{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:35:47Z","timestamp":1785800147087,"version":"3.56.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Breastfeed J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>As an essential part of Early Essential Newborn Care, 90\u2009minutes of mother-infant skin-to-skin contact is significant in improving maternal and infant outcomes. However, due to human resource constraints and the consideration of maternal and infant safety, it is difficult to achieve continuous uninterrupted skin-to-skin contact for at least 90\u2009minutes during and after cesarean delivery. The aim of this study was to investigate the efficacy and safety of the continuous uninterrupted skin-to-skin contact for at least 90\u2009minutes during and after cesarean section for exclusive breastfeeding rate during hospitalization and maternal and infant health indicators during and after cesarean delivery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a single-center, prospective randomized controlled trial conducted in one tertiary care hospital in China. We selected 280 cases of elective cesarean delivery in a tertiary maternal and child specialty hospital in Zhejiang Province from September 2018 to August 2022, which were randomly divided into two groups: in the conventional group, doulas performed at least 30\u2009minutes for early continuous SSC within 10\u201330\u2009minutes during and after cesarean delivery. In the EENC group, with immediate continuous SSC within 5\u201310\u2009minutes of neonatal delivery until surgery is completed and continued SSC after returning to the ward. Exclusive breastfeeding rate during hospitalization and maternal and infant health indicators were compared between the groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 258 cases were analyzed. Compared with the control group, the EENC group had earlier first breastfeeding initiation (13.7\u2009\u00b1\u20093.6 vs 62.8\u2009\u00b1\u20096.5\u2009minutes, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), longer duration of first breastfeeding (42.6\u2009\u00b1\u20099.0 vs 17.9\u2009\u00b1\u20097.5\u2009minutes, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), earlier onset of lactogenesis II (73.7\u2009\u00b1\u20093.6 vs 82.5\u2009\u00b1\u20097.4\u2009hours, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), higher breastfeeding self-efficacy score (128.6\u2009\u00b1\u20098.9 vs 104.4\u2009\u00b1\u20098.5, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), higher Exclusive breastfeeding rate during hospitalization (88% vs 81%, <jats:italic>P<\/jats:italic>\u2009=\u20090.018), higher maternal satisfaction scores (18.9\u2009\u00b1\u20091.1 vs 14.0\u2009\u00b1\u20092.7, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Meanwhile the EENC group showed lower incidence of neonatal hypothermia (0% vs 4.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.014), lower neonatal hypoglycemia (0% vs 5.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.007) and less cumulative blood loss within 24\u2009hours postpartum (254.2\u2009\u00b1\u200943.6 vs 282.8\u2009\u00b1\u200963.8\u2009ml, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The implementation of EENC up to 90\u2009minutes by caesarean doula company nurses is feasible and beneficial to maternal and infant health.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial Registration<\/jats:title>\n                <jats:p>ChiCTR1800018195(2018-09-04).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13006-024-00635-y","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T15:02:01Z","timestamp":1714748521000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Implementation of early essential neonatal care for newborns delivered by cesarean section in Jiaxing: a single-center prospective randomized controlled trial"],"prefix":"10.1186","volume":"19","author":[{"given":"Jianping","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuiqin","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"key":"635_CR1","first-page":"1","volume-title":"Early essential newborn care:clinical practice pocket guide","author":"World Health Organization","year":"2016","unstructured":"World Health Organization. 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Written informed consent was obtained from all individual patients included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"31"}}