PURPOSE: The purpose of this study was to examine the relationships (a) between social regulation behaviors and the cortisol response and (b) between stressors and the newborn cortisol response during the first 6 hours after birth.
PARTICIPANTS: A convenience sample of 46 mothers who planned to have a vaginal birth of a singleton term infant and planned to breast-feed completed the study. Thirty infants experienced spontaneous vaginal birth, 6 infants experienced instrument-assisted vaginal birth, and 10 infants were delivered by cesarean section after labor. Infants had Apgar scores equal to or greater than 7. Mean birth weight was 3544 +/- 456 g. Mean gestational age was 39.8 +/- 0.9 weeks.
DESIGN: A descriptive-correlational design with repeated measurements was used.
METHODS: Mothers and newborn infants were observed at 8 random times during each of the first 6 hours after birth with the use of the Index of Mother-Infant Separation, a structured observation tool. Mother holding was defined as observations in which the infant was held skin-to-skin or wrapped. Mother feeding was primarily breastfeeding or positioning for breastfeeding; however, a few mothers bottle-fed their infants. Father or other caregiver holding or feeding included skin-to-skin, wrapped holding, or bottle-feeding. Treatments ranged in intensity from vital signs to heelsticks. Newborn salivary cortisol was measured at 30 minutes of age, 2 hours of age, prebath, postbath, and at 61/2 hours of age. Cortisol area under the curve calculations indicated both total cortisol response and cortisol recovery during the 6-hour study.
MAIN OUTCOMES MEASURES: These include social regulation behaviors; mother holding, mother feeding, and father or other caregiver holding or feeding; treatments; total cortisol response; and cortisol recovery.
RESULTS: Higher mother holding was related to lower infant total cortisol response over the 6-hour period (r = -0.24, P = .05, 1-tailed, n = 46). No additional relationships reached statistical significance.
CONCLUSIONS: Findings were consistent with previous research that transitional newborn infants recover from the stress of labor and birth, yet respond to stressors during the first 6 hours of life. This study provided evidence that mother holding should be studied further for effectiveness in social regulation of the cortisol response in the transitional newborn.