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Durham University

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C-section infant care study

A research project of the Department of Anthropology.


The aim of the study is to ascertain whether the use of a side-car crib will facilitate breastfeeding initiation and improve the experience and well-being of post c-section mothers and infants. One fifth of all mothers deliver via c-section, and currently the rate of breastfeeding initiation for c-section babies at the RVI is 23.8%, compared to 55% for non-c-section babies To examine the risks and benefits of the use of side-car cribs (bedding-in) following c-section delivery in comparison to standard rooming-in for mothers and infants on the post-natal ward. The principal questions we intend to address are:

  • Is a side-car crib a safe device when used with mothers after CS ?
  • Does the use of a side-car crib enhance physical contact between mother and baby?
  • Does the use of a side-car crib facilitate breastfeeding initiation following CS?
  • Does the use of a side-car crib affect the workloads of postnatal ward staff?

This study will assess the risks and benefits of using clip-on cots during post-natal care for women and infants experiencing caesarean delivery in comparison with the use of standalone bassinets. Sixty mothers will be recruited following c-section delivery and will be randomised to one of the trial arms. Mother-infant behaviour will be videoed on the 2nd postnatal night for assessment of infant safety, mother-infant interaction, and maternal caregiving. Mothers will be interviewed on the postnatal ward and followed up via telephone interviews for 16 weeks. Standard assessment tools will be used to rate mother-infant bonding, maternal recovery, maternal confidence and satisfaction.

The negative outcomes associated with caesarean delivery have long-term implications for infant health (bonding impairment, failure to breastfeed) and maternal well-being (maternal confidence, satisfaction with birth experience, potential for post-natal depression) may be ameliorated by the enhanced ability for contact and interaction between mother and baby on the postnatal ward that is afforded by the use of a clip-on crib.

The results of this study will be applicable to all hospitals considering the implementation of a bedding-in policy on the postnatal ward.

Published Results

Journal Article

  • Tully, K.P. & Ball, H.L. (2013). Trade-offs underlying maternal breastfeeding decisions: a conceptual model. Maternal & Child Nutrition 9(1): 90-98.
  • Tully, K.P. & Ball, H.L. (2012). Postnatal Unit Bassinet Types When Rooming-In After Cesarean Section Birth: Implications for Breastfeeding and Infant Safety. Journal of Human Lactation 28(4): 495-505.
  • Klingaman (now Tully), K.P. & Ball, H.L. (2009). Practicing evolutionary medicine in a postnatal ward: Ameliorating iatrogenic obstacles to breastfeeding. Anthropology News
  • Klingaman, K. & Ball, H. (2007). Anthropology of caesarean section birth and breastfeeding: Rationale for evolutionary medicine on the postnatal ward. Durham Anthropology Journal 14(1).


From the Department of Anthropology

Related links

Further information

For further information, please contact Prof Helen L. Ball.