Newborn infants who received skin‐to‐skin contact with fathers after Caesarean sections showed stable physiological patterns

4.1 | Strength and limitations
The strengths of the study included the randomised controlled trial 
design. The reliability of the naturalistic observations was strength-
ened by using Brazelton's NBAS scale, which is a validated instru-
ment,
23
and a standardised observation protocol. In addition, the 
physiological parameters were standardised with the same proce-
dure and the same personnel conducted the naturalistic observa-
tions and performed all the measurements. They strengthened the 
validity. A possible limitation could be that all the newborn infants 
were treated under a heater for 30 minutes after birth to ensure 
their temperature was stable immediately before the interventions. 
However, it was normal after 30 minutes (36.8°C) and remained nor-
mal at the end of the study period of 120 minutes. Moreover, the 
results of our study agreed with previous research.
24
5 | CONCLUSION
Healthy newborn infants born by elective Caesarean section showed 
stable physiological patterns, temperature, heart rate and peripheral 
oxygen saturation, when they received three different caregiving 
models. The father-infant skin-to-skin contact group demonstrated 
other advantages, and no negative effects were observed. This car-
egiving model should be supported if mothers and infants need to 
be separated.
ACKNOWLEDGEMENTS
The authors are grateful to the Obstetric Service at Sótero del Río 
Hospital, chief midwife Veronica Gallegos, Dr Patricia Mena, head of 
the Neonatology Service and the midwives who made this research 
possible.
CONFLIC T OF INTEREST
The authors have no conflicts of interest to declare.
ORCID
Ana Ayala
https://orcid.org/0000-0001-8207-9629
 
REFERENCES
1. Leavitt LA. Mothers' sensitivity to infant signals. Pediatrics. 
1998;102:1247-1249.
2. Arnott B, Meins E. Continunitity in mind-mindedness from preg-
nancy to the first year of life. Infant Behav Dev. 2008;31(4): 
647-654.
3. Negayama KJT, Momose K. Embodied intersubjective engage-
ment in mother–infant tactile communication: a cross-cultural 
study of Japanese and Scottish mother–infant behaviors during 
infant pick-up. Front Psychol. 2015;6:66. https://doi.org/10.3389/
fpsyg.2015.00066
4. Stevens J, Schmied V, Burns E. Immediate or early skin-to-skin con-
tact after a Caesarean section: a review of the literature. Maternal 
Child Nutri. 2014;10(4):456-473.
5. Widström AM, Lilja G, Aaltomaa-Michalias P. Newborn behaviour 
to locate the breast when skin-to-skin: a possible method for en-
abling early self-regulation. Acta Paediatr. 2011;100(1):79-85.
6. Christensson K, Cabrera T, Christensson E. Separation distress call 
in the human neonate in the absence of maternal body contact. 
Acta Paediatr. 1995;84(5):468-473.
7. Velandia M, Uvnäs-Moberg K, Nissen E. Sex differences in new-
born interaction with mother or father during skin-to-skin contact 
after Caesarean section. Acta Paediatr. 2012;101(4):360-367.
8. Christensson K, Siles C, Moreno L. Temperature, metabolic adapta-
tion and crying in healthy full-term newborns cared for skin-to-skin 
or in a cot. Acta Paediatr. 1992;81(6–7):488-493.
9. Erlandsson K, Christensson K, Dsilna A, Jonsson B. Do caregiv-
ing models after caesarean birth influence the infants' breathing 
adaptation and crying? A pilot study. J Children's Young People's 
Nursing. 2008;2(1):7-12.
10. Christensson K. Fathers can effectively achieve heat conservation 
in healthy newborn infants. Acta Paediatr. 1996;85(11):1354-1360.
11. Velandia M, Matthisen AS, Uvnäs-Moberg K, Nissen E. Onset 
of vocal interaction between parents and newborns in skin-to-
skin contact immediately after elective Caesarean section. Birth. 
2010;37(3):192-201.
12. Moore E, Bergman N, Anderson GC, Medley N. Early skin-to-
skin contact for mothers and their healthy newborn infants. 
Cochrane Database Syst Rev. 2016;25(11):CD003519. https://doi.
org/10.1002/14651 858.CD003 519.pub4
13. Bystrova K, Widström AM, Matthiesen AS. Skin-to-skin con-
tact may reduce negative consequences of “the stress of being 

---