Table 1.

Summary of papers included in the review

Study	Intervention type	Study sample	Aims of study	Methodology	Outcome measures	Important results	Critical appraisal scorea & level of evidence
Brady et al., 2014 (USA)	Early SSC	All staff/eligible mother/infant couplets in a maternity unit of approximately 1,200 mother/infant couplets	To implement SSC for all eligible mother/infant couplets after CS in the operating room	Quality improvement project	SSC implemented in the operating room.	In first month, 43% of women undergoing a CS experienced SSC in the operating room; after 10 months >70% experienced this. In the year prior to implementation, 9% of infants born by CS were exclusively breastfeeding on discharge. After 10 months, 19% were exclusively breastfed on discharge.	Observational checklist (seven questions, Barley et al., 2011): 5/7 = Yes 1/7 = N/A 1/7 = No
					Increase exclusive breastfeeding rates at discharge		Level of evidence for effectiveness: 4d
Chapman et al., 2001 (USA)	Breast pumping; electric pump for ×6 sessions each 10–15 mins	Intervention group: 30 women, control group: 30 women	1. To measure impact of increased breast stimulation via breast pumping on breast milk transfer during the first 72 hrs after CS 2. To investigate potentially dormant effects of breast pumping before onset of lactation, including effects on milk transfer during first 2 weeks after birth and subsequent breastfeeding duration	RCT	Milk transfer (by test weighing)	Breast pumping between 24 and 72 hrs after CS did not improve milk transfer. Participants in the pumping group tended to have lower milk transfer than in the control group. Primipara in pumping group breastfed for 5 months less than their counterparts in the control group; however, this difference was not statistically significant.	*CASP RCT checklist of 11 questions: 5/11 = Yes 2/11 = Can't tell 4/11 = No
							Level of evidence for effectiveness: 1c
Chertock, 2006 (Israel)	Post CS breastfeeding assistance and guidance along with early post‐CS maternal–infant contact	Intervention group: 306 women (Muslim 101 and Jewish 205) control group: 264 women (93 Muslim and 171 Jewish)	1. To examine post‐CS breastfeeding rates at discharge, 10 and 16 weeks postpartum 2. To decrease the time lapsing from CS to maternal–infant contact, thereby increasing early post‐CS infant holding and breastfeeding initiation in the intervention group as compared with the control group 3. To increase post‐CS breastfeeding rates in the intervention group as compared with the control group	Prospective population based, none randomized, evaluation	Hold infant early post‐CS period (0–4 hrs). Breastfeeding initiation. Breast feeding early post‐CS period (0–4 hrs)	Timing of post‐CS maternal–infant contact and breastfeeding initiation outcomes for Jewish and Muslim women statistically significantly improved following the intervention.	CASP cohort study checklist of 10 questions: 4/10 = Yes 4/10 = Can't tell 2/10 = No
							Level of evidence for effectiveness: 3c
Chertock & Shoham‐Vardi, 2004 (Israel)	1. Breastfeeding education prior to elective CS when possible 2. Bringing the infant to interested and non‐sedated mother in the post‐CS recovery room for immediate post‐CS holding and/or breastfeeding 3. Providing support and assistance with positioning and latching 4. Continuing follow‐up breastfeeding support throughout the hospital stay. A goal for the intervention was to bring infants to their mothers during the first 4 hrs	Intervention group: 306 women (Muslim 101 and Jewish 205) control group: 264 women (93 Muslim and 171 Jewish)	1. To examine post‐CS breastfeeding rates at discharge, 10 and 16 weeks postpartum 2. To decrease time lapsing from CS to maternal–infant contact, thereby increasing early post‐CS infant holding and breastfeeding initiation in the intervention group as compared with the control group, 3. To increase post‐CS breastfeeding rates in the intervention group as compared with the control group	Prospective population based, none randomized, evaluation	Overall and exclusive breastfeeding at 10 weeks. Overall and exclusive breastfeeding at 16 weeks	Overall and exclusive 4‐month breastfeeding duration rates were statistically significantly higher for the intervention group as compared with the control group for the Jewish women at 10 and 16 weeks postpartum. Because few Muslim women ceased breastfeeding, only exclusive breastfeeding rates were evaluated. At 10 and 16 weeks, significantly more Muslim women in the intervention group were exclusively breastfeeding as compared with the control group, although rates dramatically declined by 16 weeks.	CASP cohort study checklist of 10 questions: 7/10 = Yes 3/10 = No
							Level of evidence for effectiveness: 3c
Moran‐Peters et al., 2014 (USA)	SSC	six women	To evaluate the implications of unavailability of SSC following a CS and to identify perceptions of women who performed SSC after their second CS, particularly related to facilitation of breastfeeding in order to compare CS experiences in which SSC was and was not present	A Quality Improvement project. (Qualitative)	Not applicable	Two main themes from analysis: (a) Mothers' relationships with their newborns and (b) mothers' experiences with breastfeeding. Overall, the women reported a better experience with the most recent CS because of contact with the baby. They also had a better breastfeeding experience.	CASP qualitative research checklist of 10 questions: 9/10 = Yes 1/10 = Can't tell
							Level of evidence for meaningfulness: 3
Stevens et al., 2014 (USA & Europe)	Early SSC	Seven papers included, small sample sizes in individual papers	To evaluate existing evidence on the facilitation of immediate or early (within 1 hr) SSC following CS for healthy term newborns and identify facilitators, barriers, and associated maternal and newborn outcomes	Literature review	Implementation of immediate or early SSC in operating theatre, mother/newborn emotional well‐being, parent/newborn communication, maternal pain, and newborn feeding outcomes.	With appropriate collaboration SSC during CS, surgery can be implemented. Limited evidence that immediate or early SSC after CS may increase breastfeeding initiation, decrease time to the first breastfeed, reduce formula supplement in hospital, increase bonding and maternal satisfaction, maintain the temperature of newborns, and reduce newborn stress.	CASP systematic review checklist of 10 questions: 9/10 = Yes 1/10 = Can't tell
							Level of evidence for effectiveness: 1b
Tully & Ball, 2012 (UK)	Sidecar bassinet on postnatal unit	20 dyads allocated to sidecar bassinet, 15 dyads allocated stand alone.	To test the effect of the sidecar bassinet on postnatal unit breastfeeding frequency and other maternal–infant behaviors compared with the stand‐alone bassinet following CS	Randomized trial with a parallel design	Infant location, bassinet acceptability, breastfeeding frequency, breastfeeding effort, maternal–infant contact, sleep states, midwife presence, and infant risk	Differences in breastfeeding frequency, maternal–infant sleep overlap, and midwife presence not statistically significant. The 20 dyads allocated to sidecar bassinets breastfed a median of 0.6 bouts per hour compared with 0.4 bouts per hour for the 15 stand‐alone bassinet dyads. Participants in the intervention group expressed overwhelming preference for the sidecar bassinets. Bed sharing was equivalent between the groups, although the motivation for this practice may have differed. Infant handling was compromised with stand‐alone bassinet use, including infants positioned on pillows while bed sharing with their sleeping mothers.	CASP RCT checklist of 11 questions: 6/11 = Yes 2/11 = Can't tell 3/11 = No
							Level of evidence for effectiveness: 1c

^aHighest level of quality met when “Yes” answered for all included questions.

CASP = Critical Appraisal Skills Programme; CS = caesarean birth; SCC = skin‐to‐skin contact; RCT = randomized controlled trials.