What is Skin-to-Skin Care?
Skin-to-skin care means placing dried, unclothed newborns on their mother’s bare chest, with warmed light blankets or towels covering the baby’s back. This can occur immediately after vaginal birth prior to cord clamping with the newborn placed on the mother’s abdomen, dried, and with a blanket placed over the baby. The baby can be moved to mother’s chest after the cord is clamped. Fathers can engage in the initial skin-to-skin contact if mother has a cesarean birth.
All routine procedures including maternal and newborn assessment can still take place during skin-to-skin care or can be delayed until after the sensitive period immediately after birth.
The World Health Organization and United Nations Children’s Fund recommended that all healthy mothers and babies have constant skin-to-skin contact immediately following birth for at least an hour, and until after the first feeding, for breastfeeding women.
The sensitive time after birth is also known as the “magical hour,” “golden hour,” or “sacred hour,” and requires respect, protection, and support.
A series of innate behaviors were found to follow skin-to-skin care including birth cry, relaxation, awakening and opening the eyes, activity (looking at the mother and breast, rooting, hand to mouth movements, soliciting sounds), a second resting phase, crawling towards the nipple, touching and licking the nipple, suckling at the breast and finally falling asleep.
If mothers are not ready for full skin-to-skin contact, even holding your newborn’s hand or giving you newborn a massage or stroking their face, arms, hands, legs, feet, and back can be beneficial so they feel your warmth and love.
Avoid using perfume or scented toiletries including shaving gel, lotions, aftershave, or shower gels, because they may mask your natural scent which babies are most attracted to.
Skin-to-skin care can still take place during bottle-feeding too, so that babies still receive that close bond and attachment.
Physiological Benefits for Baby
Simultaneously at birth, newborns have a heightened, protective response to tactile, odor, and thermal cues. After initiation of skin-to-skin care, this response stimulates behaviors that help meet the newborn’s basic biological needs, activates neuroprotective mechanisms, enables early neurobehavioral self-regulation, and reduces stress.
Studies show that newborns that received skin-to-skin care cry less, had enhanced cardi-respiratory stability, including oxygen saturation levels, more stable blood glucose levels, and enhanced thermal regulation.
The risk of neonatal hypothermia is reduced by skin-to-skin care as the mother’s breast temperature adjusts to regulate the newborn’s temperature, and also prevents heat loss.
Skin-to-skin care also helps protect against infection and promotes breastfeeding by allowing an early opportunity for the baby to “crawl” to the breast.
Babies who had early skin-to-skin care were found more likely to exclusively breastfeed at hospital discharge and after discharge, as well as to breastfeed for longer periods of time.
May support continuous nursing for babies who are allowed that immediate skin-to-skin contact and therefore increase milk production, resulting in infant weight gain.
Psychological Benefits for Baby
Interrupted skin-to-skin care may disrupt a newborn’s innate protective behaviors, lead to behavioral disorganization, and make self-attachment and breastfeeding more difficult.
Signs of stress have shown to significantly decrease after 60 minutes of skin-to-skin care.
Heightened levels of the maternal reproductive hormone, oxytocin, which crosses the placenta to her baby, considerably influence the sensitive period during about the first hour after delivery. This hormone massively increases during skin-to-skin care, promotes maternal/newborn attachment, reduces maternal and newborn stress, and supports the newborn transition to postnatal life.
Benefits for Mommy
Helps create a strong maternal-infant bond, supports an affective response to the baby from the mother, and positively impacts maternal behavior.
The oxytocin released that causes the uterus to contract stimulates motherly feelings after birth as a mother touches, gazes at, and breastfeeds her newborn. During skin-to-skin care, a greater amount of oxytocin is released.
Beta-endorphins are released during the contact that helps the mother feel calmer and respond to her baby. Research suggests improved bonding and attachment for mothers and babies, as well as increased confidence.
Skin-to-skin care promotes successful breastfeeding, especially uninterrupted skin-to-skin care for a minimum of an hour.
The more often the baby and mother engage in skin-to-skin care, the more often the mother can learn how to best care for, comfort, and soothe her newborn.
When mothers room-in with their babies after birth, meaning keeping mothers and babies together 24 hours a day, they have ample opportunities for bonding and other benefits. Mothers produce more milk, and produce more milk sooner, breastfeed for longer durations, and are more likely to breastfeed exclusively.
Skin-to-skin care while rooming in decreases risk for psychological maternal stress and depressed feelings after hospital discharge.
Breast engorgement pain was found to be less with mothers who engaged in skin-to-skin care.
Mothers who had a cesarean birth reported less postoperative pain when engaged in skin-to-skin contact than mothers who were separated from their baby.
Crenshaw, J. (2014). Healthy birth practice #6: Keep mother and baby together—it’s best for mother, baby, and breastfeeding. The Journal of Perinatal Education 23 (4), 211-217. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235060/
Moore, E., Anderson, G., Bergman, N., Dowswell, T. (2014). Early skin-to-skin contact for mothers and their healthy newborn infants, The Cochrane Database of Systematic Reviews, 5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3979156/
BabyCentre. (2015). Skin-to-skin with your baby. Retrieved from https://www.babycentre.co.uk/a25017209/skin-to-skin-with-your-baby.