2.1 | Randomisation The day before the elective Caesarean section, 130 prospective
parents were selected in consecutive order and informed about the
study, verbally and in writing. The parents were assured that they
could withdraw from the study at any time, without any impact on
the care they and their infant received. They were also told that
their anonymity would be protected. The randomisation was per-
formed using sealed, opaque envelopes that contained information
about group allocation. The infants were randomised to one of three
groups. In the cot group, the infants were placed in a cot on their
side, dressed in a diaper, cotton pyjamas and a cotton hat, with the
father sitting in a chair near the infant. In the fathers' arms group, the
infants were placed in a supine position in the fathers' arms, dressed
in a diaper, cotton pyjamas and cotton cap. In the father-infant skin-
to-skin contact group, the infants were dressed in a cotton diaper,
and placed skin-to-skin on their fathers' chest in a prone, 30º to 45º
upright position. The fathers were seated in a comfortable semi-
reclined armchair, and both the father and infant were covered with
a blanket.
2.2 | Procedures All newborn infants received the same routine care before the
start of the intervention. Immediately after the Caesarean birth,
the umbilical cord was cut and the infant was dried. If required, oral
suctioning of mucus from the infant's mouth was conducted. The
Apgar score was measured from one to 10, at one and five minutes
after birth. The infant was wrapped in two towels and shown to the
mother, then cared for under a heater for 30 minutes and eventu-
ally transferred to the neonatal unit. The mother, in turn, was trans-
ferred to the post-surgery unit.
All infants were checked 30 minutes after birth by a midwife in
the presence of the father. Each infant was examined, measured and
weighed, and their ear temperature was noted. If the infant fulfilled
the inclusion criteria, they were allocated to the assigned caring
model according to the randomisation process. All the infants were
wearing a cotton diaper and covered with two blankets during this
assessment.
The intervention began 45 minutes after birth, and the in-
fant's physiological variables and their state of wakefulness were
Keynotes • This study focused on the wakefulness and physiological
parameters of full-term infants, who are frequently sep-
arated from their parents after an elective Caesarean.
• The 95 infants were randomised to three groups: cot,
fathers' arms or skin-to-skin contact with their father
and at 15-minute intervals, from 45 to 120 minutes after
birth.
• The skin-to-skin group demonstrated some advantages
over the other two groups when it came to establishing
stable physiological parameters and wakefulness.