The Importance of Skin to Skin After Delivery. You Should Know…

By JoLyn Seitz, MD Jan 31, 2017

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Placing your baby skin-to-skin on your body has been scientifically proven to be one of the best things you can do! Numerous research studies have found benefit after benefit from spending time with your newborn in skin-to-skin contact. It reaps multiple benefits for both baby and parents.

How can something so simple be so effective? The data has convinced leading organizations to recommend skin-to-skin contact, among them the World Health Organization, American Academy of Pediatrics, Academy of Breastfeeding Medicine and the Neonatal Resuscitation Program.

The first inclination that this practice could be revolutionary evolved in South America in the 1970s. Two physicians in Bogotá, Colombia, didn’t have enough incubators to care for all the premature babies in their hospital. So, they placed these tiny naked babies directly on their mothers’ bodies with both mother and baby covered by an exterior wrap, allowing the mom’s body heat to warm the baby. The babies thrived. The doctors named their technique the kangaroo mother method. The kangaroo mother method also includes breastfeeding instruction and support as well as earlier discharges. Later, this term was shortened to kangaroo care and has been associated primarily with the skin-to-skin aspect.

Researchers say a baby in skin-to-skin contact with the mother stimulates a specific part of the newborn’s brain. The baby is stimulated to move to mom’s breast, attach and begin feeding. This first step – getting sustenance – encourages physical development. A second step also happens. The baby will open his or her eyes and first gaze upon mother. This encourages emotional and social development. Numerous other research studies have revealed scores of additional benefits. Briefly, here are some of them:

For baby:

  • Better able to absorb and digest nutrients
  • Better body temperature maintenance
  • Cries less often
  • Demonstrate improved weight gain
  • Experience more stable heartbeat and breathing
  • Higher blood oxygen levels
  • Long-term benefits, such as improved brain development and function as well as parental attachment
  • More successful at breastfeeding immediately after birth
  • Spend increased time in the very important deep sleep and quiet alert states
  • Thermoregulation
  • Stronger immune systems

For mother:

  • Experience more positive breastfeeding
  • Improved breast milk production
  • Likely to have reduced postpartum bleeding and lower risk of postpartum depression

Kangaroo care research: baby benefits

Maintaining body temperature is essential for good health. Babies can lose body heat rapidly. Newborns don’t have the skills to keep themselves warm through shivering or covering up with clothes or a blanket, so nature steps in through the process known as thermoregulation. Thermoregulation is the process that allows the body to maintain its core temperature, even when environmental temperatures change. Thermoregulation is a particularly common problem with premature infants, though it can also affect full-term infants. Through skin-to-skin contact, the mother’s breasts automatically adjust to cool down or warm baby up, similar to when baby was in the womb.

Weight gain improves because your baby doesn’t use as much energy to regulate body temperature. Instead, that energy can go toward growing. Improved breastfeeding also contributes to healthier weight gain. Newborns that have skin-to-skin contact immediately after birth are twice as likely to breastfeed within the first hour. Mom’s prolactin level rises as a result—this is a hormone that is critical in maintaining a strong milk supply.

Skin-to-skin contact also helps baby’s body self-regulate, which stabilizes the heartbeat and breathing patterns. Seventy-five percent of heart and breathing episodes are reduced using skin-to-skin contact. Pain has also been shown to be reduced through skin-to-skin contact. Consequently, these babies cry less often.

Cortisol, or stress hormones, is measurably lower after only 20 minutes of skin-to-skin contact. When cortisol and somatostatin are reduced, gastrointestinal problems lessen because it allows for better absorption and digestion of nutrients. When these hormones are reduced, your baby’s body can better preserve healthy fat that helps to maintain birth weight and keep body temperature warm.

Mom’s mature immune system passes antibodies through the skin and breast milk to baby. Skin-to-skin contact also increases baby’s skin hydration, providing a protective barrier that prevents harmful bacteria from entering through baby’s skin.

During skin-to-skin contact, most infants fall asleep easily and achieve deep sleep, also known as quiet sleep, for an hour or more. Quiet sleep is beneficial for accelerating brain patterning and maturation. Development of mature brain function in infants is impacted by the quality of a baby’s sleep cycling.

Brain development begins with positive sensory stimulation at birth. Sensations that tell the baby’s brain that the outside world is safe include mother’s smell, movements and skin-to-skin contact. If the brain does not receive those assurances, brain development does not progress as efficiently. Brain maturation effects are long-term. A study of premature infants showed they had better brain functioning as teenagers compared to adolescents who had been placed in incubators. Researchers attributed it to stabilizing heart rate, oxygenation and improving sleep, which supports the brain to better develop. Another study showed that children who grew up lacking attachment to their parents did more poorly in school and were more likely to be depressed than children who had secure parental attachments. Skin-to-skin contact is one of the earliest steps in forming attachment to parents.

Research results: mom’s benefits

When mom and baby are together, hormones that regulate lactation balance out, helping mom to produce more milk and breastfeed more successfully. Newborns’ heightened sense of smell helps them seek out the nipple and begin breastfeeding more quickly when placed skin-to-skin. One study showed that moms who practiced kangaroo care were more likely to breastfeed exclusively and for longer periods. And moms who were having breastfeeding difficulties saw improvements almost immediately when they started skin-to-skin care one to two times a day for about an hour each time.

When you are holding your baby skin-to-skin, your oxytocin levels increase, which reduces your blood pressure and lowers stress levels. Increased oxytocin also helps restore pre-pregnancy hormone levels, reducing the risk of postpartum depression.

What about dad?

Dads should definitely get in on skin-to-skin care too. If you’re the father, hold your baby on your bare chest. You will enjoy the emotional benefits and the intimacy it creates between you and your newborn child. Knowing you are improving your baby’s health is also a big plus!

Be proactive when your baby is born

Immediately after birth, there are three steps to take to provide skin-to-skin care for your baby:

  • Have someone place your naked baby on your bare chest so the two of you are nestled chest-to-chest.
  • Turn your baby’s face sideways in a position that keeps the airway open.
  • Remain this way for at least an hour or more before hospital staff takes baby away to be weighed and measured.

You may have to request this in advance or check with the hospital you have selected to see if it is their practice. Many American hospitals have implemented skin-to-skin contact for full-term newborns immediately following birth. But there are also many care facilities that still present babies to their mothers for the first time cleaned up, diapered and bundled in a blanket. Likewise, North American moms are not always receptive to being exposed when staff or visitors may be entering and leaving their room. If you are uncomfortable with the idea of being exposed, have your partner or staff member make it clear no visitors will be allowed until you are ready.

Once staff has dried off your baby and placed baby on your tummy, all interaction should be only between baby and you. If you want to try breastfeeding immediately, see if your baby is interested. Don’t feel pressured, if your baby is not. Simply enjoy the time and relax.

A medical professional should remain in the room in case you or baby should have any problems after birth. General medical procedures usually done immediately after birth, such as eye drops and vitamin K injection, can be done a couple hours after birth without any disadvantages.

Many medical experts in this field recommend skin-to-skin contact immediately after a cesarean section, also called a c-section, and for premature babies. Mothers who are getting stitched up following a c-section have reported feeling less stressed practicing skin-to-skin during stitching. Studies show that premature babies are more metabolically stable and breathe better when skin-to-skin contact is introduced immediately after birth. If your newborn is premature, you may be hesitant to try. Take comfort in the fact that you are surrounded by professional staff ready to help if there’s a need.

Even if your baby does not latch on during the first hour or two, you and baby will still benefit. While most babies take to the breast right away or almost right away, some babies do not. Don’t push your baby to breastfeed; just relax and respond if and when your baby begins rooting.

Both parents can enjoy this time with baby. Most birthing rooms and nurseries have comfortable rocking chairs and screens where dad can snuggle with baby too.

Skin-to-skin improves health for sick babies

If your baby is very ill or suffering from acute respiratory distress syndrome, then immediate medical care precludes skin-to-skin time. Neonatal intensive care unit (NICU) staff, who often includes skin-to-skin care in their developmental care practices, will work with you to make skin-to-skin contact possible. In NICU, a baby has more stress and emotional needs. Ongoing tests, noises and procedures are very different from the quiet, warm womb the baby has known. Being able to hold these babies skin-to-skin – even with monitors attached and/or equipment attached to them – still has been shown to help them relax and be more contented.

One study even found that premature newborns who had prolonged skin-to-skin contact with their mothers while hospitalized actually had better survival odds. Since kangaroo care in South America originated, 124 studies around the world have confirmed its value for premature newborns throughout the world. Several studies showed that newborns who received standard medical care, as well as skin-to-skin contact, had a 36 percent lower death rate than those who only received standard care. These babies also had about one-half the risk of developing sepsis, were 78 percent less likely to develop hypothermia and were 88 percent less likely to have dangerously low blood sugar. It’s important to note that these studies were done in various countries, which means the definition of standard medical care varied. Also, some countries in the studies also had much higher complication rates than the United States.

Practice skin-to-skin at home

Once you are home with your baby, it’s still beneficial to make this practice a part of your day. While only in a diaper, snuggle your baby upright on your chest. Revel in the closeness and tactile comfort you both are enjoying. If the air is a bit chilly, place a blanket loosely over both of you. Make these sessions as comforting as you can. Avoid diaper changing or other tasks that might make baby unhappy before you start.

Good times to work it into your home routine include during breast or bottle-feeding, first thing in the morning or right after baths. Try to keep baby in position for an hour because this allows baby to go through a full sleep and wake cycle. Being on mom’s chest helps your baby settle in better to that rhythm. Babies can benefit from skin-to-skin for months. Some experts recommend it for at least three months for full-term babies and six months for premature babies. So snuggle up with your baby and enjoy the experience of being a parent.

Contact your provider or lactation consultant if you have any questions, concerns or would like more information about skin-to-skin contact.

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