A total of 76 mother-child pairs volunteered to participate in this study. According to the inclusion/exclusion criteria, 6 pairs were excluded due to premature birth (before 37 weeks of pregnancy); 4 mothers were excluded due to interruption of breastfeeding (the cause being the mother) within the first 48 h after birth; 6 other pairs were excluded (the newborns who required care in the neonatal intensive care unit (NICU)).
Following the secondary selection according to the inclusion/exclusion criteria, a convenience sample group of 60 pairs of new-born mothers, aged over 16, who expressed their desire for exclusive natural nutrition and accepted inclusion in the study, healthy (without cardiovascular or renal comorbidities) who declare that they choose to breastfeed immediately after birth, from which written consent was obtained. The medical data of patients and newborns were taken from the clinic’s electronic system and then stored in a database and identification. The post hoc analysis indicated this sample size yielded a power of 89.6% with the probability of type I error of 0.05.
Patients hospitalized and included in the study group align the ten steps of the Baby Friendly Hospital initiatives, especially step 3 (inform all pregnant women about the benefits and management of breastfeeding), step 5 (show mothers how to breastfeed and how to breastfeed to maintain lactation) and step 7 (rooming practice—in postnatal care allows mothers and babies to stay together 24 h a day).
Inclusion criteria:

Pregnant women who declare that they want to breastfeed immediately after birth;

Pregnant women over the age of 16, with secondary education;

The signed consent of the mother for the inclusion of the newborn in the study;

Only term newborns and without comorbidities are eligible.

Exclusion criteria:

Pregnant with preterm delivery;

Pregnant women with cardiovascular and renal comorbidities, mental illnesses in the antecedents;

Newborns who required maneuvers and intensive therapy treatments at birth.

Because it is not possible to accurately predict the day of birth and because no patient included in the study had a scheduled elective birth, the cortisol level was determined from the saliva sample collected at the time of hospitalization. Hospitalized patients were included only if they were in induced labor, and we only considered cortisol determinations of births that occurred within 0–24 h of saliva collection. Cortisol levels can increase due to hospitalization, pain and the type of birth. Its value represents a conclusive factor for studying the relationship between cortisol levels and breastfeeding success.
To evaluate the success of natural nutrition after birth [36 (link)], the LATCH score was evaluated 24 and 48 h after birth, by a single nurse with experience in conducting clinical and research studies, with the aim of minimizing interpretation errors.
The HADS scale has 14 items of which 7 are for anxiety, and 7 are for depression. Each item is evaluated on a Likert scale with 4 anchors, from 0 = never, to 3 = always. The items for anxiety are represented by odd questions (1,3,5,7,9,11,13) and indicate a level of depression rated on a Likert scale. The items for depression are represented by even questions (2,4,6,8,10,12,14) and indicate a level of depression rated on a Likert scale. To rate the answers, the score is calculated for each scale: anxiety, respectively, depression, taking into account the grid, summing up the scores obtained for the items of the scales separately (Table 1).
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