A Skin-to-Skin Contact Facilitating Garment used by Mother-Infant Dyads: Exploring its Acceptability, Usage and Effect on Health Outcomes in the Postnatal Period.

Abstract

Abstract
Background and Setting
To date, no systematic investigation has considered the role of facilitating ongoing skin-to-skin contact (SSC) through babywearing for healthy, term babies to address early breastfeeding cessation and encourage relational development. Set in a large city in the West Midlands, England, this study recruited a diverse sample of healthy, term infants and their mothers to trial a skin-to-skin facilitating garment.
Aims
The study aimed to assess the safety and efficacy of the skin-to-skin facilitating garment, known as the Snuby, by examining its effects on neonatal thermoregulation, breastfeeding at six weeks post-birth, and its effect on engagement with SSC and dyadic relational bonding.
Methodology and Analyses
A multiphase mixed methods design was used, including a feasibility study (n=11) using participant observation and descriptive analyses, a randomised controlled trial (n=98) using purpose-made data collection tools and statistical inferential analyses, and a qualitative follow-up phase (n=44) using semi-structured interviews and the framework method of analysis.
Results
The Snuby was as efficacious at maintaining neonatal normothermia in SSC as conventional facilitation with a blanket or covering. The study did not identify a significant correlation between the Snuby and the frequency of SSC episodes, nor breastfeeding rates at six weeks post-birth. These findings are explained by the barriers and resources identified in the qualitative phase. The process of bonding was identified as a motivator and outcome of using the Snuby. Unexpectedly, the garment invoked reciprocal dyadic communication and was used as a means to safeguard the integrity of the mother-infant relationship in times of stress.
Implications
These findings suggest that the Snuby is a safe means of skin-to-skin facilitation. Contrary to expectations, the provision of the garment does not address early breastfeeding cessation; further research should seek to confirm this. The Snuby garment appears to mitigate against the impact of breastfeeding stress on the development of the mother-infant relationship, and as such, has a potential application in the promotion of mother-infant bonding.

Date of Award	2020
Original language	English
Awarding Institution	Birmingham City University
Supervisor	Helen McIntyre (Director of Studies)