Maternal stress and breastfeeding outcomes in the NICU couplet care experience: a prospective cohort study

Abstract

Objective: Couplet care is an innovative approach to provide postpartum care in the neonatal intensive care unit (NICU) with little known about its impact on infant feeding outcomes and maternal stress. Study design: We compared breastfeeding outcomes and maternal NICU-related stress among mother-infant dyads based on exposure to couplet care in a prospective cohort study. Result: Among 19 couplet-care exposed (CCE) dyads and 19 traditional postpartum care dyads, CCE mothers had lower self-reported stress related to parent-infant relationship as compared to traditional care (P < 0.001). CCE infants received relatively more feeds at the breast (P < 0.001), more breastmilk feeds (P = 0.002), and fewer feeds by staff (P < 0.001). Adjusted for gestational age, marital status, and infant length of stay, couplet care was associated with being in a higher tertile of percent breastmilk feeds (aOR 7.29, 95% CI 1.45–36.65). Conclusion: NICU couplet care was associated with improved parental stress and breastfeeding outcomes during hospitalization.