Extended kangaroo mother care – Examining the utility of skin-to-skin contact over the first year of life

Le résumé fourni par la source

Kangaroo mother care which involves skin-to-skin contact (SSC) between mothers and newborns with support for exclusive breastfeeding, is an important innovation if practiced beyond the first week of life up to 1-year of age. We posit that extended SSC can benefit postpartum metabolic health. Using a narrative literature review, we examine the interaction between hormones oxytocin and cortisol, which are either released or antagonized by the neural actions of skin-to-skin contact. Oxytocin is released during SSC, which promotes attachment, improves parent-infant interactions and lowers levels of cortisol. No studies to date have reported SSC use beyond the first 5 to 7 weeks postpartum. Although no differences have been observed in infant body weight, increased head circumference has been noted among pre-term and low birth weight infants. Improved breastfeeding outcomes have also been observed. Oxytocin release is protective against type-2 diabetes and obesity in postpartum women, given its effects on β-cell function, improved insulin response and reduction of plasma glucose levels. Oxytocin has anti-inflammatory, analgesic and thermoregulatory effects. Hypothetical benefits due to oxytocin-cortisol dynamics, can be assumed for maternal posttraumatic stress, postpartum depression and anxiety. Sleep patterns, duration of crying and length of sleep are dose-dependent in effect. Postnatal skin-brain connection and thermoregulation via epidermal keratinocytes may mediate the relationship between SSC and autism spectrum disorder. The extended use of SSC can lower dependence on pharmacotherapeutic options concerning postpartum mental health and galactagogue use while supporting maternal-infant psychosocial well-being and lowering stress via hormonal action and HPA-axis activation. • We propose the study of extended KMC between 6-months to 1-year postpartum. • We propose that extended KMC/skin-to-skin contact can lower the risk of type 2 diabetes. • Metabolic health outcomes may be improved due to increased oxytocin and lowered cortisol. • KMC/SSC may improve sleep in a dose-dependent manner. • Postnatal skin-brain connection and thermoregulation can mediate the relationship between SSC and autism. • Barriers, feasibility, acceptability and fidelity in addition to dose-response relationships need to be examined to inform best practices and policy recommendations.

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