Study designs of evaluations included in the review
Randomised controlled trials (RCTs) or quasi-randomised trials were eligible for inclusion in the review.
Specific interventions included in the review
Studies of maternal/baby skin-to-skin contact were eligible for inclusion. This was defined as the mother holding the baby naked (or covered with a warm towel or blanket) against her skin between the breasts as soon as possible after birth and left undisturbed for an unrestricted period of time. Studies of skin-to-skin contact with someone other than the mother were not eligible for inclusion in the review. The average duration of skin-to-skin contact in the included studies ranged from 15 to 90 minutes. The comparators included cot care, babies being placed in a cot for 90 minutes post delivery, separation of the mother and baby for 12 or 24 hours, wrapped baby having brief contact with the mother then separation for 12 to 24 hours, and baby cleaned, dressed and held by the mother.
Participants included in the review
Studies of healthy full-term newborn babies and their mothers were eligible for inclusion. Five studies included only primiparous mothers. Four studies were carried out in developed countries, while three were conducted in a developing country. Six studies specified that mothers had an uncomplicated vaginal delivery. Three studies specified the gestational age range was between 37 and 42 weeks, while one specified a gestational age of over 38 weeks.
Outcomes assessed in the review
The primary outcomes of interest were the success of the first breast-feeding experience and the duration of breast-feeding. The authors stated that there were no validated tools to assess the success of first breast-feeding experience, therefore, the primary study authors' definition of success would be accepted. The secondary outcomes of interest were the timing of the first breast-feed and baby factors, such as temperature and behaviour. The outcomes assessed in the included studies were duration of breast-feeding, the proportion of mothers breast-feeding at discharge and at 2 months, the temperature of the baby at 90 minutes post delivery, the proportion of babies crying at 90 minutes post delivery, and the amount of crying during 90 minutes post delivery. No studies reporting on the initiation of breast-feeding were identified.
How were decisions on the relevance of primary studies made?
Two authors independently assessed studies for inclusion in the review. Any discrepancies were resolved in consultation with the third author.