Punthmatharith 2001.
Methods | Randomized controlled trial (computerized minimization technique). | |
Participants | 196 healthy full‐term 37‐42 weeks' gestation infants and their mothers. | |
Interventions | All infants received standard care for the 1st 30‐60 min post birth. After the cord was clamped they were shown briefly to mom and moved to a warmer. 1) SSC group = beginning 60 min post birth infants received (M = 30 min) of SSC. Mothers were encouraged to breast feed on infant demand. Infants and mothers transferred to the postpartum unit at 120 min post birth for 24 hour rooming‐in. Mothers encouraged to provide SSC 15‐30 min before each breastfeeding. No other fluids given to infants. 2) Control group = swaddled infant given to mom after episiotomy repair and they were transferred together to the recovery room for 2 hours, then to postpartum for 24 hour rooming‐in. Mothers encouraged to breast feed on infant demand. Cup feeding was encouraged if the infant required supplementation. | |
Outcomes | Observation of maternal affectionate behaviors during a breastfeeding at 36‐48 hours post birth, 4 sub‐scales of the maternal‐infant bonding questionnaire (attention/connection to the infant, preparation for nurturing the infant, role of mother, breastfeeding the infant) at 36‐48 hours and week 4 post birth, Mother's perception of the adequacy of her milk supply, and breastfeeding status 36‐48 hours and week 4 post birth, infant weight day 2 and 1 month post birth. | |
Notes | Study was done in a Baby Friendly Hospital in Songkhla, Thailand. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Sequence generation was by computerized minimization method with stratification for 10 factors including parity, age, SES, medication, ward, planned duration of breastfeeding, previous breastfeeding, experience, infant weight and sex. |
Allocation concealment (selection bias) | Low risk | Computerized minimization method but no clear description of what happened at the point of randomization. |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Mothers would be aware of group assignment and it was stated that because of lack of privacy and cultural factors mothers might feel reluctant to accept the intervention. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | It was not clear whether there was an attempt to blind staff or outcome assessors and the impact of lack of blinding is not clear. |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | 195 women were randomized and 167 remained available to follow‐up. Loss was balanced across groups. |
Selective reporting (reporting bias) | Unclear risk | Assessment from unpublished thesis. |
Other bias | Low risk | Groups appeared comparable at baseline (stratified). Recruitment was at convenient times, so the sample may not have been representative of the population. |