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Wednesday, December 23, 2015

Mother's touch: Skin to Skin contact, the difference between life and death

The Importance of Skin to Skin Contact - The Natural Child Project
There are now a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby's temperature is more stable and more normal, the baby's heart and breathing rates are more stable and more normal, and the baby's blood sugar is more elevated. Not only that, skin to skin contact immediately after birth allows the baby to be colonized by the same bacteria as the mother. This, plus breastfeeding, are thought to be important in the prevention of allergic diseases. When a baby is put into an incubator, his skin and gut are often colonized by bacteria different from his mother's.
We now know that this is true not only for the baby born at term and in good health, but also even for the premature baby. Skin to skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their needs for oxygen, and keeps them more stable in other ways as well.
From the point of view of breastfeeding, babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without any help and they are more likely to latch on well, especially if the mother did not receive medication during the labour or birth. As mentioned in "Breastfeeding - Starting out Right", a baby who latches on well gets milk more easily than a baby who latches on less well. When a baby latches on well, the mother is less likely to be sore. When a mother's milk is abundant, the baby can take the breast poorly and still get lots of milk, though the feedings may then be long or frequent or both, and the mother is more prone to develop problems such as blocked ducts and mastitis. In the first few days, however, the mother does not have a lot of milk (but she has enough!), and a good latch is important to help the baby get the milk that is available (yes, the milk is there even if someone has "proved" to you with the big pump that there isn't any). If the baby does not latch on well, the mother may be sore, and if the baby does not get milk well, the baby will want to be on the breast for long periods of time worsening the soreness.
To recap, skin to skin contact immediately after birth, which lasts for at least an hour has the following positive effects on the baby:
  • Are more likely to latch on
  • Are more likely to latch on well
  • Have more stable and normal skin temperatures
  • Have more stable and normal heart rates and blood pressures
  • Have higher blood sugars
  • Are less likely to cry
  • Are more likely to breastfeed exclusively longer
There is no reason that the vast majority of babies cannot be skin to skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence.
Prenatal Yoga Center | Study Finds Benefits For Skin to Skin contact with Newborn
Part of my job as a doula is to hold a prenatal meeting with the couple IÂ’m working with, then type up notes from that meeting and return them to the couple for review. Over the years I have established a format for the questions I ask, although I do change them each time according to the couple’s intentions for their birth. One question that remains unchanged, though, is this: “Would you like immediate skin-to-skin contact (SSC)?” Rarely do I hear a parent say no to this question. After my notes are typed up, I encourage the parents to share these birth preferences with their care provider – this ensures everyone is on the same page. The feedback about SSC is generally the same and unless there is a medical reason, new mothers always get skin-to-skin contact with their babies. ItÂ’s no surprise that new parents would want the mother to hold her delicious new bundle, allow the oxytocin to flow, look deeply into her babyÂ’s innocent eyes and fall in love with her child immediately after giving birth. Additionally, if her baby is interested in breastfeeding right away, the mother will continue to produce oxytocin, which allows her to have the contractions that will help expel the placenta and shrink the uterus.
Despite these benefits, I usually witness the mother holding baby for mere moments before that baby is whisked away and placed under the heater, administered the vitamin K shot and eye drops, weighed, foot-printed, swaddled and then returned to the mother. Though parents have the option to postpone these hospital procedures for up to an hour, they often (unfortunately) take precedence over prolonged and immediate SSC, delaying the mother receiving her baby by about 30 minutes. During this time, the mother is delivering the placenta, which can take anywhere from 5 to 30 minutes, and being stitched up in the event of tearing or an episotomy. It is possible, as long as everything looks normal and there is no hemorrhaging, for the mother to keep the baby on her chest during these procedures and spend time with her baby.
Skin-to-skin contact helps save the lives of Newborn, New Study - News of the World
As many as 4 million babies worldwide die each year during their first month of life, and infants born early or at a low birth weight are at particular risk. Health technologies such as incubators can help improve outcomes in high-risk infants; however, such equipment is not widely available in low- and middle-income countries, where 99% of all neonatal deaths occur.
Lead author Ellen Boundy, SD ’15, who worked on the study while at Harvard Chan School and is an epidemiologist at the Massachusetts Department of Public Health, Chan, and co-authors analyzed 124 studies published between 2000 and 2014 that looked at skin-to-skin contact as a component of KMC. Some studies included additional care practices such as breastfeeding and close follow-up in their definition of KMC.
They found that among newborns weighing less than 2000 grams (4.4 pounds) who survived to receive KMC, there was a 36% reduction in mortality and 47% lower risk of sepsis or major infection. Newborns who received KMC also had higher oxygen levels and head circumference growth, as well as lower pain measures. In addition, KMC increased the likelihood of exclusive breastfeeding at hospital discharge by 50%. The results were relatively consistent across low- middle- and high-income countries.

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