Efficacy of the Standard Breast Crawl Technique on Maternal and Newborn Outcomes After Term Vaginal Birth: A Randomized Controlled Trial

Abstract

IntroductionThe breast crawl technique is a strategy for initiating breastfeeding during the first hour of life, an important goal with long‐lasting effects on newborn health and development. However, there is a lack of research to back up the benefits of the standard breast crawl technique over routine skin‐to‐skin care.MethodsA single‐center single‐masked randomized controlled trial was conducted among 132 women who had given birth vaginally to a full‐term newborn. The study group had received the standard breast crawl (SBC) technique and the control group had received skin‐to‐skin contact (SSC). The outcome measures included time to initiation of breast crawl and breastfeeding, LATCH score, newborn breastfeeding behavior, time to expulsion of placenta, episiotomy suturing pain, amount of blood loss, and uterine involution.ResultsOutcomes were analyzed for 60 women in each group who remained eligible. Compared with those in the SSC group, women in the SBC group had shorter time to initiation of the breast crawl (7.40 minutes vs 10.42 minutes, P = .001), shorter time to initiation of breast feeding (23.18 minutes vs 30.58 minutes, P = .003), higher LATCH scores (7.57 vs 5.35, P = .001), and higher newborn breastfeeding behavior scores (11.38 vs 9.08, P = .001). Women in the SBC group also had decreased mean time to birth of the placenta (4.67 minutes vs 6.58 minutes, P =.001), lower episiotomy suturing pain scores (2.72 vs 4.50, P =.001), and decreased maternal blood loss (16.66% vs 53.33%, P = .001); were more likely to involute the uterus below the umbilicus after 24 hours of birth (77% vs 10%, P = .001); and had higher maternal birth satisfaction score (7.15 vs 2.0, P = .001).DiscussionThe study demonstrates improvement of newborn and maternal short‐term outcomes with use of the SBC technique. Findings support the use of SBC technique as a routine labor room practice to improve immediate maternal and newborn outcomes.