Skin to Skin – the Golden Hours after Birth

Skin to Skin – the Golden Hours after Birth

A human baby is born totally helpless. It needs its mother to survive: her food, her arms, her body, her temperature, her sound, her presence. When a baby lies on her mother’s body, she feels safe, knows she is protected and can relax. Today we talk about that skin-to-skin contact, which even sounds like a medical treatment and which is actually what humanity has been replicating throughout its existence as part of our survival strategy as a species.

What is the Mother Kangaroo Method?

Skin-to-skin contact was routinely established as a method of care for premature babies in 1979 at the San Juan de Dios Hospital in Bogotá, Colombia. It was based on the so-called “Mother Kangaroo Method”, which consisted of placing the newborn skin-to-skin with her mother, if possible 24 hours a day.

This “small” decision proved to have multiple advantages over traditional routines of keeping the baby in the incubator and results demonstrated this by reflecting increased survival rates of babies and decreased illness rates.

We have had to wait for scientific evidence to tell us that the best for any baby is its mother and immediate contact with its body after birth. Healthy full-term babies are still immature creatures who need the care of an adult to thrive.

All senses are concentrated on breastfeeding:

When a baby is born, she is ready to breastfeed. It is vital that she succeeds, because her survival biologically depends on it. So they are born with all their senses alert:

Smell: It allows them to distinguish and differentiate the smell of their mother and it is the smell they prefer to any other. This capacity is especially powerful and sensitive in the first hours of life.

Taste: the baby is able to recognise the taste of her mother’s colostrum, which tastes the same as the amniotic fluid. She prefers this to any other flavour; whether it is another mother’s breast milk or artificial milk.

Sight: this is the most limited sense at birth, but it is able to recognize faces and even reproduce facial expressions. It sees dark colors more easily, that’s why it is believed that the areola gets darker, so that newborns can see very clearly where the food is.

Hearing: she is able to recognize a mother’s voice and prefers it to any other sound or music. In fact, if the baby is placed between two people and the two people talk to her and call her at the same time, she will turn her head towards her mother’s voice.

Touch: the baby responds to getting touched, at both pain and pleasure, and also responds to the temperature of her mother’s body.

When a baby is born, she needs very few elements to survive: warmth, love, food and social interaction. All of this is built into her mother’s body and care.

The first contact: skin to skin and the golden hours

All mammals display a sequence of behaviours and actions aimed at initiating and maintaining nursing, and human babies could not be any different. During birth norepinephrine hormones are released, activating the baby. This release keeps them active for 2 hours, the so-called “sensitive period” or golden hours follow. Healthy full-term newborns spontaneously latch on to the nipple and start breastfeeding for approximately 55-70 minutes after birth.

The following pattern can be observed in newborns immediately after birth:

  • Once placed on their mother’s tummy, the newborn baby enters a state of calm alert, marked by attention and concentration.
  •  She starts to suck her hands and taste the remaining amniotic fluid that reminds her of what she has to look for. Her sense of smell helps her to find colostrum which smells exactly the same.
  •     She begins to pull herself, nearly crawl: driven by her desire to reach the breast, she begins to make crawl-like movements, pushing herself forward with her legs.
  •     Head elevation: she raises her head and nods almost similar to a woodpecker in search for the nipple.
  •     Crying: she may become a little restless halfway through and may look tired.
  •     Licking: she sticks out her tongue and produces saliva which triggers the gastric hormones.
  •     Stimulation of the search reflex: when she reaches the breast and touchs the nipple with her cheek, she opens her mouth to try and latch.
  •     Nipple encounter: finally she finds the nipple and latches on.
  •     Start of sucking motions: the newborn baby starts sucking immediately.
  •     Eye contact with mother: while breastfeeding, she will look for her mother’s eyes.

Skin-to-skin contact with the mother is a natural continuity of the wellbeing she enjoyed inside her mother’s womb: a thermally stable environment, with continuous feeding where she can hear her voice and feel her heartbeat.

Newborns placed immediately on their mother’s breast or allowed to make their own searching movements and latch onto the breast themselves are more likely to achieve successful breastfeeding journeys. Most routine checks can be performed while the baby is on the mother’s body and those that are not, can be postponed for a few hours.

Research has shown that this first contact during the golden hours is so important, that it is worth postponing all other postpartum routines such as washing the mother, the baby, weighing the baby and so on, to let the mother-child bond getting established. Nothing that is not a matter of life or death is that important to interfere into these precious moments.

 

Skin-to-skin recommendations by WHO

The mother kangaroo method

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