Skin-to-skin contact (SSC), placing your naked newborn baby on your bare chest immediately after birth, has been found to be so beneﬁcial to helping a baby adapt to life outside the womb that the World Health Organisation has recommended it becomes routine practice in hospitals.
However, most babies are cleaned, dressed and swaddled before being handed back to mom. Backed by a series of studies, Dr Nils Bergman, honorary research associate in Human Biology and senior lecturer in Paediatrics at the University of Cape Town, argues that skinto-skin contact should be every baby’s birth right. Dr Bergman first introduced SSC to South Africa in 1995. His wife, Jill Bergman, a doula and author of the book Hold Your Prem, based on her husband’s studies, has taken on the task of putting his scientific research into practical applications for parents. Here, she explains the benefits of skin-to-skin contact.
Skin-to-skin contact reduces risk of low blood sugar
Having spent nine months in a temperature-controlled environment, newborns aren’t able to regulate their body temperature well. If babies lose too much heat, they have to use their meagre energy supplies to keep their temperature stable. Mothers are able to thermally sync with their babies – a mother can raise her body temperature by up to 2°C to warm her baby, or drop her body temperature by 1°C to cool him. With you helping to regulate your baby’s temperature, skin-to-skin contact can help him produce energy from his body stores until he is breastfeeding well. This helps reduce the risk of hypoglycaemia (low blood sugar levels).
SSC helps regulate breathing
A baby who is left undisturbed in skin-to-skin contact with his mother is also able to better regulate his breathing. This may, in turn, help to stabilise his heartrate.
SSC boosts immunity naturally
Your baby needs your beneficial microbes. His first dose, as he emerges from the ‘sterile’ environment of the womb, comes from your vaginal canal, but a further beneficial dose can also come through skin-to-skin contact with your newborn. Seeding your baby with these bacteria, in particular lactobacilli, boosts his immune system and also helps put the founding bacteria in his gut that he needs to digest his first meal of colostrum, which is packed with powerful antibodies.
SSC decreases infant crying
Prolonged infant crying at birth is not something that the midwives at Genesis Clinic, a midwifery obstetric unit in Johannesburg, like to hear, shares Jeanell du Plessis, a senior midwife at the clinic. Drawing on research by Dr Bergman and his colleagues, Jeanell explains that infants want to be with their mothers – it’s the environment most similar to the womb where they can smell, taste and hear what they are familiar with. Prolonged separation triggers crying and what’s dubbed the ‘protest-despair response’, a stress response that destabilises body temperature and cardio-respiration. The stress hormone cortisol can take around one hour to wash out of your baby’s system, explains Jill. So, two minutes of separation from you to put on a nappy, one minute of weighing on a scale, one minute of being rubbed down and cleaned and dressed are all minutes of stress that can provoke crying and undermine the stabilisation of your baby’s physiology. This all means that routine tasks traditionally undertaken to ensure a baby’s wellbeing, such as observing and measuring a baby (for the Apgar), are better done with the baby on the mother’s chest, or at the bedside with minimal separation. Some, like weighing the baby, should be delayed until after the first breastfeed. In fact, even if your baby needs oxygen, it is best initiated on the mother’s chest, she asserts.
Premature babies and skin-to-skin
Because skin-to-skin care significantly reduces the amount of crying, pre-term babies stand to benefit even more than full-term babies. Not only could excessive infant crying be a waste of calories meant for growth, but it may also increase the risk of intraventricular haemorrhage, which is bleeding into the fluidfilled areas (ventricles) inside the brain, explains Jill.
The benefits go both ways
The benefits of SSC extend beyond your baby’s physiological stability. It also promotes the release of oxytocin and this helps the uterus to contract, helping to prevent excessive post-partum bleeding, explains Jeanell. Oxytocin, also known as the love hormone, plays an additional role in promoting bonding (or what scientists refer to as attachment behaviours), so post-birth skin-to-skin contact is an ideal way to fall in love with your baby. There are also benefits in store for breastfeeding mothers. The other hormone triggered for release by SSC is prolactin – your body’s cue to start producing milk. Moms of babies who are offered skin-to-skin contact tend to complain less of breast engorgement and have better breastfeeding success one to four months post birth. Their infants also tend to initiate breastfeeding more effectively than babies who are swaddled.
Plan ahead for skin contact
Regardless of how your baby is born (vaginal delivery or C-section), it seems that only good can come from skinto-skin care. Ensuring skin-to-skin contact may require some prior planning with your healthcare practitioner. For it to have the most benefit, it needs to look something like this:
- As early as possible after birth – and ideally prone on your bare chest, the SSC is uninterrupted, your infant is thoroughly dried and covered across her back with a pre-warmed blanket and her head is covered with a dry cap (that is replaced if it becomes damp).
- If possible, for the first 1 000 seconds of your baby’s life, hold your baby skin- as the baby is born – to-skin with minimal have your healthcare provider place your baby in skin-to-skin contact with you.
- This can be done prior to the delivery of the placenta and the clamping of the cord.
- Your healthcare provider can gently dry your baby by ‘hugging’ a soft towel or blanket to your baby while she lies on you.
- The temperature of your healthy, newly delivered infant will remain in a safe range, provided she is placed to no disturbance.
- Your midwife, obstetrician and paediatrician should monitor you and your infant with the objective of keeping skin-to-skin contact a prerogative.
- To get your healthcare practitioner on board, you can refer them to the study Early skin-to-skin contact for mothers and their healthy newborn infants found online at the Cochrane Library or nino.org.
When complications prevent SSC
- Medically necessitated suctioning, or even the first steps of resuscitation, can happen while your baby is lying on you, says Dr Bergman.
- Alternatively, if this isn’t possible, mothers and fathers can stay close by and reassure their infants by speaking softly to them.
- If the complications involve mom, it is also possible to use dad as a skin-to-skin care giver as baby is likely to be familiar with dad’s voice.
Did you know?
A mother can raise her body temperature by up to two degrees Celsius to warm her baby, or drop her body temperature by one degree Celsius to cool him.