The Effect of Immediate Skin-to-Skin Contact on Exclusive Breastfeeding: An Instrumental Variable Approach
Sangyun Lee1, Yongnam Kim1,2,3
1Department of Education, Seoul National University, Seoul, Republic of Korea.
Acta Paediatrica (Oslo, Norway : 1992)
|May 12, 2025
Summary
Immediate skin-to-skin contact significantly boosts exclusive breastfeeding rates in South Korea. This practice increases the likelihood of mothers exclusively breastfeeding for up to three months postpartum.
Area of Science:
- Maternal and Child Health
- Public Health
- Neonatal Care
Background:
- Exclusive breastfeeding rates in the Republic of Korea have significantly declined.
- Promoting exclusive breastfeeding is a key public health objective.
- Understanding interventions that support breastfeeding is crucial.
Purpose of the Study:
- To estimate the causal effect of immediate skin-to-skin contact (SSC) on exclusive breastfeeding.
- To provide evidence-based recommendations for improving breastfeeding practices in South Korea.
Main Methods:
- Analysis of data from the Korean Early Childhood Education & Care Panel (2022 birth cohort).
- Instrumental variable analysis using mode of delivery (vaginal vs. emergency C-section) as an instrument.
- Two-stage least squares (2SLS) method for statistical estimation.
Main Results:
- Mothers practicing immediate skin-to-skin contact were 36.3% more likely to exclusively breastfeed at 1 month postpartum.
- Significant increases in exclusive breastfeeding rates were observed at 2 months (26.9%) and 3 months (26.2%).
- Sensitivity analyses confirmed the robustness of the findings, with a statistically significant effect at 1 month even with assumption deviations.
Conclusions:
- Immediate skin-to-skin contact has a positive and sustained influence on exclusive breastfeeding rates up to 3 months postpartum.
- Findings are critical for healthcare settings where immediate SSC is not standard practice.
- Highlights the need for targeted training and policy interventions to promote SSC and enhance breastfeeding outcomes.
Keywords:
breastfeedinginstrumental variablemendelian randomisationsensitivity analysisskin‐to‐skin contactMore Related Videos
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