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Skin-to-skin contact after birth: the best start to life

What if I told you that by doing one simple thing, you could make your baby the happiest little creature on earth? That this one thing can get your baby stabilized after the birth quicker than any medical intervention?  That it will make you almost instantly forget all the drama of the birth that just happened? That it will dramatically increase your chances of breastfeeding successfully and prevent a whole host of potential problems?

Well, I have good news: such a thing exists! It’s called skin-to-skin contact, and the name says it all: it’s you holding the baby with his skin against yours. Immediately after birth, that’s really the only place a baby should be: on his mother’s chest, skin to skin. It’s simple and very low-tech, but the effects are profound.

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Early skin-to-skin contact: effects on baby

Join me for a moment in imagining what being born must feel like: for 9 months you’ve been cocooned in a dark, warm, safe place, floating weightlessly with the constant reassuring sound of mama’s heart beating nearby. Then suddenly, you’re evicted from this comfortable little nest, pushed out into a world of cold, noise and bright lights. In an instant everything you’ve ever known is gone – and it’s a pretty scary world out there!

Now don’t get me wrong: the jolt of being born is important because it alerts baby’s whole system to the change in environment; most importantly, it helps them to start breathing. But after the initial birth cry we need baby to calm down so that everything can return to normal and he can get down to the important business of breastfeeding and growing. And placing baby in skin-to-skin contact with mom is the quickest way to do this. When a baby is in skin-to-skin contact:

  • Baby’s heartbeat is more stable and baby breathes more easily. This means that more oxygen reaches every part of his body.
  • Baby’s blood sugar is more stable. It is very rare for a baby in skin-to-skin contact to get low blood sugar; in fact, low blood sugar can often be fixed simply by placing the baby in skin-to-skin contact
  • Baby stays nice and warm. People are often worried that baby will get cold because he is not wearing any clothes, but in reality mom’s body does an excellent job of keeping baby warm. A new mom’s skin temperature is, on average, 1 degree warmer than other people, and it can change according to the baby’s temperature: increasing by up to 2 degrees to warm a cold baby, or cooling by 1 degree to cool down a baby that’s getting too hot. Even if it’s cold in the room, a light blanket placed over mom and baby is all that is needed.
  • Baby cries less. This is important, because a baby who is crying cannot focus on breastfeeding or growing. If baby cries a lot, his levels of stress hormones will increase; this causes his whole system to go into a “shutdown” mode where growth and brain development are impaired.
  • Baby will breastfeed more easily. Babies are born with all the reflexes that they need for breastfeeding, but all those reflexes only work if baby is put in the right place to practice them. By now it should not surprise you that the best place for activating baby’s breastfeeding reflexes is – tadaa! – skin-to-skin with mom. Any lactation consultant will tell you that most breastfeeding problems can be prevented (or even solved) just by skin-to-skin care.

Early skin-to-skin contact: effects on mom

We tend to focus very much on the baby in the moments after birth –and rightly so! But we need to also remember the mom. If you’ve ever given birth, or been present during a birth, you’ll know: it’s hard work! The greatest reward for a mom after all that is meeting her beautiful new baby. Early skin-to-skin contact has benefits for the mom, too:

  • Mom’s hormones make it easy to bond with baby in that instant. This makes for a smoother transition to motherhood and a less stressful early parenting experience.
  • The movement of the baby on the mom’s stomach and breasts helps the placenta to detach and be delivered more easily.
  • The level of milk-producing hormones are very high shortly after the birth, so if breastfeeding starts within the first hour or so, it sets the stage for great milk production.

The nuts and bolts: how to do skin-to-skin

Doing skin-to-skin contact is actually very straightforward: as the baby is born, he is placed directly onto his mother’s tummy. His face and body can be gently wiped dry with a soft cloth. As long as baby is breathing, there’s no reason not to place baby in skin-to-skin immediately – all the observations and the cutting of the cord can be done while the baby is in skin-to-skin, and procedures like weighing, bathing, vaccines and so on can be done later. They can even stitch an episiotomy while you are doing skin-to-skin. The most important thing you need to do is to discuss this with your doctor or midwife before the time, to make sure that they will respect your wishes.

But I’m having a c-section!

Doing skin-to-skin is doubly important if you’ve had a c-section, because babies born via c-section are at higher risk for breastfeeding problems. In fact, I believe that the routine separation of mom and baby after a c-section is the main reason why these babies struggle with breastfeeding! Again, you will need to talk to your doctor. More and more doctors are allowing babies born via c-section to be placed in skin-to-skin contact in the theatre – you’ll never know if you don’t ask! But even if you can’t bring the doctor around to your point of view, and your first contact with your baby is when you are back in the ward, don’t think that it’s too late. As soon as you get your baby, undress him and place him in skin-to-skin. You may get a few strange looks, but you will be doing your baby and yourself an enormous favour. In the meanwhile, while you are being stitched up, arrange that dad (or even grandma!) holds baby skin-to-skin; it will still be a lot better than leaving baby in an incubator. I’ve seen first-hand how quickly a baby’s breathing and heart rate stabilize if she’s taken out of the incubator and placed on dad’s chest.

How long?

After birth, baby should be in skin-to-skin contact for no shorter than an hour. If baby still hasn’t started breastfeeding at the end of the first hour, don’t let anyone take baby away until he’s had his first breastfeed. Remember those feeding reflexes we were talking about earlier? The first breastfeed is crucially important for “fixing” those reflexes in baby’s mind. If baby gets taken away from mom before he’s had a breastfeed, it’s almost as if they forget how breastfeeding works, and it’s a lot harder to teach them what to do.

The first breastfeed

From everything I’ve said up to this point, I hope that two things are clear: firstly, skin-to-skin contact is important for a whole host of reasons, not only for breastfeeding. And secondly: skin-to-skin contact is one of the best ways to ensure that your breastfeeding journey starts off on the right foot.

What’s truly amazing is how babies can start breastfeeding by themselves, without any assistance. Yes, you read that right: if you place a baby in skin-to-skin contact with his mom, he can get himself to the breast, latch on and start feeding without any help. Basically, all you need to do is be there and watch that baby doesn’t fall off the bed; he will do the rest. Of course, you can help baby and guide him toward the breast – you two are a team! But never force baby to the breast before he’s ready: you won’t make him breastfeed, but you may cause him to want to avoid the breast. If you want to know a bit more about the first breastfeed and the  breast crawl, check out this post. Remember: the first feed is just an introduction to the breast. Don’t worry yet about how the baby is latching or whether he’s getting the milk out. As long as baby got the nipple in his mouth and started sucking on it, you’ve achieved your goal. And if all goes well, it will be the beginning of a long and happy breastfeeding relationship.

Beyond the first breastfeed

Skin-to-skin contact shouldn’t end at the first breastfeed. In fact, it’s recommended to keep baby in skin-to-skin as much as possible during the first 24 hours, if not longer. There’s no danger of overdoing it, so keep baby skin-to-skin for as long as you like.

As baby gets older, skin-to-skin becomes a useful way of solving all sorts of problems: getting more sleep, increasing your milk supply, helping baby to latch better, settling a fussy baby, soothing stomach cramps – pretty much anything, really. It’s also an awesome way for dad to bond with baby. So do plenty of skin-to-skin while you have the chance; soon – too soon – baby will be too big for it, and I promise you you’ll miss it!

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