Skin-to-skin

I am a big champion for immediate and continuous skin-to-skin contact between Mama and baby, having not only read many articles on the subject, but having also attended workshops in which an emphasis was placed on the importance of this seemingly simplistic idea. With this knowledge in-hand, I consistently share the concept and its benefits to both my Doula clients and my prenatal class students, encouraging them to consider integrating the idea into their birth plan and/or early parenting.



I do this hopefully, that it may eventually become the norm for all births. I am encouraged by relatively recent policy changes at the two Winnipeg maternity hospitals; they both boast having a "skin-to-skin policy" for all babies whenever possible.



It all sounds great, right?



Sadly, my experience of the difference between policy and implementation is, to say the least, frustrating. While I know that the hospitals really do want to make this important change (which is, by the way, part of the "Baby-friendly Hospital Initiative" as developed by UNICEF), the application of this policy remains inconsistent.



Most of the nurses now at least give lip service to the idea, but some do not appear to fully understand the concept- it's not simply a matter of putting baby on Mum's chest for 10 to 20 minutes while the nurse catches up with charting, then remove baby for bathing and measurements and carry on. It is about leaving the mother and baby *undisturbed* for at LEAST two hours (or more).



Don't get me wrong, I understand why the medical staff wish to get weights and measurements as soon as possible after the birth, but are those few grams he or she might gain from that initial breastfeeding *really* going to make such a huge difference that baby HAS to be weighed prior to that? Is there a more baby-friendly approach that we can take?



Let me explain to you some of the benefits of immediate and continuous skin-to-skin contact for both Mama and babe ...


When baby is lying skin-to-skin on his Mama's chest, he can hear her breathing, as well as her heartbeat and her voice. These are already familiar to him from his time in-utero (athough they do sound a bit different to him now that he is no longer surrounded by water), this familiarity is reassuring and helps him calm himself as he adjusts to the outside world. Studies have shown that babies' breathing, temperature and heartrate all even out when kept in constant skin-to-skin contact with their mothers. Other studies have shown that the skin temperature of the mother's chest will either increase or decrease, by as much as 1°C, in order to either warm or cool the baby, in response to the baby’s as well as the ambient, temperature.



The mere presence of the baby on his mother’s chest stimulates the hypothalamus to release oxytocin, which in turn stimulates the letdown response, or milk-ejection reflex, as well as promoting uterine contractions in the mother. This is good news for new mums who are anxious about improving their breastfeeding success; by snuggling their babies skin-to skin, they are stimulating milk production even without the baby latching onto the breast!

Immediate skin-to-skin contact enables the baby to be colonized by the same bacteria as his mother, which is believed to improve the overall immune response.



As for bathing, were you aware that the main reason the baby "needs" to be bathed isn't about the baby, but about protecting the hospital staff from potential infection from the bodily fluids that often cover a newborn? A nurse once told me, "We have to wear gloves whenever we handle a baby until he or she has had a bath." As a parent, in that case, you might well consider delaying that first bath as a means of protecting your baby!



Recent studies have shown the benefits of vernix to go beyond keeping the skin from drying out in-utero. In fact, vernix has been shown to have the same anti-biotic properties as colostrum - that's a pretty powerful layer of protection. So by not immediately washing our babies, we are not only minimizing their stress as they transition to life outside of the womb, we are also giving them an added natural immune boost, and a secondary benefit is that all staff who handle our babies will wear gloves while doing so- which could, in theory, greatly reduce our babies' risks for developing iatrogenic infections.



So, now that you know just a few of the amazing benefits of skin-to-skin contact, here are some guidelines:

1)      Place baby skin-to-skin as soon after birth as is possible

2)      Baby should be naked, except, perhaps, for a diaper

3)      Ideally, Mum should be inclined at a 30° angle

4)      Baby should be placed between the breasts, lying vertically, head pointing towards Mum’s head, bum towards Mum’s legs

5)      Blankets to be placed over both Mom and baby together, with nothing between them

6)      Measurements such as length and head circumference can be performed while baby is skin to skin, with a mind to minimizing interference during this important time

7)      APGAR scores can easily be obtained while baby is skin-to-skin

8)      Baby’s first bath should be delayed, if at all possible, for the first few hours after birth

9)      Dads can also snuggle skin-to-skin with baby! (click here for more info)

Food for thought ...