The Role of Skin-to-Skin Contact and Noise Management in Noise-Induced Stress on Breastfeeding Self-Efficacy and Neonatal Cortisol Levels

Objective: To evaluate the effects of skin-to-skin contact (SSC) and noise control on noise-induced stress, breastfeeding self-efficacy, and neonatal cortisol regulation. Methods: A retrospective study of 182 mother–infant pairs admitted between January 2023 and January 2025 divided into three groups based on perinatal care protocols: Standard group ( n = 62) receiving routine care with no noise control, Noise Control group ( n = 55) with noise control, and Noise Control + SSC group ( n = 65) with both noise control and SSC protocol. Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Infant Breastfeeding Assessment Tool (IBFAT), neonatal cortisol levels, heart rate (HR), oxygen saturation (SpO₂), and breastfeeding initiation time were compared. Results: Cortisol levels in both neonates and mothers were higher in the Standard group compared to the Noise Control and Noise Control + SSC groups at 24 and 72 h ( P < 0.05). The Noise Control + SSC group exhibited lower cortisol levels than the Noise Control group at both timepoints ( P < 0.05). Neonatal HR was higher, and SpO₂ was lower in the Standard group compared to the other two groups ( P < 0.05). BSES-SF and IBFAT scores were significantly lower in the Standard group ( P < 0.05), with longer breastfeeding initiation time and lower exclusive breastfeeding rates at 72h ( P < 0.05). Conclusion: Noise control and SSC remarkedly reduced noise-induced stress biomarkers, improved short-term breastfeeding self-efficacy, and accelerated lactation initiation. These findings support SSC as a low-cost intervention to buffer perinatal environmental stressors in clinical settings.