Skin-to-Skin Contact

What your baby wants

by Susan Miller, BScN

The first hours and days after birth are a shock to a newborn’s system, and in many cultures, babies are cradled naked against their mother’s bare chest at birth and kept very close to the mother in the early days. In the Western world, there is now more emphasis on the value of skin-to-skin contact for newborns and especially for babies born early. This is not a new concept. Mother Nature has programmed newborns to crave skin-to-skin contact because it is good for them and ensures their survival.

Thirty years ago there was a strong movement around “Gentle Birth” following the publication of Frederick Leboyer’s landmark book Birth Without Violence (1974). Leboyer advocated gentle practices which included immediate skin-to-skin contact for newborns as a way of easing their transition into the world. In North America, modern Midwifery and Attachment Parenting practices are based on many of Leboyer’s gentle, more natural birth approaches.

There is now much scientific evidence around neonatal brain development and lifelong outcomes to support the notion that babies need to be close to their mothers almost continuously right after birth. Studies over the past 30 years have shown the benefits of skin-to-skin contact. Hospital maternity settings are gradually changing to incorporate more “family-centred” and “baby-friendly” practices to give babies the most optimal start in life. Almost all hospitals today provide 24-hour “rooming in” to mothers and their babies so that they are not separated at this very sensitive time.

What are the benefits of skin-to-skin?

Dr. Nils Bergman, MD, Senior Medical Superintendent of the Mowbray Maternity Hospital in Cape Town, South Africa, is the world’s leader in research on the needs of newborns, including preterm infants. Dr. Bergman’s premise is that newborns need a certain “habitat” in order to thrive and survive. This habitat is primarily the mother’s body. It is critically important that right from birth, the mother and baby are not separated. In the first hours and days after birth, a baby is learning the scent of its mother, and he has been programmed to suck. New babies need to do a lot of sucking to stimulate their mother’s breasts to make milk. Babies also need to get the “golden” colostrum that is a small amount of special milk high in antibodies. Colostrum also acts as a laxative to help prepare the baby’s intestines to handle the milk that will be coming in on the second to third day post-partum. Unfortunately a baby’s need to suck is often misread as hunger in the first three days. Giving a newborn many ounces of formula or sugar water overfills his tiny stomach that is designed to hold only about one ounce per feed. Babies who are not near to their mothers and receive early supplements and soothers often have difficulties with establishing and continuing breastfeeding throughout the first year.

When a newborn is removed from the habitat of his mother he will exhibit the universal “protest-despair response” to separation. He is trying to find warmth and protection. If this fails and separation is prolonged, the baby goes into despair mode where there is a massive increase in stress hormones and a decrease in temperature and heart rate. The baby is now in survival mode. Research suggests that prolonged separation of the infant and mother can have longlasting effects on the baby’s social and emotional development. Baby’s optimal brain development also depends largely on the hands-on and skin-to-skin contact received through their parents’ loving care.

Mothers do not want to be separated from their babies either. The influence of the “mothering hormone” prolactin (which is at a high level right at birth) causes a mother to want to be with and protect her baby. Mothers who have their baby skin-to-skin with unrestricted breastfeeding have a more sustained and higher level of prolactin than those who are separated from their babies. Prolactin is necessary to stimulate the production of milk. Science is finally catching up with what intuitive mothers have known all along; something good happens when a mother and baby spend more time together.

Bergman’s overall prescription for newborn babies and their mothers is to be together skin-to-skin constantly for at least six hours after birth. Having more opportunities for skin-to-skin contact in the first few days facilitates frequent sucking and breastfeeding which happens about every 60 to 90 minutes. Also, the baby’s temperature, heart rate and breathing are kept at an optimal level so he is comfortable and relaxed. He has very little reason to cry because he has everything he needs. The baby’s level of relaxation helps him to grow and thrive as he is not spending energy crying.

Skin-to-skin contact has even more significance for babies born early (before 37 weeks gestation). It is now standard practice in neonatal intensive care units to have parents and even grandparents hold their premature infants skin-to-skin for periods of up to two hours a day or more when it is medically safe to do so. Numerous studies have shown that this early skin-to-skin contact known as Kangaroo Mother Care (KMC) is more effective than some of the most sophisticated medical treatments and technologies that have been developed to help premature newborns.

The practice of having baby skin-to-skin at the time of birth and in the early days and weeks also has a positive influence on babies with colic. There is no absolute guarantee that every case of colic (excessive crying) can be prevented but babies who are held and carried a lot often cry much less than babies who are left on their own. Babies who feel safe and secure right from the start tend to be babies who continue to be more calm and relaxed as they grow and develop.

For the typical term newborn, early skin-to-skin contact and breastfeeding is seen as the very best start. As babies grow, the need for close physical contact with a parent or caregiver continues throughout the first year and beyond. It is important that parents and their caregivers know the benefits of providing early and continuous skin-to-skin contact for newborns. This is an evidence-based practice that leads to the most optimal outcomes for mothers and their babies. This ancient and intuitive practice is simple to do and provides positive lifelong benefits for babies and their parents.

Susan Miller R.N. BScN is a Perinatal Educator and Certified Breastfeeding Counsellor. She works with pre- and post-natal families in the Greater Victoria area and is the proud grandmother of baby Meredith.