Effect of Kangaroo Mother Care on breastfeeding self-efficacy in primiparous women, 3 month after child birth

Document Type : Original Article


1 PhD student of reproductive health, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran.

2 Assistant professor, Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associated Professor, Department of Obstetrics & Gynecology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant professor, Department of Midwifery, Women's Health Research Center, School of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran.

5 Assistant professor, Department of Social Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Ira.


Introduction: Breast milk is the best nutritional supply for infants and exclusive nutrition with breastfeeding for the first 6 months of life and its continuation until 2 years are recommended. One of the important variables during breastfeeding length is breastfeeding self-efficacy which is the mother’s confidence and belief about her ability for breastfeeding. This study was performed with the aim to evaluate the effect of kangaroo mother care on breastfeeding self-efficacy in primiparous women, 3 month after child birth.
Methods: This randomized control trial was performed on 72 primiparous women referred to Mashhad Omolbanin Hospital for delivery in 2013. Participants were randomly divided into two groups of kangaroo mother care group and routine care group, and were followed up for breastfeeding self-efficacy 3 months postpartum. Data were analyzed by SPSS software version 14 and Chi-square and student t-test. P < 0.05 was considered significant.
Results: Mean breastfeeding self-efficacy score 3 months post partum was 56.29±4.57 in kangaroo mother care group and 51.87±10.43 in routine care group which showed statistically significant difference (P= 0.035).
Conclusion: Kangaroo mother care immediately after birth leads to increased rate of breastfeeding self-efficacy in mothers and is an easy, cost-effective, and available method to increase the rate of breastfeeding.


  1. Schanler RJ, Dooley S, Gartner LM, krebs N, Mass S. Breastfeeding handbook for physicians. 2nd ed. Washington: American Academy of Pediatrics; 2006. p. 19-32.
  2. Kliegman RM, Stanton B, Geme JS, Schor N, Behrman RE. Nelson textbook of pediatrics. 19th ed.  Amsterdam: Elsevier; 2011; p. 459-60.
  3. Veghari GH, Rahmati R. Breastfeeding Status and Some of its Related Factors in the Golestan Province. IJN. 2011; 24 (71):8-18.
  4. Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Breastfeeding and the use of human milk. Pediatrics. 2012; 129(3):e827-41.
  5. Angela Taft. Policy-at-a-glance – Breastfeeding Policy. Australia: Public Health Association of Australia; 2010.Available from: http://www.phaa.net.au/documents/policy/101216_Breastfeeding%20Policy.pdf 15/2013
  6. Walke M. Core curriculum for lactation consultant practice. Sudbury: Jones and Bartlett; 2006.p.147.
  7. Forster DA, McLachlan HL. Breastfeeding Initiation and Birth Setting Practices: A Review of the Literature. J Midwifery Womens Health. 2007; 52 (3): 273–80.
  8. Genna CW. Supporting Sucking Skills in Breastfeeding Infants.2nd ed. Jones & Bartlett Learning; 2013. p. 106-8.
  9. Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2007;5::CD003519.
  10. Moor E, Anderson G. Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. J Midwifery Womens Health. 2007; 52(2):116-25.
  11. Blyth R, Creedy DK, Dennis CL, Moyle W, Pratt J, De Vries SM. Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory. Birth. 2002; 29(4):278-84.
  12. Varaei SH, Mehrdad N, Bahrani N. The relationship between self- efficacy and breastfeeding .Hayat. 2009; 15(3):31-8.
  13. Carlson Bowles B. Promoting Breastfeeding Self-Efficacy: Fear Appeals in Breastfeeding Management Clinical Lactation. Clinical Lactation.2011; 2 (1): 11-14.
  14. Puig G, Sguassero Y. Early skin-to-skin contact for mothers and their healthy newborn infants: RHL commentary (last revised: 9 November 2007). The WHO Reproductive Health Library; Geneva: World Health Organization. Available from: http://apps.who.int/rhl/newborn/gpcom/en/ 15/2013
  15. Arona S, Mukin C,Wehrem J,Kuhh P. Major factors influencing feeding rate; Mother perception of fathers attitude and milk supply. Pediatrics. 2000; 106(5): 67.
  16. Betgman N. Kangaroo mother care and skin to skin contact as determinant of breastfeeding success. Mowbray Maternity Hospital, Cape Town, South Africa; 2005.
  17. Karimi A, Tara F, Khadivzadeh T, Aghamohammadian Sharbaf HR. The Effect of Skin to Skin Contact Immediately after Delivery on the Maternal Attachment and Anxiety Regarding Infant. IJOGI. 2013; 16(67): 7-15.
  18. Alikasifoglu M, Erginoz E, Gur ET, Baltas Z, Beker B, Arvas A. Factors influencing the duration of exclusive breastfeeding in a group of Turkish women. J Hum Lact .2001; 17(3): 220-6.
  19. Hasanpoor Sh, Bani S, Ansari S, Ebrahimi H.Measuring Breastfeeding Self – Efficacy among Pregnant Women Referred to Health Centers of Ahvaz. Nursing & Midwifery Journal. 2010; 5(19): 47-53.
  20. Janke JR. Development of the breastfeeding attrition prediction tool. Nursing Research.1994;43,100-104.
  21. Azhari S, Baghani R, Akhlaghi F, Ebrahimzadeh S, Salehi Federdi J. Comparing the effect of hands – on and hands off breastfeeding methods on self – efficacy in primiparous mothers. 2011; 17 (4):248-55.
  22. McQueen KA, Dennis CL, Stremler R, Norman CD. A pilot randomized controlled trial of a breastfeeding self-efficacy intervention with primiparous mothers. J Obstet Gynecol Neonatal Nurs. 2011; 40(1):35-46.
  23. karbandi S, Hosseini S, Masoudi R, Mamori G. The effect of relaxation training on breastfeeding self-efficacy of mothers with preterm infants: A randomized clinical trial. Journal of Clinical Nursing and Midwifery. 2014; 3 (2) :37-45
  24. Rahmatnejad L, Bastani F. An investigation of Breast Feeding Self Efficacy and its Relationship with exclusive breast feeding. Alborz University Medical Journal . 2012; 1 (1) :31-6.
  25. Karimi A, Khadivzadeh T, Tara F. Evaluate effects maternal infant skin-to-skin contact on success of first breastfeeding and exclusive breastfeeding in neonatal period . Mashhad:Nursing & Midwifery School, Mashhad University of Medical Sciences; 2008.