There are now a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby’s temperature is more stable and more normal, the baby’s heart and breathing rates are more stable and more normal, and the baby’s blood sugar is more elevated. Not only that, skin to skin contact immediately after birth allows the baby to be colonized by the same bacteria as the mother. This, plus breastfeeding, are thought to be important in the prevention of allergic diseases. When a baby is put into an incubator, his skin and gut are often colonized by bacteria different from his mother’s.
We now know that this is true not only for the baby born at term and in good health, but also even for the premature baby. Skin to skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their need for extra oxygen, and keeps them more stable in other ways as well. This website is an excellent resource for additional information www.kangaroomothercare.com
To appreciate the importance of keeping mother and baby skin to skin for as long as possible in these first few weeks of life it might help to understand that a human baby, like any mammal, has a natural habitat: in close contact with their parents. When a baby or any mammal is taken out of this natural habitat, it shows physiologic signs of being under stress. When a baby is swaddled it cannot interact with his mother, the way nature intended. With skin to skin contact, the mother and the baby exchange sensory information that stimulates and elicits “baby” behaviour: rooting and searching the breast, staying calm, breathing more naturally, staying warm, maintaining his body temperature and maintaining his blood sugar.
From the point of view of breastfeeding, babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without any help and they are more likely to latch on well, especially if the mother did not receive medication during the labour or birth. A baby who latches on well gets milk more easily than a baby who latches on less well. When a baby latches on well, the mother is less likely to be sore. When a mother’s milk is abundant, the baby can take the breast poorly and still get lots of milk, though the feedings may then be long or frequent or both, and the mother is more prone to develop problems such as blocked ducts and mastitis. In the first few days, however, the mother does have enough milk, but because it is not abundant, as nature intended, the baby needs a good latch in order to get that milk. A good latch is important to help the baby get the milk that is available. If the baby does not latch on well, nipples become sore, the baby does not feed well, the baby will want to be on the breast for long periods of time which worsens the soreness.
Skin to skin contact immediately after birth, which lasts for at least an hour (and should continue for as many hours as possible throughout the day and night for the first number of weeks) has the following positive effects.
* Is more likely to latch on
* Is more likely to latch on well
* Maintains his body temperature normal better even than in an incubator
* Maintains his heart rate, respiratory rate and blood pressure normal
* Has higher blood sugar
* Is less likely to cry
* Is more likely to breastfeed exclusively and breastfeed longer
* Will indicate to his mother when he is ready to feed
There is no reason that the vast majority of babies cannot be skin to skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence.
The baby should be dried off and put on the mother. Nobody should be pushing the baby to do anything; nobody should be trying to help the baby latch on during this time. The baby may be placed vertically on the mother’s abdomen and chest and be left to find his way to the breast, while mother supports him if necessary. The mother, of course, may make some attempts to help the baby, and this should not be discouraged. This is baby’s first journey in the outside world and the mother and baby should just be left in peace to enjoy each other’s company. The eye drops and the injection of vitamin K can wait until after the first breastfeed.
If the baby does not take the breast right away, do not panic. There is almost never any rush, especially in the full term healthy baby. One of the most harmful approaches to feeding the newborn has been the bizarre notion that babies must feed every three hours. Babies should feed when they show signs of being ready, and keeping a baby next to his mother will make it obvious to her when the baby is ready. There is actually not a stitch of proof that babies must feed every three hours or by any schedule, but based on such a notion, many babies are being pushed into the breast simply because three hours have passed. The baby who is not yet interested in feeding may object strenuously, and thus is pushed even more, resulting, in many cases, in baby refusing the breast because we want to make sure they take the breast. And it gets worse. If the baby keeps objecting to being pushed into the breast and gets more and more upset, then the “obvious next step” is to give a supplement and then we are further compromising breastfeeding. Mothers and babies should be skin to skin to allow nature to take it’s natural course.
Adapted from Dr. Jack Newman’s article The Importance of Skin to Skin. “All of our information sheets may be copied and distributed without further permission on the condition that it is not used in ANY context that violates the WHO International Code on the Marketing of Breastmilk Substitutes (1981) and subsequent World Health Assembly resolutions”