Parent-Child Skin to Skin Contact After Birth

The manner in which a new baby is welcomed into the world during the first hours after birth may have short- and long-term consequences. There is good evidence that normal, term newborns who are placed skin to skin with their mothers immediately after birth make the transition from fetal to newborn life with greater respiratory, temperature, and glucose stability and significantly less crying indicating decreased stress. Mothers who hold their newborns skin to skin after birth have increased maternal behaviors, show more confidence in caring for their babies and breastfeed for longer durations. Being skin to skin with mother protects the newborn from the well-documented negative effects of separation, supports optimal brain development and facilitates attachment, which promotes the infant's self-regulation over time. Normal babies are born with the instinctive skill and motivation to breastfeed and are able to find the breast and self-attach without assistance when skin-to-skin. When the newborn is placed skin to skin with the mother, nine observable behaviors can be seen that lead to the first breastfeeding, usually within the first hour after birth. Hospital protocols can be modified to support uninterrupted skin-to-skin contact immediately after birth for both vaginal and cesarean births. The first hour of life outside the womb is a special time when a baby meets his or her parents for the first time and a family is formed. This is a once-in-a-lifetime experience and should not be interrupted unless the baby or mother is unstable and requires medical resuscitation. It is a "sacred" time that should be honored, cherished and protected whenever possible.

There are many well-documented benefits of skin-to-skin contact between a newborn infant and its mother. Skin-to-skin contact improves physiologic stability for both mother and baby in the vulnerable period immediately after birth, increases maternal attachment behaviors, protects against the negative effects of maternal–infant separation, supports optimal infant brain development, and promotes initiation of the first breastfeeding, resulting in increased breastfeeding initiation and duration rates.
SKIN-TO-SKIN CONTACT PROVIDES PHYSIOLOGIC STABILITY
Being skin to skin with mother stabilizes the newborn's respiration and oxygenation, increases glucose levels (reducing hypoglycemia), warms the infant (maintaining optimal temperature), reduces stress hormones, regulates blood pressure, decreases crying and increases the quiet alert state.

Thermal synchrony is a phenomenon whereby the temperature of mother's chest increases to warm a cool baby and decreases to cool an overly warm baby. While often seen with premature infants who are skin to skin in kangaroo care, this phenomenon is equally important for the newborn infant who has just exited the warmth of mother's womb into the cooler extra-uterine environment, wet and easily chilled. In a study done with babies after cesarean delivery, babies held skin to skin by their fathers had higher temperature and glucose levels compared to those of babies left alone under warmers.

SKIN-TO-SKIN CONTACT PROMOTES MATERNAL ATTACHMENT BEHAVIORS
Attachment is so necessary for survival of the newborn mammal, that nature has not left it to chance, and has provided biochemical activators that prime the brain's reward circuitry to increase maternal care-giving behaviors. Hormones known to influence attachment behaviors are increased by skin-to-skin contact. This is true in adults as well, but is especially important in the vulnerable newborn period. Oxytocin is one such hormone that has been particularly well studied in relationship to attachment and is often referred to as the "love hormone." It has been shown to increase relaxation, attraction, facial recognition, and maternal care-giving behaviors, all necessary to ensure infant survival. Oxytocin is increased during skin-to-skin contact and levels spike whenever the newborn's hand massages mother's breasts.

Multiple studies in the 1970–1980s compared behaviors of mothers who had short periods (as little as 15 minutes) of skin-to-skin contact with their newborns to those who briefly viewed their infants and then were reunited every 4 hours for feeding while the babies were otherwise kept in a nursery separate from their mothers. At the end of the postpartum hospital stay, mothers who had even brief early skin-to-skin contact with their infants were more confident and comfortable handling and caring for their babies than mothers who had been separated from their babies.

SKIN-TO-SKIN CONTACT PROTECTS FROM THE NEGATIVE EFFECTS OF SEPARATION
Babies are born ready to interact with mother. If a newborn has not been exposed to excessive medication, its alert awareness and intense focus on its mother's face is obvious to all who are present. Until the moment the cord is cut, a mother and her baby are literally a single biological organism. Until several months after birth, mother and baby remain a single "psychobiological organism." The experience of an infant who is separated from the mother is graphically described by Gallager. "Mother and offspring live in a biological state that has much in common with addiction. When they are parted, the infant does not just miss its mother. It experiences a physical and psychological withdrawal from a host of her sensory stimuli not unlike the plight of a heroin addict who goes 'cold turkey."'

SKIN-TO-SKIN CONTACT SUPPORTS OPTIMAL BRAIN DEVELOPMENT
Bonding and attachment are so critical for survival that nature has made it possible for both to occur at any time during a lifetime. However, the longer after birth the process is begun, the more difficult it is and greater is the risk of incomplete bonding or insecure attachment. Fortunately, human beings are capable of recovering from most types of trauma with appropriate insight, support, and healing techniques. The bottom line is — whatever supports early mother–infant attachment, supports infant brain development!

SKIN-TO-SKIN CONTACT INCREASES BREASTFEEDING RATES AND DURATION
The baby finds the breast, latches and suckles without assistance or interference. After adequate familiarization with the new environment and mother's nipple, the newborn opens his mouth wide, cupping the tongue which is now low in the bottom of the mouth, grasps the nipple in a correct latch and begins to suckle. This usually occurs about an hour after birth.