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  • Athina Vandevoort

Skin-to-skin contact immediately after birth: how can it benefit both you and your baby?

Updated: Aug 19, 2019

Immediate skin-to-skin contact after birth is the practice where your newborn baby is placed naked on the mother’s bare chest, immediately after birth. The baby is still wet from the amniotic fluid, so he gets dried off and covered up with a blanket or towel. The nurse can put a hat on him to prevent cooling, especially for babies with a lot of hair that doesn’t dry fast. There are numerous short- and long-term health benefits linked to skin-to-skin. Immediate skin-to-skin for an hour after birth is recommended by the World Health Organization (WHO). Unfortunately, it is often still common practice to separate mother and baby immediately after birth to perform standard measurements and checks. Visions of a bundled up, cleaned up baby handed to the mother is a standard look in modern-day media. So what are the benefits to skin-to-skin contact and how can you make sure you get to insert this practice after birth?


Skin-to-skin and breastfeeding

Breastfeeding is the recommended method of feeding the newborn by the World Health Organization (WHO). It is free, readily available, safe, and has many health benefits that formula still cannot offer. However, breastfeeding is also a learned skill. Many women struggle with initial feeding in the early weeks. It is therefor important that we can offer as many factors possible that may benefit the success rate of breastfeeding.

Immediate skin-to-skin has been proven to increase the success rate and duration of nursing (Karimi, Sadeghi, Maleki-Saghooni & Khadivzadeh, 2018). There are several reasons for this. During the immediate postpartum, the newborn baby goes through a range of phases. After the initial first cry to expel the last fluids from the lungs follows a brief resting period, where the infant familiars himself with the mother’s smell, taste, the sound of her voice… Research has shown that babies who are put skin-to-skin and are left undisturbed, will on average take 30 to 45 minutes to crawl to the breast by themselves and start suckling. After one hour to 90 minutes, most infants will grow tired, barely respond to stimuli and go into a resting phase that may last several hours. This means that any amount of time the baby is away from the mother straight after birth, precious minutes of this ‘Golden Hour’ window are missed to optimize breastfeeding. If anything, these tests and measurements will be easier for hospital staff to perform, as the infant will be in a much more calm and relaxed state.

Furthermore, it has been proven that during skin-to-skin contact the production of oxytocin in both the infant and the mother surges, while the cortisol levels significantly drop ( Vittner et al, 2018). Oxytocin is the love hormone that is also released when we cuddle or look at somebody we love. Oxytocin during breastfeeding helps with the milk ejection reflex.


Skin-to-skin and maternal bonding

As mentioned above, skin-to-skin brings a surge of oxytocin with it. This has been proven to aid in maternal and infant bonding (Adeli & Aradmehr, 2018). It also gives you a chance to take a moment to yourselves: count your baby’s toes and fingers, stare into his eyes and marvel at what you two created, compare who baby looks like the most. You are still high on natural endorphins, especially if you had a drug-free birth, and you will feel on top of the world. Take advantage of that moment to indulge in all the cuddles!


Skin-to-skin and third stage of labour

Skin-to-skin has been proven to lead to a shorter third stage of labour (this phase starts as soon as your baby is born until your placenta is born), and can have a preventative effect on postpartum hemorrhaging or excessive bleeding (Karimi, Miri, Salehian, Khadivzadeh & Bakhshi, 2019). Oxytocin (here we are again) also has an effect on the uterus, helping it contract. Due to contracting, the uterus can expel the last remains of mucus, amniotic fluid, membranes and help the placenta separate from the uterine wall, lowering the risk of excessive bleeding. With the baby laying on the mother’s chest, he will also instinctively gently kick his legs, stimulating the uterus to contract even more.


Skin-to-skin and baby’s temperature

Newborn infants are prone to hypothermia, or abnormally low body temperature. This is often cited as a reason to separate mother and baby and either wrap baby up or place the infant under a warmer. However, extensive research has shown that babies suffer much less from hypothermia if they are kept skin-to-skin with the mother (Safari, Saeed, Hassan & Moghaddam-Banaem, 2018). During skin-to-skin contact, the mother’s skin radiates heat to the newborn. The baby’s senses in return get activated, and he learns how to regulate his own temperature. A win-win!


Skin-to-skin in special circumstances

When a mother has to give birth through a c-section, she often worries her preferences for birth are out of the door, but it doesn’t have to be this way. Many doctors embrace the practice of a gentle cesarean, where natural, vaginal birth is mimicked in as many ways possible. One of the options is to not have your arms strapped to the table and have your baby placed on your chest as well immediately after birth. Some hospitals and doctors even go as far as not separating mother and baby at all, leaving baby on mother’s chest while they close up, but this practice is unfortunately not as common. Usually, if you request skin-to-skin with a cesarean, the baby will be placed on your skin for a couple of minutes, after which he will be taken to the nursery. You can state in your birth plan that you want the father to have skin-to-skin contact after transferring to the nursery, while waiting for the mother to come out of recovery. Skin-to-skin contact with daddy has all the benefits of temperature regulation and parental bonding, and gives the dad an intimate first moment with his son or daughter! If not specifically stated, standard practice in some hospitals will place baby in a bed in the nursery until mother requests for her baby.

In case of a premature delivery, most practitioners will want mother and baby to be separated and sometimes, admittance in the NICU is needed. However, if all seems well with baby, there is no reason to not place him skin-to-skin with mother. Premature born babies have even more issues with regulating their temperature, so they will benefit even more from this contact. If admittance in the NICU is needed, it is often still possible to have skin-to-skin contact with your little one. Sometimes you might have to wait until your baby is stabilized, or maybe he needs a small tube for feeding, or some extra oxygen support. Kangaroo care (the practice where baby is placed on your tummy or chest) may still be possible from a chair next to baby’s incubator. Ask your healthcare practitioner about the options!


Claim your right of holding your baby

Some hospitals might have outdated protocols and will routinely want to separate mother and baby; however, it is your full right to state your preference of holding your own baby immediately after birth. Here are some tips to facilitate the practice:

o Look for an obstetrician who supports the practice. You can approach him during pregnancy regarding his or her view regarding skin-to-skin. If he doesn’t support the practice, you can look for alternative obstetricians who support your view of labour and birth

o Make a birth plan in which you state all your birth preferences. Pass it along to the hospital staff during your hospital tour or registration, and bring a copy when you go into labour. Let your husband pass it the nurse on duty upon arrival

o Employ a doula who can be present during your birth to encourage and empower you to express your wishes to the hospital staff

o Consider taking antenatal classes to deepen your knowledge regarding the subject


References

Adeli, M. & Aradmehr, M. (2018). A comparative study of maternal-neonate abdominal and

kangaroo (skin-to-skin) skin contact immediately after birth on maternal attachment behaviors up to 2 months.

Karimi, F.Z., Heidarian Miri, H., Salehian, M., Khadivzadeh, T. & Bakhshi, M. (2019). The Effect of Mother-Infant Skin to Skin Contact after Birth on Third Stage of Labor: A Systematic Review and Meta-Analysis

Karimi, F.Z., Sadeghi, R., Maleki-Saghooni, N. & Khadivzadeh, T. (2018). The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: A systematic review and meta-analysis

Safari, K., Saeed, K.K., Hasan, S.S. & Moghaddam-Banaem, L. (2018). The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor

Vittner, D., McGrath, J., Robinson, J., Lawhon, G., Cusson, R., Eisenfeld, L., Walsh, S., Young, E. & Cong, X. (2018). Increase in Oxytocin From Skin-to-Skin Contact Enhances Development of Parent-Infant Relationship.

“WHO recommendation on skin-to-skin contact during the first hour after birth” (2012). Retrieved from https://extranet.who.int/rhl/topics/newborn-health/care-newborn-infant/early-skin-skin-contact-mothers-and-their-healthy-newborn-infants

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