Skin-to-skin contact at birth: a challenge for promoting breastfeeding in a "Baby Friendly" public maternity hospital in northeast Brazil

Objective: to identify prevalence of compliance with the fourth step of the Baby Friendly Hospital Initiative - to put the babies in skin-to-skin contact with their mothers immediately after birth for at least half an hour - in a public hospital in Northeast Brazil. Methods: this was a cross-sectional study using data from interviews with mothers who had recently given birth during a typical week in 2014. Results: 107 mothers were interviewed; 9.3% had completed the fourth step properly; the fourth step was negatively associated to cesarean section (p<0.01), and adequacy was not associated with receiving guidance on breastfeeding during the prenatal period or with breastfeeding in the first hour of life. Conclusion: low compliance with the fourth step is cause for concern, especially because this is a Child Friendly Hospital; cesarean section was detrimental to infant skin-to-skin contact with their mothers immediately after birth.