“Promoting immediate skin-to-skin contact and early breastfeeding for all newborns: an underappreciated intervention to reduce neonatal mortality” by Marshall, vrkotecha

Summary Immediate skin-to-skin contact (SSC) between mothers and newborns and early initiation of breastfeeding (EIBF) may play a significant and underappreciated role in reducing neonatal mortality. These practices are distinct in important ways from more broadly recognized (and clearly impactful) interventions like kangaroo care and exclusive breastfeeding, and they are recommended for both preterm and full-term infants. A large evidence base indicates that immediate SSC and EIBF substantially reduce neonatal mortality. Many randomized trials show that immediate SSC promotes EIBF, reduces episodes of low blood sugar, improves temperature regulation, and promotes cardiac and respiratory stability. All of these effects are linked to lower mortality, and the biological pathways between immediate SSC, EIBF, and reduced mortality are compelling. A meta-analysis of large observational studies found a 25% lower risk of mortality in infants who began breastfeeding within one hour of birth compared to initiation after one hour. These practices are [...] ---Outline:(02:52) Introduction(05:12) A. The burden of neonatal mortality remains large, and much is preventable(06:03) B. Immediate SSC and EIBF appear to reduce neonatal mortality(06:58) EIBF is associated with reductions in mortality in large observational trials(09:55) Experimental evidence shows that SSC improves important clinical outcomes(11:23) EIBF and other outcomes of SSC are congruent with mortality benefits(14:27) C. A visual summary of pathways from SSC and EIBF to impact(15:20) D. The mortality benefit may be substantial, even with pessimistic assumptions(18:55) E. SSC and EIBF have almost no cost and few associated risks(20:45) F. Rates of SSC and EIBF vary widely and are often very low(23:38) G. SSC and EIBF can be increased by basic promotional interventions(23:45) SSC can be dramatically improved by targeting hospitals and health workers(25:47) EIBF can be moderately increased by targeting mothers or broader communities(28:09) The potential ceiling is high(29:08) H. Few actors are working specifically to increase universal SSC and EIBF(30:01) Key uncertainties and how we could be wrong(35:22) Additional research needed(37:44) Disclosures(38:35) References--- First published: March 28th, 2025 Source: https://forum.effectivealtruism.org/posts/bLZj9puhixeYajTJ2/promoting-immediate-skin-to-skin-contact-and-early-1 --- Narrated by TYPE III AUDIO. ---Images from the article:Apple Podcasts and Spotify do not show images in the episode description. Try Pocket Casts, or another podcast app.