Learning Objective #1: The learner will be able to discuss the benefits of skin-to-skin holding as they relate to neonatal outcome.

Learning Objective #2: The learner will be able to describe the differences in breastmilk for women who skin-to-skin hold their infants.

---

The practice of skin-to-skin holding of infants clad only in diapers against their mothers’ chest for more than an hour at a time is thought to promote the mother’s ability to produce breastmilk, but has not been tested.  The purpose of this study was to describe the effect of skin-to-skin holding on breastmilk composition measured in calories. 

Hypothesis: There is a significant difference in composition of maternal breastmilk pumped after skin-to-skin holding premature infants as compared to breastmilk pumped after non-holding conditions.

Design: Repeated measures crossover design.  Dependent variable: maternal response measured in caloric composition of maternal breastmilk.  Independent variable: skin-to-skin holding intervention.

Sample: Paired sample of 12 breastfeeding first-time mothers. 

Instrument: All maternal breastmilk was tested for caloric composition using a Creamatocrit Plus centrifuge.  The Creamatocrit technique is especially useful to guide the fractionation of breast milk. 

Procedure: After obtaining a signed informed consent from the infants’ mother, a 4-day study schedule was determined.  Each mother had a consistent breast milk pumping schedule throughout study enrollment, held her infant for an hour in the SCN twice during the study at a consistent time of day, and pumped within 30 minutes after holding.  All expressed maternal breast milk was recorded during study enrollment for volume and composition results. 

Data Analysis: The hypothesis of this study was tested using repeated measures ANOVA.  Both milk volume (ml) and milk composition (cal/ml) immediately after holding were compared to all other conditions.  The composition showed a clear difference between conditions, thereby supporting the hypothesis (p<0.005).

Implications:  The results imply that composition may be a more effective measurement to use when studying the effects of skin-to-skin holding on mother’s breastmilk.  This data makes a very good argument for the consistent implementation of holding in clinical practice.