In honor of World Breastfeeding Week, I wanted to write something about the importance of skin to skin contact for mothers and babies at delivery. As a practicing OB this is something I try to encourage.
I believe that skin to skin contact immediately following delivery should be routinely practiced for healthy mother infant dyads with term deliveries. This helps support the “10 Steps” as it encourages breastfeeding initiation within the first 30 minutes after delivery. Much of the medical technology involved in childbirth helps us recognize when problems occur. It can also help us recognize when mothers and infants are healthy at birth. This should be the expected situation for normal birth.
Immediately after delivery of a healthy infant my “routine” is to place the baby skin to skin on the mother’s chest and abdomen. This may occur while the umbilical cord is still attached. The family then can participate in cutting the cord if so desired. The baby and mother can then be dried off and the baby replaced skin to skin on the mother’s chest with warmed blankets covering them both. (Mother’s skin to a baby wrapped in a blanket – the baby burrito – doesn’t work as effectively)….
In addition to facilitating breastfeeding, this helps maintain newborn temperature and allows the new family to enjoy each other!
Medical evidence supports skin to skin contact at delivery. One study found that the group of babies left with their mothers for at least 1 hour after delivery was more likely to display effective suckling. Other studies have found that immediate skin to skin contact extended the length of both any breastfeeding and exclusive breastfeeding. It has also been found that skin to skin contact maintains the infant’s temperature. To me this seems like such a better option than the “warmer” in the corner. The longer length of this skin to skin contact appears to improve the duration of exclusive breastfeeding.
Most research on skin to skin contact involves vaginal delivery. A recent study using skin to skin contact in the recovery room after cesarean delivery also supports this practice in maintaining infant temperature. I encourage this for my families as well. I also think that this provides an excellent opportunity to start breastfeeding as often the new mother still has some pain relief from her spinal or epidural from the delivery.
Skin to skin contact for premature infants in the neonatal nursery has found additional beneficial effects on milk volume and maternal confidence. Kangaroo mother infant care has shown multiple benefits to the premature infant including improved breastfeeding rates. Skin to skin contact can also reduce infant pain related to newborn procedures.
As an OB, I encourage the practice of routine skin to skin contact for healthy moms and babies around the time of delivery (unless a medical condition in either the mother or infant exists that would require other management). Other “routines” that are done after birth can be postponed until after this critical and wonderful experience for the new family.
Pamela Berens is a professor of Obstetrics, Gynecology and Reproductive Sciences at The University of Texas Health Science Center at Houston and a member of the Academy of Breastfeeding Medicine.
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