Document Type : Original Article


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


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.


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