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 Baby-Friendly Hospital; cesarean section was detrimental to infant skin-to-skin contact with their mothers immediately after birth.