The content, experiences, and outcomes of interventions designed to increase early skin-to-skin contact in high-income settings: A mixed-methods systematic review

Aim: To explore the content, experiences, and outcomes of interventions designed to increase early skin-to-skin contact (SSC) in high-income settings. Methods: A mixed-methods systematic review was undertaken across six bibliographic databases. References of all included studies were hand-searched. All papers were quality appraised using a mixed-method appraisal tool. A narrative synthesis was used to synthesise both quantitative and qualitative findings. Results: Database searches generated 1,221 hits, and two studies were identified via hand-searching. Ten studies were included; most (n =7) were designed to improve SSC following a caesarean section, and half were of low/poor quality. Outcomes related to SSC prevalence and/or duration (n =7), breastfeeding prevalence, (n =4) and six explored mothers’ and/or health professionals’ experiences of the intervention. While the interventions had ‘some’ impact on the prevalence of SSC, the duration was often limited and not in line with WHO recommendations. Breastfeeding rates (exclusive/any) were found to improve but generally not to a significant extent. Mother and healthcare professionals were positive about the interventions, with barriers to implementation noted. Most interventions targeted healthcare professionals, rather than mothers. Conclusion: High-quality interventions that increase SSC in line with WHO recommendations, and that target both health professionals and parents are needed