The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling

Bystrova, K.; Matthiesen, A.-S.; Widström, A.-M.; Ransjö-Arvidson, A.-B.; Welles-Nyström, B.; Vorontsov, I.; Uvnäs-Moberg, K.

doi:10.1016/j.earlhumdev.2006.03.016

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Volume 83, Issue 1 , Pages 29-39, January 2007

The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling

K. Bystrova
- Department of Hospital Pediatrics, St. Petersburg State Pediatric Medical Academy, St. Petersburg, Russia
- Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Retzius väg 13 A, 171 77 Stockholm, Sweden
A.-S. Matthiesen
- Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Retzius väg 13 A, 171 77 Stockholm, Sweden
- Department of Statistics, Stockholm University, Stockholm, Sweden
A.-M. Widström
- Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Retzius väg 13 A, 171 77 Stockholm, Sweden
- Corresponding author. Tel.: +46 08 524 824 13; fax: +46 08 524 824 00.
A.-B. Ransjö-Arvidson
- Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Retzius väg 13 A, 171 77 Stockholm, Sweden
B. Welles-Nyström
- Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Retzius väg 13 A, 171 77 Stockholm, Sweden
I. Vorontsov
- Department of Hospital Pediatrics, St. Petersburg State Pediatric Medical Academy, St. Petersburg, Russia
K. Uvnäs-Moberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Animal Physiology, Swedish University of Agricultural Sciences, Skara, Sweden

Accepted 30 March 2006.

Abstract

Background

Few investigations have considered evaluating the effects of certain combinations of ward routines like swaddling of the baby and separation of mother and baby on infant variables such as neonatal weight loss.

Aims

To study the effect of different ward routines in respect to proximity to mother and type of infant apparel, on breastfeeding parameters (amount of ingested milk, volume of supplements, number of breastfeeds, total duration of breastfeeding time) day 4 after birth as well as recovery from neonatal weight loss and infant's weight on day 5.

Study design and subjects

In a randomized trial with factorial design four treatment groups including 176 mother–infant dyads were studied 25–120 min after birth. Randomized treatments focused on care routines administered to the infants after delivery and later in the maternity ward as well as to the type of clothing the infants received. Group 1 infants were placed skin-to-skin with their mothers after delivery, and had rooming-in while in the maternity ward. Group 2 infants were dressed and placed in their mothers' arms after delivery, and roomed-in with mothers in the maternity ward. Group 3 infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group 4 infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or clothed in baby attire. Breastfeeding parameters were documented during day 4 after birth. Infant's weight was measured daily.

Results

Babies who were kept in the nursery received significantly more formula and significantly less breast-milk, than did babies who roomed-in with their mothers. Swaddling did not influence the breastfeeding parameters measured. However, swaddled babies who had experienced a 2-h separation period after birth and then were reunited with their mothers tended to have a delayed recovery of weight loss compared to those infants who were exposed to the same treatment but dressed in clothes. Furthermore, swaddled babies who were kept in the nursery and received breast-milk supplements had a significantly delayed recovery of weight loss after birth when compared to those infants ingesting only breast-milk. On day 5, regression analyses of predicted weight gain in the exclusively breastfed infants indicated a significant increase per 100 ml breast-milk (59 g), compared to the predicted weight gain on day 5 per 100 ml supplements in the swaddled babies (14 g) (P=0.001).

Conclusion

Supplements given to the infants in the nursery had a negative influence on the amount of milk ingested. In addition, supplement feeding or a short separation after birth when combined with swaddling was shown to have a negative consequence to infant weight gain.

Keywords: Maternity routines, Separation, Swaddling, Supplements, Neonatal weight loss