AB112. The effects of skin-to-skin contact on maternal postnatal attachment in lying-in clinics in Metro Manila

Background: Maternal postnatal attachment is critical for infant development. Studies show that skin-to-skin contact (SSC) beyond Essential Intrapartum and Newborn Care (EINC) improves maternal responsiveness (Potgieter and Adams, 2019), instinctive maternal behaviors, and psychological well-being (Feng and Zhang, 2023). This highlights SSC’s role in establishing the foundation for future mother-child relationships. This study aims to determine the effects of daily structured, uninterrupted 1-hour SSC on maternal attachment towards their newborn, highlighting their emotional bonding.

Methods: A quasi-experimental design with a pretest-posttest nonequivalent group was utilized. Participants included postpartum mothers selected via convenience sampling from lying-in clinics in Metro Manila, all mandatorily practicing EINC. Inclusion criteria included at least 20 years old, literate, with healthy full-term newborns, no delivery complications, and living with a relative. Exclusion criteria included mother-infant perinatal complications, with toddlers, and residing outside Metro Manila. The 60 participants were equally divided into two groups; the intervention group performed 1-hour SSC daily, while the control group continued their routine care for 2 weeks. The Mother-to-Infant Bonding Scale (MIBS) was used, with 8 adjectives rated on a 4-point Likert scale, wherein lower scores indicate stronger bonding.

Results: A t-test analysis revealed significantly decreased mean scores of both intervention (2.8 to 0.93) and control groups (3.13 to 1.83), suggesting improved attachment. An item-level analysis of each adjective revealed no significant changes in the items “Loving” and “Joyful”. “Resentful” and “Dislike” significantly improved; the control group showed greater decline in “Resentful” and the intervention group in “Dislike”. Only the control group significantly improved for “Neutral or felt nothing” while only the intervention group significantly improved in “Protective” and “Disappointed”. Although scores for “Aggressive” significantly declined in both, the intervention group had a greater decrease.

Conclusions: Structured SSC demonstrated potential in enhancing maternal attachment by reducing negative responses and promoting protectiveness, remaining a valuable adjunct for fostering maternal-infant bonding.

Keywords: Early postnatal period; maternal postnatal attachment; Mother-to-Infant Bonding Scale (MIBS); skin-to- skin contact (SSC); structured SSC