Skin skin contact improves breastfeeding but not cognitive results in very premature infants: clinical trial

Researchers led by the Trondheim University Hospital in Norway report that two hours of immediate skin contact with the skin between mothers and very premature infants after birth do not improve cognitive, engine or language development within the age of 2 to 3 years. Infants receiving intervention showed significantly improved breastfeeding results.

Very premature infants born between 28 and 31 weeks of gestation run an increased risk of long -term disabilities, in particular cerebral paralysis, cognitive and linguistic delays, psychiatric conditions and visual or auditory deficits.

The World Health Organization recommends contact with early maternal skin (SSC) as a potentially protective intervention based on previous evidence indicating improved thermoregulation, reduced infant mortality and better physiological stability.

In the study, “immediate contact from skin to skin in very premature newborns and the neurode development of early childhood”, published in Jama Network OpenThe researchers conducted an open randomized clinical trial to assess whether the immediate SSC improves the neurode development of early childhood in very premature infants.

In total, 108 newborns born between 28 and 32 weeks of gestation were registered in three Norwegian hospitals between 2014 and 2020. Eligible infants weighed more than 1,000 g and required less than 40% of oxygen support at birth. The newborns were randomized to receive two hours of immediate SSC in the delivery room or standard care involving a direct transfer to the neonatal intensive care unit in an incubator.

The main result was cognitive development at 2 to 3 years old, measured using Bayley scales for the development of infants and toddlers, third edition (BSID-III). Secondary measures included language development scores and engines, as well as data on breastfeeding practices and questionnaires declared by parents.

No significant difference in cognitive development was found between groups. At 2 to 3 years old, the BSID-III average cognitive composite scores were 99.6 in the SSC group and 99.4 in the standard care group (average difference, 0.21; 95%CI, −5.26–5.68; p = 0.94).

The risk of development delay was similar between groups, with 51% of children in the SSC group and 49% in the standard care group below the clinical thresholds on at least one evaluation (rating report, 1.10; 95% CI, 0.47–2.56; p = 0.83).

Breastfeeding results have favored the SSC group. At the end of the hospital, 84% of infants from the SSC group were breastfed, compared to 67% in the standard care group. At 12 months, 44% of infants from the SSC group were still breastfed, compared to 26% in the standard care group. No significant difference in unwanted results or complications have been observed between groups.

The cognitive scores were almost identical between the groups, with an average difference of 0.21 points (95%CI, −5.26–5.68; p = 0.94). No difference has emerged in the risk of development delay between SSC and control groups (51%against 49%, rating of dimensions 1.10 (95%CI, 0.47–2.56); p = 0.83). However, significantly more infants from the SSC group were breastfed at the leaving the hospital (84% against 67%; p = 0.04), with higher rates of breastfeeding and a trend towards higher rates at 12 months (44% against 26%; p = 0.07).

The authors have not pointed out any neurodevelopmental advantage of immediate SSC at the age of 3, but noted clinically significant gains in breastfeeding and the connection of maternal children. These results reflect previous studies binding SSC to better parental psychological health and emotional connection in a neonatal environment.

Rather than pursuing additional tests, the authors recommend a broader adoption of this low -cost intervention depending on its safety and its sustained breastfeeding service. Improving the proximity of parents of parents can have practical meaning in neonatal care, even when neurodevelopmental scores are not affected.

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