Skin to Skin Contact

Jack is Born at Heath Hospital

Skin-to-skin contact, when possible, is important for getting breastfeeding off to a good start.

Skin-to-skin contact (SSC) following birth is incredibly important for all babies, including preterm babies.  It is easy to do – a mother simply holds her baby with his stomach down (prone position) against the front-side of her chest between her breasts, neither with clothes between them.  A blanket can be placed on the outside of the baby while he is wearing a diaper and/or a hat.  Ideally, SSC should begin immediately following birth and last through the first breastfeed – or for the first 1 ½ – 2 hours following birth. The results are amazing!

A new baby has just come from the safest place he’s known – inside his mother’s womb.  There, he has been cared for completely having every need met immediately.  He was protected, hearing gentle noises buffered by the womb; his heart rate and oxygen saturation levels were optimal; he was held, warm, fed, and loved on demand.  After birth, this same baby has entered a whole new world and the safety of being skin-to-skin against his mother’s body helps him in this transition.

Today the over-medicalization of the birthing process many times leads to the separation of mother and baby following birth.  Lights are bright, sounds are loud and unfamiliar, scales are cold, and the person he knows best, his mother, is not always nearby.  Research shows this separation of mother and baby is highly stressful and can lead to what is known as “protest despair” in baby.  When babies are separated following birth, babies exhibit a ten-fold increase in stress hormone levels.1  This stress should not be underestimated either!  The baby will protest by crying. His heart rate, blood pressure, and breathing will increase.  After protesting, he will despair, moving to a state of dissociation.  Left in this state of distress, away from his mother, can have lasting emotional effects. And maternal levels of oxytocin (which is often referred to as the love hormone and significantly impacts bonding) peak following birth. When mom and baby can’t be together, precious bonding time is lost in their relationship.

SSC is a safe and simple alternative to separation following birth.  In fact, babies’ body temperatures are better regulated in SSC than in an incubator; heart rates are more stabilized; cortisol and blood glucose levels are more normalized; and there are greater chances for breastfeeding success . . . not to mention the precious time of cuddling and bonding together.   For mothers, SSC not only helps to regulate her body temperature, but heightens oxytocin levels and milk volume, promotes bonding , and increases confidence in her mothering ability.2 Babies who are placed in SSC following birth are much more likely to spontaneously breastfeed than those who are not.

SSC was first used in Colombia, South America in the 1980s for babies in the NICU when there wasn’t space available in conventional incubators.  Compared to babies cared for in environments with greater technology, the babies receiving skin-to-skin contact each day fared much better.3  Research on SSC and twins has found that each breast uniquely regulates its temperature depending on what each baby needs.  If one baby was too cool, the breast temperature on that side would increase; if the other baby was too hot, that breast would decrease in temperature.4  SSC after birth has also been shown to significantly increase the survival rate of babies who are born with very low birth weights.5

In addition to its many positive benefits immediately following birth, SSC continues to have a positive impact on breastfeeding in the early weeks and months with your new baby.  SSC continues to promote bonding between mother and baby, helps baby to latch, increases a mother’s milk supply, and can even help a baby who is refusing the breast to begin to nurse.  The benefits of SSC are increased, the longer and/or more frequently a baby is held this way.

The first hours after birth are critical to bonding with your new baby and can never be returned.  All necessary interventions in a healthy newborn can be done while baby is skin-to-skin with his mother.  Bathing, weighing, etc. can all wait until later.  Postpone all non-essential things and relax and enjoy this precious time with your new little blessing.

Kangaroo Mother Care

Kangaroo Mother Care

Kangaroo Mother Care

Kangaroo Mother Care can help an infant breastfeed sooner.

Kangaroo Mother Care (KMC) is incredibly important for all babies, especially preterm babies.  It is easy to do – a mother simply holds her baby with his stomach down (prone position) against the front-side of her chest between her breasts, neither with clothes between them.  The baby can be placed inside the mother’s clothes, or a blanket can be placed on the outside of the baby. The baby may be wearing a diaper and/or a hat.  KMC should begin as soon as possible following birth and for increasing amounts of time as the baby matures.  (It is possible to hold an intubated baby in KMC.) The results are amazing!

KMC was originally discovered in Colombia, South America and in the 1980s when, because of overcrowding in the incubators, some mothers were encouraged to hold their babies in continuous skin-to-skin contact.  They found this was a great way for mothers to be involved in the care of their preterm babies, with less likelihood of acquiring certain illnesses, and the ability for the baby to learn to breastfeed at his own pace.  Research has now shown that babies cared for in this environment (vs. the standard incubator care) have more regular breathing patterns and body temperatures, are less susceptible to infections, have better weight gain, sleep more soundly, breastfeed earlier and for a longer duration, have a lower risk of death, and are discharged from the hospital sooner.1

KMC allows babies to learn how to breastfeed at their pace.  They are able to smell their mother’s milk and practice sucking throughout the day.  It allows a mother’s supply to be more stable and research has shown the duration of breastfeeding is prolonged.2  More babies are discharged from the hospital exclusively nursing, and babies are typically able to nurse at the breast earlier than their counterparts in the incubator.

Breastfeeding involves a complex range of reflexes and responses including the gag reflex, rooting reflex, and coordinating suck-swallow-breathe patterns at the same time.  This last reflex, being able to suck-swallow-breathe at the same time, typically develops between 32-35 weeks.  However, babies in KMC demonstrate the ability to accomplish these milestones even earlier – some as early as 28-30 weeks!3

Not only are there tremendous growth and development benefits for babies nurtured in KMC, but the cost savings are significant.  Hospitals seeking to receive the BFHI status (Baby-Friendly Hospital Initiative) are progressively looking to implement ways to help moms nurture their preterm babies in KMC.  Some have recliners next to each incubator and/or an adjoining room to the NICU with maternal beds for moms who have been discharged to sleep and still be able to closely care and nurture their babies.  Whether or not your hospital has these things, you can still care for your baby in KMC.  Any amount of time each day you are able to spend skin-to-skin with your baby will make a significant impact.

KMC can, and should, continue after hospital discharge.  In fact, early discharge is many times possible with close follow-up for mothers caring for their baby in this way.  KMC should continue until baby has reached 2 kg. (Although skin-to-skin contact is always beneficial, even for full-term babies are a few months old!)

Though no mom plans to have a preterm baby, if you find yourself in this position, there is so much you can actively do to help and nurture this tiny new life.  And as your baby grows and developments through the milestones you will feel proud and confident in caring for your baby and know you are nurturing him in the best possible way in the beginning of life.