Effect of Combined Skin-to-Skin Contact and Kangaroo Care on Breastfeeding and Bonding in Cesarean-Born Newborns (SSC-CS)

February 8, 2026 updated by: Paria Mohammadiasl, Istanbul University - Cerrahpasa

The Effect of Consecutive Skin-to-Skin Contact Applied by the Mother and Father on Breastfeeding Parameters and Bonding in Babies Born by Cesarean Section

This randomized controlled study aims to evaluate the effect of consecutive skin-to-skin contact applied by the mother and father on breastfeeding parameters and parent-infant bonding in babies born by cesarean section. The study includes two groups: an intervention group receiving consecutive skin-to-skin contact by the father followed by the mother, and a control group receiving routine postnatal care. Breastfeeding success and parental bonding will be assessed using validated measurement tools during the early postnatal period and follow-up.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The global increase in cesarean section rates has become a significant public health concern. In Türkiye, the cesarean section rate reached 57.4% in 2023, one of the highest among OECD countries. Babies born by cesarean section are often deprived of early skin-to-skin contact in the immediate postnatal period due to maternal physical limitations, which may negatively affect breastfeeding outcomes and parent-infant bonding.

Skin-to-skin contact and kangaroo care are evidence-based practices known to support neonatal physiological stability, breastfeeding success, pain management, and parent-infant bonding. However, operational and clinical barriers following cesarean delivery often limit the early implementation of maternal skin-to-skin contact. While the effects of skin-to-skin contact have been extensively studied in the context of mother-infant dyads, evidence regarding father-infant skin-to-skin contact remains limited, particularly in term infants.

Delayed maternal contact following cesarean delivery may result in missed opportunities for early bonding and breastfeeding initiation. In this context, involving fathers in early skin-to-skin contact may provide an effective strategy to compensate for delayed maternal contact. Active paternal participation in newborn care has been shown to support infant development, enhance paternal role adaptation, and strengthen family bonding.

This randomized controlled study will be conducted in the delivery and postpartum units of a private mother- and baby-friendly hospital in Istanbul, Türkiye. The study population will consist of mothers and term newborns born by cesarean section who meet the inclusion criteria. Sample size will be determined using G*Power software.

Participants will be randomly assigned to one of two groups. In the intervention group, newborns will receive uninterrupted skin-to-skin contact with the father for 30 minutes immediately after birth. Painful procedures, including hepatitis B vaccination and vitamin K administration, will be performed during father-infant skin-to-skin contact. Following maternal recovery and confirmation of clinical suitability, consecutive skin-to-skin contact will be initiated between the mother and the newborn. The first breastfeeding attempt will occur during maternal skin-to-skin contact.

The control group will receive routine postnatal care according to the hospital's standard protocol.

Breastfeeding success will be assessed using the Bristol Breastfeeding Assessment Tool prior to discharge, on postpartum day 2, and at one month postpartum. Maternal and paternal bonding will be evaluated using the Maternal Postnatal Attachment Scale (MPAS) and the Paternal Postnatal Attachment Scale (PPAS) at the same time points. Breastfeeding parameters and parental bonding outcomes will be statistically compared between the two groups.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Sevil professor/Advisor, PhD
  • Phone Number: 43162 +90 212 866 3700
  • Email: sevil@iuc.edu.tr

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion criteria:

  • Mothers who delivered by cesarean section
  • Mothers and fathers willing to participate and provide written informed consent
  • Newborns who are stable after birth
  • No health conditions in mothers or fathers that would prevent participation in skin-to-skin contact

Exclusion criteria:

  • Serious maternal or neonatal illness
  • Newborns requiring NICU admission
  • Mothers or fathers unwilling to participate
  • Any maternal or paternal condition preventing the implementation of skin-to-skin contact

Additional note:

-Eligibility is based on biological sex (female for mothers, male for fathers, newborns of any sex), not on gender identity.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Consecutive Skin-to-Skin Contact Group ( İntervention )
Newborns in this group receive consecutive skin-to-skin contact, first applied by the father for 30 minutes immediately after cesarean delivery, followed by skin-to-skin contact with the mother as soon as maternal clinical condition allows. Routine newborn care is provided alongside the intervention.
Behavioral: Intervention
Consecutive skin-to-skin contact is applied to newborns born by cesarean section, first by the father for 30 minutes immediately after birth, followed by skin-to-skin contact with the mother as soon as maternal clinical condition allows. Routine newborn care is provided alongside the intervention.
No Intervention: Routine Care Group ( Control )
Newborns in this group receive routine postpartum and newborn care according to the hospital's standard clinical protocol following cesarean delivery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Maternal Postnatal Attachment Scale (MPAS)
Time Frame: 3 months
Maternal-infant attachment will be measured using the Maternal Postnatal Attachment Scale (MPAS). This 19-item Likert-type self-report scale assesses the mother's emotions and thoughts toward her infant.
3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Paternal Postnatal Attachment Scale (PPAS)
Time Frame: 3 months
Paternal-infant attachment will be measured using the Paternal Postnatal Attachment Scale (PPAS). This 19-item scale evaluates the father's emotional approach, involvement, and interaction with the infant.
3 months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bristol Breastfeeding Assessment Tool (BBAT)
Time Frame: 3 months
Breastfeeding success will be assessed using the Bristol Breastfeeding Assessment Tool (BBAT). The tool evaluates mother-infant interaction during breastfeeding, infant positioning, latch, and sucking effectiveness, providing a systematic score of breastfeeding performance.
3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Investigators

  • Study Chair: sevil İnal, PhD, Cerrahpaşa University, Faculty of Health Sciences, Midwifery Department
  • Principal Investigator: Paria Mohammadiasl, MSc, Zeytinburu Avrasya Hospital / Cerrahpaşa University, Midwifery Department

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 1, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

February 8, 2026

First Submitted That Met QC Criteria

February 8, 2026

First Posted (Actual)

February 13, 2026

Study Record Updates

Last Update Posted (Actual)

February 13, 2026

Last Update Submitted That Met QC Criteria

February 8, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • MD-PM-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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