Hold me close
The importance of skin-to-skin time.
The first moments after birth are not only a beautiful and special time for bonding with your new baby, but also critically important to your baby’s development – so much so that some researchers believe what happens in the first hour can impact your child’s future. Michelle Walton – a therapeutic reflexologist specialising in pregnancy, labour and the postpartum period, a doula and owner of Johannesburg-based Birthrite – explains that the first hour after birth is crucial, because newborns go through nine distinct developmental phases during this time. “Therefore, what happens in this first hour can have a lifetime effect on the baby, both negative and positive.” This is why skin-to-skin contact (also known as kangaroo care), for the first hour straight after birth is so vitally important, no matter what type of birth you’ve had, maintains Jill Bergman, a seasoned skinto-skin expert who runs Neuroscience for Improved Neonatal Outcomes (Nino) from Cape Town.
MOM’S CHEST IS BEST
The proven benefits of skin to skin are so clear that the World Health Organization recommends all newborns receive skin to skin immediately after birth. “There are many studies that show that when mothers and babies are together, skin to skin, immediately after birth, the baby is more content and calm, and his temperature, heart and breathing rates as well as blood sugar levels are more stable than a baby who is not skin to skin with Mom,” says Erica Neser, a certified lactation consultant based in Stellenbosch. “It also allows the baby to be colonised by the mother’s good bacteria, which appear to assist the baby’s immune system.” Jill explains that it’s the baby’s sensory perception of Mom – the familiar sound of her voice and heartbeat, the rhythm of her breathing and, most importantly, the smell of her that he knows so well from the amniotic fluid – that reassures baby he is in a safe environment, which in turn calms him down and helps him stabilise more easily. It’s good for you, too. Studies show that moms who practise skin to skin straight after birth experience several benefits, most importantly less breast engorgement and less anxiety in the first few days after birth.
BREASTFEEDING BOOST
Perhaps the most significant benefit of skin to skin is its proven ability to boost breastfeeding success.
A study shows that babies who receive skin-to-skin care are twice as likely to be exclusively breastfed than those who don’t. Michelle attributes this to your physical reaction to skin-to-skin contact with your baby: “It aids the release of the milk producing hormone prolactin and the hormone oxytocin, which releases it, so there will be greater milk production than if there is no skin to skin.” Jill says this physical contact is so important that if your baby is taken away after birth, you may struggle to breastfeed: “Your body basically says, ‘I don’t have a baby, so there’s no point producing milk.’”
Michelle adds that skin to skin also helps keep both you and baby calm, which makes latching easier and more effective. “It also is the stimulant that switches on the baby’s own reflex to seek out your nipple to begin breastfeeding without help from anyone.”
START SKIN TO SKIN STRAIGHT AWAY
Ideally, you should have at least one hour of uninterrupted skin-to-skin time with Baby, and that hour should start the second he is born and placed straight onto your chest.
“Some of the routine checks, including the Apgar test, can be done right there on your chest. And certainly weighing, measuring, eye drops, vaccinations, vitamin K injection, bath and dressing can happen an hour or more later,” reasons Erica. “Baby should only be taken away – briefly – for these procedures after the first breastfeed.”
Jill stresses that there are very few instances where you can’t hold your baby straight after birth – such as if, for example, the baby needs advanced resuscitation or you have a major bleed that requires immediate medical attention. “If there is a known medical concern prior to the birth or if the baby is very premature, he may be taken away for medical assistance immediately after birth,” explains Michelle.
The bottom line, according to Jill, is that “taking baby away from you for any reason other than a serious medical problem is unethical and may have harmful consequences for the baby. It also ignores the latest evidence-based medicine.” This is true for babies taken away from their moms after caesarean sections, says Jill, who asserts that the only exception should be when you have had general anaesthetic and are physically unable to hold Baby.
Experts across the world agree, yet skin to skin after a c-section is not always standard practice. A recent study by Dr Rebecca Dekker shows that the biggest obstacle to skin to skin after c-section is the clinical culture of the operating room. She reports that the most common medical reason doctors give for removing c-section-delivered babies from their mothers was the risk of hypothermia, as the mother’s body temperature may be lower than normal due to operating rooms being kept at cooler temperatures. “However, the research evidence that we have suggests that babies who undergo skin-to-skin care for 30 to 50 minutes after a c-section are not at higher risk for hypothermia,” Dr Dekker explains. Interestingly, she found no research to show why babies born by c-section shouldn’t have skin to skin, only several studies that prove why they should.
Perhaps the most significant benefit of skin to skin is its proven ability to boost breastfeeding success.
DAD WILL DO TOO
If you are, for whatever reason, unable to hold Baby, then Dad’s chest is the next best option. He too can have a profound impact on the baby’s health and wellbeing. “One study has shown that babies in skin to skin with Dad were more easily comforted, became calmer, and reached a drowsy state earlier than the babies who were placed in cots,” Erica says.
“Dads can facilitate baby’s pre-feeding behaviour during this sensitive period, and should be regarded as the primary caregiver if baby needs to be separated from you.” That Dad gets Baby for skin-toskin time if you are unable to, or that baby is given to you for skin to skin if you have a c-section are two scenarios you should clearly specify in your birth plan – or birth wish, as Michelle prefers to call it, “As things often don’t go according to plan.” Another way of ensuring your wishes are carried out is to employ the services of a doula. “Your partner also needs to be strong and be there to protect your wishes as the birthing mother,” Michelle adds. ●