to‑skin contact for mothers and their healthy newborn
infants. Cochrane Database Syst Rev 2003;30:206‑207CD003519.
5. Vakelian K. Effects of kangaroo care immediately after birth on
attachment behavior of a mother one and three months after birth.
J Nurs Res 2010;4:7‑14.
6. Mellien AC. Incubators versus mothers’ arms: Body temperature
conservation in very‑low‑birth‑weight premature infants. J Obstet
Gynecol Neonatal Nurs 2001;30:157‑64.
7. Bohnhorst B, Heyne T, Peter CS, Poets CF. Skin‑to‑skin (kangaroo)
care, respiratory control, and thermoregulation. J Pediatr
2001;138:193‑7.
8. Carfoot S, Williamson P, Dickson R. A randomised controlled trial
in the North of England examining the effects of skin‑to‑skin care
on breast feeding. Midwifery 2005;21:71‑9.
9. Hatami A, Talebi Touti Z. Patterns of breastfeeding in infants.
Hayat J 2007;13:71‑6.
10. Kareme A, Tara F, KHadeivzadeh T, Agha Mohamadean SH. The
effect of skin contact between mother and infant immediately after
delivery on maternal attachment and anxiety related to baby. Iran
J Obstet Gynecol Infertil 2012;16:7‑15.
11. Nahedi F, Tavafean F, Hedarzadeh M, Haje Zadeh E. Midwives
comments regarding the mother and baby skin to skin contact
immediately after birth. J Med Counc Islam Repub Iran
2014;31:124‑30.
12. Jefferies AL; Canadian Paediatric Society, Fetus and Newborn
Committee. Kangaroo care for the preterm infant and family.
Paediatr Child Health 2012;17:141‑6.
13. Arivabene JC, Tyrrell MA. Kangaroo mother method: Mothers’
experiences and contributions to nursing. Rev Lat Am
Enfermagem 2010;18:262‑8.
14. Curry MA. Maternal attachment behavior and the mother’s
self‑concept: The effect of early skin‑to‑skin contact. Nurs Res
1982;31:73‑8.
15. Svensson KE, Velandia MI, Matthiesen AS, Welles‑Nyström BL,
Widström AM. Effects of mother‑infant skin‑to‑skin contact on
severe latch‑on problems in older infants: A randomized trial. Int
Breastfeed J 2013;8:1.
16. Forster DA, McLachlan HL. Breastfeeding initiation and birth
setting practices: A review of the literature. J Midwifery Womens
Health 2007;52:273‑80.
17. Venancio SI, de Almeida H. Kangaroo‑Mother Care: Scientific
evidence and impact on breastfeeding. J Pediatr (Rio J) 2004;
80:173‑80.
18. Feldman R, Eidelman AI. Skin‑to‑skin contact (Kangaroo care)
accelerates autonomic and neurobehavioural maturation in
preterm infants. Dev Med Child Neurol 2003;45:274‑81.
19. Charpak N, Ruiz JG, Zupan J, Cattaneo A, Figueroa Z, Tessier R,
et al. Kangaroo mother care: 25 years after. Acta Paediatr
2005;94:514‑22.
20. Keshavarz M, Noroze F, Seed Fatemi N, Haghghani H. Effect
of Skin to Skin Contact on Maternal State Anxiety in a Cesarean
Section Ward . 2011;5:2‑6.
21. Messmer PR, Rodriguez S, Adams J, Wells‑Gentry J, Washburn K,
Zabaleta I, et al. Effect of kangaroo care on sleep time for neonates.
Pediatr Nurs 1997;23:408‑14.