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  • A pilot ultrasound study shows that a brief gestalt intervention immediately improves the suck of breastfeeding babies who fuss at the breast or who cause maternal nipple pain
  • What does the research tell us about approaches to fit and hold currently used for breastfeeding support?
  • What does the research tell us about skin-to-skin contact or Kangaroo Mother Care for term infants?
  • The Thompson method: a large hospital-wide study found no improvement in breastfeeding outcomes

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  • S5: Empowering women to change the biomechanics of infant suck and protect themselves from musculoskeletal pain: the gestalt method
  • CH 1: What does the research tell us about approaches to fit and hold during breastfeeding?

What does the research tell us about skin-to-skin contact or Kangaroo Mother Care for term infants?

Dr Pamela Douglas12th of May 202511th of Dec 2025

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Kangaroo Mother Care is recommended for low birth weight infants in any setting by the World Health Organisation

The World Health Organisation recommends Kangaroo Care for at least eight hours a day for low birth weight infants unless critically ill, regardless of the setting, because of definitive evidence that Kangaroo Care improves outcomes. You can find these guidelines and the evidence-base here.

Kangaroo Mother Care improves outcomes for term newborns

Skin to skin contact (SSC) helps stabilise any newborn's body temperature, heart rate, and respiration (whether preterm or term). SSC improves any newborn's breastfeeding outcomes (whether preterm or term).

Updated Moore et al 2025 Cochrane Systematic Review

  • SSC immediately post-birth "probably increases rates of exclusive breastfeeding at hospital discharge to one month postbirth" - moderate certainty evidence, though analyses have substantial heterogeneity.

  • SSC "probably increases infant axillary temperature" - though the mean deviation is not clinically meaningful.

  • SSC "probably increases blood glucose levels".

  • SSC doesn't appear to result in a difference in placental sepration time or the duration of third stage labor, nor maternal postpartum blood loss.

The authors conclude: "This review supports immediate SSC after birth, regardless of mode of birth, for mothers and their healthy full-term and late preterm infants in middle-income and high-income countries. No included studies were conducted in low-income countries. SSC probably promotes exclusive breastfeeding and improves infant thermoregulation and blood glucose levels."

Chu et al 2025

This is a retrospective study of 2205 women with term babies at Shanghai Changning District Maternal and Child Health Hospital, China. 1120 pairs were routinely roomed-in, 1085 pairs also performed continuous skin-to-skin contact. SSC was initiated within one hour after birth in both groups, but daily continuous SSC was not otherwise promoted in the roomed-in only group. Data was collected from the medical records made during hospital stay.

The continuous SSC group practiced

  • Mother's chest and breasts exposed and infant undressed

  • Soft blanket covered infant's back for warmth

  • Mother semi-reclined at 30-60 degrees

  • Infant in contact with mother's body, ensuring airways safety

  • Infant's buttocks supported with mother's hands

  • Twice daily, each session lasting 60 minutes, for three days.

There was no difference between the birth weight averages of the two groups. Compared to the routine rooming-in only group, the continuous STS group had

  • Lower weight loss after birth

  • Higher breastfeeding rate

  • Less use of jaundice medication.

Caesarian section delivery was also found to be a risk factor for excessive weight loss.

Recommended resources

All agree that fit and hold problems are the most common cause of nipple pain. So why isn't every woman shown how to prevent it, or how to do a quick and early repair?

What does the research tell us about approaches to fit and hold currently used for breastfeeding support?

The belief that 'there is no right way to breastfeed, only your way' doesn't help breastfeeding women (and may cause harm)

The Thompson method: a large hospital-wide study found no improvement in breastfeeding outcomes

An ultrasound study shows that a brief gestalt intervention immediately improves the suck of breastfeeding babies who fuss at the breast or who cause maternal nipple pain

Selected references

Boundy EO, Dastjerdi R, Spiegelman D. Kangaroo Mother Care and neonatal outcomes: a meta-analysis. Pediatrics. 2016;137(1):e20152238.

Chu H, Ye J, Dang J, Lu Q, Li L. The impact of mother-infant rooming-in and continuous skin-to-skin contact on newborns. Frontiers in Pediatrics. 2025;13:1577094.

Conde-Agudelo A, L D-RJ. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews. 2016;2017(8):CD002771.

Moore ER, Brimdyr K, Blair A. Immediate or early skin‐to‐skin contact for mothers and their healthy newborn infants. . Cochrane Database of Systematic Reviews. 2025(10):Art. No.: CD003519. DOI: 003510.001002/14651858.CD14003519.pub14651855.

Sivanandan S, Sankar MJ. Kangaroo mother care for preterm or low birth weight infants: a systematic review and meta-analysis. BMJ Global Health. 2023;8:e0101728.

Svensson KE, Velandia M, Matthiesen A-ST, Welles-Nystrom BL, Widstrom A-ME. Effects of mother-infant skin-to-skin contact on severe latch-on problems in older infants: a randomized trial. International Breastfeeding Journal. 2013;8:1.

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Next up in What does the research tell us about approaches to fit and hold during breastfeeding?

The Thompson method: a large hospital-wide study found no improvement in breastfeeding outcomes

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Dr Thompson showed that the cross-cradle hold and asymmetric face-breast bury worsen women's experience of nipple pain during breastfeeding

In 2011 Dr Thompson published an important historical account of Australian breastfeeding practice over the past 40 years.

Then in 2016, Dr Thompson led a well-conducted retrospective medical record analysis of 654 new mothers who were referred to her, which investigated for causes of nipple pain and engorgement. This very important study showed increased risk nipple pain occured when the breastfeeding woman

  • Used cross-cradle hold

  • Used breast shaping to achieve nipple-to-nose

  • Used asymmetric application of ‘4 points’ of the infant's face (the two cheeks, chin, and nose)

  • Had inflammatory mastitis.

    …
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Possums acknowledges the traditional owners of the lands upon which The Possums Programs have been created, the Yuggera and Turrbal Peoples. We acknowledge that First Nations have breastfed, slept with, and lovingly raised their children on Australian lands for at least 65,000 years, to become the oldest continuous living culture on Earth. Possums stands with the Uluru Statement from the Heart.