Pratiche ospedaliere a confronto. Effetto su allattamento, ansia, depressione postpartum e alcune caratteristiche del bambino

Aims This study was aimed to value the effect of some hospital practices (rooming-in, skin to skin) on mother’s and infant’s subjective and objective wellness. The indexes considered were: mother’s sleep and rest, subjective pain, level of anxiety, risk of depression, coping and subjective perception for the mother; infant’s weight and growth, Apgar score, icteric index, crying and soothability. Methods Longitudinal study on 71 couples of mother and infant, divided into two groups according to the kind of hospital attended for the delivery: 34 from San Bonifacio (VR) hospital, that is following OMS/UNICEF guidelines and is defined Baby Friendly Hospital, and 37 from Arzignano (VI ) hospital (not following OMS/UNICEF guidelines at all). The research is based only on Italian healthy infants. The measures (January- March 2006) mentioned above were collected at hospital removal and after six weeks. Mothers were interviewed before leaving the maternity hospital through an open/ended questions interview and filled in the STAI; after six weeks the following measurement instruments were administered: a second interview, the STAI, the Edinburgh Postnatal Depression Scale, a diary about infant crying and a questionnaire about strategies mother used to soothe her baby. Results The qualitative analysis shows that in the hospital of San Bonifacio mothers give more importance to their closeness to their infant (according to BFH project) then mothers of Arzignano that give more importance to doctors and their role. The quantitative analysis shows the following significative differences: in the first group (San Bonifacio) 85,3% of infants were full breast-feeded, while in the second group only 32,4% of infants were; in the first group there was 97,1% of natural births (T.C. 17% in the last years) while in the second group there was 70,3% (T.C. over 25% in the last years); in San Bonifacio group 97,1% of mothers stayed with their children immediately after birth, while in the second group only the 2,9%; in the first group 88,2% of mothers practised total rooming-in while in the second group only the 2,9%. After six weeks in the first group there were still more mothers that breast-feeded (any breastfeeding) their infants even if the difference in the trend isn’t significant ( in the first group from 84,8% at hospital removal to 60,6% after six weeks; in the second group from 34,3% at hospital removal to 37,1% after six weeks). Instead the difference in soothability and cry are significant: in the second group 20% of infants is difficult to comfort while in the first group only 3% of infants that cry also less. There aren’t significant results about level of anxiety and risk of postnatal depression after six weeks. Discussion The hospital politics can influence the choice of mother about breast-feeding; a prompt and careful support from the health care professionals can help to promote breast-feeding with some practices as skin to skin and rooming-in. Another interesting data is the different rate of breastfeeding in the two hospitals after birth and after six weeks: which factors can influence these results? The tipe of birth and full breastfeeding can influence it? The children of the two groups show different levels of soothability: children of the second group are less consolable. More than whole variables that appear after hospital removal, is sure that breastfeeding influence this aspect. Key words hospital practices, birth, breast-feeding, infant crying and soothability