Guest blogger: Anna Blair, PhD, ALC, CLC, IBCLC
At the Healthy Children Project, we’re not accustomed to taking a break to celebrate accomplishments. We get so excited for the next project that we sometimes don’t stop to have cake and say YAY! However, this one deserves a pause. As one of the co-researchers of the Cochrane review that was published last week, I can certainly attest to the fact that we have a lot to celebrate!! The latest Cochrane review gets to say, in strong language, skin-to-skin contact immediately after birth should be standard care – after vaginal and cesarean births.
Our work groups were divided into a breastfeeding team, a maternal outcomes team and a neonatal team. I was part of the breastfeeding team. But I was also part of smaller group that did a large amount of the writing. Many of my co-authors agreed that while the work was intensely demanding, it was at the same time profoundly worthwhile—a true testament to the magnitude of this undertaking! When I was working on my master’s degree and then PhD (oh those many years ago!), I wrote a lot about the power and the experience of being part of great groups. I can say unabashedly, this was a truly great group. When we got together and wrote, it was genuinely collaborative and special. The expertise of everyone in the room was something words just cannot fully describe.
Such an immense amount of work goes into a Cochrane review… critical appraisal of studies, statistics, analysis and Cochrane’s specific method for analysis… 69 trials with over 7,000 dyads! I am so thankful to have been part of this project and to be fortunate enough to have the incredible guidance of our lead researchers, Dr. Bette Moore (who completed the previous skin-to-skin Cochrane reviews) and Healthy Children’s own Dr. Karin Cadwell. Dr Karin Cadwell and I (along with colleagues) have uncovered modifiable factors for latching babies in our latest research that impacts effective breastfeeding. The team of researchers hailed from every continent (except Antarctica) and, to me, reads like a who’s who in the field of skin-to-skin and breastfeeding research.
Where do I start? Dr. Elsa Giugliani (and who in breastfeeding hasn’t been impressed with every study she has written?)…Drs. Siri Lillieskö and Wibke Jonas have done groundbreaking research on immediate skin-to-skin contact with premature infants… Drs Rebecca Hill, Julie Grady, Irena Zakarija-Grkovic and Azza Ahmed’s wide ranging work on breastfeeding have contributed to our knowledge of breastfeeding by answering previously unanswered questions…Dr Rukhsana Haider, whose work on peer counseling and infant nutrition widens our understanding of implementing supportive breastfeeding programs… Dr. Yuki Takahashi’s recent research showed that when clinicians interfered with skin-to-skin and breastfeeding in the first hour by “helping” babies get to the breast, moms had more sore nipples. Drs Jeni Stevens and Jeannette Crenshaw’s work on skin to skin in the OR has been impactful on the field showing that skin-to-skin after Cesarean birth is possible and desirable.
Remember when I said we’re always focused on the next project? Our current research implementing skin-to-skin contact and looking at the consequences on breastfeeding overlapped with this one! The team of Cochrane authors also included a several people from our Uganda research and implementation team – Louise Basterache, and Drs Scovia Mbalinda, Mike Kagawa, Kristin Svensson (whose work on skin-to-skin contact as a solution for breastfeeding with babies up to 4 months old is groundbreaking!), along with Dr. Cadwell, myself and Dr. Brimdyr. Dr. Kajsa Brimdyr has led the ethnographic research on skin to skin by videotaping hundreds of babies in their first hour, confirming the late Dr. Ann Marie Widström’s 9 stages of babies while skin to skin.
If you have not read the work of these incredible researchers, teachers and program implementors, put them on your Autumn Reading List (I am not sure that an Autumn Reading List is a thing, but it should be)
I could go on and on raving about how meaningful and impressive this whole team’s work has been! You can find a recommended reading list of the favorite papers they’ve written on our website – https://centerforbreastfeeding.org/cochrane-review-2025/.
If you are newer to the world of research and evidence-based practice, Cochrane reviews are considered the highest standard for evidence. They use a specific method from the Cochrane organization to synthesize existing randomized controlled trials. As you read the article, you will notice that we had to lower the risk of bias because mothers know their baby is skin-to-skin so they can’t be blinded!
In later weeks, Kristin Stewart, writer of OurMilkyWay blog, will write about the significance of skin to skin being standard care, relating back to the universal principals of bioethics – do no harm. I know I am not alone in looking forward to that post in the future. Because this review says that it should be the standard of care, there should be access to this for all.
In the meantime, we’ll keep perfecting the art of the “cake break” as we keep working hard to research, work collaboratively and make a difference in the field!
Here are some important links that I hope you will check out.
To read more about the findings, a summary can be found on Healthy Children Project’s website:
https://centerforbreastfeeding.org/cochrane-review-2025/
The full article (including the plain language summary) can be found here:
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003519.pub5/full
Thank you, Kristin, for allowing me to have this moment to celebrate the publication of this Cochrane Review!
