The Importance Of Skin-To-Skin Contact

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, heart, and breathing rates are more stable and normal; and the baby’s blood sugar is elevated. In addition, 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.

To recap, skin-to-skin contact immediately after birth for at least an hour has the following positive effects on babies:

• more likely to latch on

• more likely to latch on well

• more stable and normal skin temperatures

• more stable and normal heart rates and blood pressures

• higher blood sugars

• less likely to cry

• more likely to breastfeed exclusively longer

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 mother, of course, may make some attempts to help the baby, and this should not be discouraged. The mother and baby should just be left in peace to enjoy each other’s company. The mother and baby should not be left alone, however, especially if the mother has received medication, and it is important that not only the mother’s partner, but also a nurse, midwife, doula, or physician stay with them—occasionally, some babies do need medical help and someone qualified should be there “just in case.” The eye drops and the injection of vitamin K can wait a couple of hours. Immediate skin-to-skin contact can also be done after cæsarean section, even while the mother is getting stitched up, unless there are medical reasons which prevent it.

Studies have shown that even premature babies, as small as 1200 g (2 lb 10 oz) are more stable metabolically (including their blood sugar levels) and breathe better if they are skinto- skin immediately after birth. The need for an intravenous infusion, oxygen therapy, or a nasogastric tube, for example, does not preclude skin-to-skin contact. Skin-to-skin contact is quite compatible with other measures taken to keep the baby healthy. Of course, if the baby is quite sick, the baby’s health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin-to-skin with the mother immediately after birth. Indeed, in the premature baby, as in the fullterm baby, skin-to-skin contact may decrease rapid breathing into the normal range.

Even if the baby does not latch on during the first hour or two, skin-to-skin contact is still good and important for the baby and the mother for all the other reasons mentioned.

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 because three hours have passed. The baby, not interested yet 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 he or she takes 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 it is obvious where we are headed.