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Maternal Schizophrenia, Skin-to-Skin Contact, and Infant Feeding Initiation

Research output: Contribution to journalArticlepeer-review

Clare Taylor, Hilary Brown, Natasha Saunders, Lucy Barker, Eyal Cohen, Simon Chen, Cindy-Lee Dennis, Joel Ray, Simone Vigod

Original languageEnglish
Pages (from-to)145-153
Number of pages9
JournalSchizophrenia Bulletin
Issue number1
Early online date26 Jul 2021
E-pub ahead of print26 Jul 2021
Published21 Jan 2022

Bibliographical note

Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.All rights reserved.

King's Authors


BACKGROUND: The World Health Organization recommends mothers and infants be in direct skin-to-skin contact immediately after birth and initiate breastfeeding as soon as possible. Little is known in women with schizophrenia. METHODS: We conducted a population-based cohort study using administrative health data from Ontario, Canada (2012-2014), comparing women with (n = 471) and without schizophrenia (n = 218 435), and their infants, on the primary outcomes of any skin-to-skin contact and opportunity to initiate breastfeeding within the first 2 h after birth. For dyads with available data, secondary outcomes of intention to breastfeed, breastfeeding support, any breastmilk, and exclusive breastmilk at discharge were assessed. Modified Poisson regression was used to generate relative risks (aRR) and 95% confidence intervals (CI), adjusted for maternal age, parity, neighbourhood income, region of residence, smoking in pregnancy, and maternal medical and non-psychotic psychiatric comorbidity for all outcomes. RESULTS: Maternal schizophrenia was associated with lower likelihood of skin-to-skin contact (65.2% vs 78.1%; aRR 0.88, 95% CI: 0.82-0.94), and breastfeeding initiation post-delivery (38.9% vs 52.6% aRR 0.80, CI: 0.71-0.90) compared to dyads unexposed to maternal schizophrenia. Secondary outcomes followed a similar pattern. The magnitude of the effect was slightly less when restricting the cohort to full-term, vaginal deliveries, not admitted to NICU, and infant not discharged to social services. CONCLUSIONS: Reduced maternal-infant skin-to-skin contact and breastfeeding initiation immediately after birth may significantly impact maternal-child bonding and the establishment breastfeeding in this population. Mothers with schizophrenia may require individualized support to promote these WHO recommended hospital practices in the early post-natal period.

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