Breastfeeding Medicine

Physicians blogging about breastfeeding

Celebrating Skin to Skin

with 6 comments

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.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by vpdn

August 2, 2010 at 6:07 am

Posted in policy, The Ten Steps

6 Responses

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  1. Dr. Berens,
    In the case of a typical C-section, do you put the baby on mom while you close the incision, or are they separated until the surgery is closed?

    Kathy

    August 2, 2010 at 5:35 pm

    • Kathy,
      It really depends on the situation. We usually do skin to skin in the recovery area so that is the “usual” practice. This may not be routine in some hospitals yet so we are working toward that. It is sometimes possible in non-emergent situations with the awake mother, heatlhy baby and another family member to do the skin to skin while still in the operating room, but it does depend on what resources the hospital has available. It is improtant to talk with the peolpe involved about what you would like and what they can offer to help you acheive that goal! Thanks, Pamela

      Pamela

      August 10, 2010 at 1:44 pm

  2. Thank you for brining attention to this important subject.
    If you would like to please see:
    http://cesareanparents.blogspot.com/2010/04/skin-to-skin-in-or.html
    The above is a link to a photo of me and my baby having skin to skin while still in the O.R. He started nursing before my incision was even closed.

    Mj

    August 5, 2010 at 12:06 pm

  3. Mj — I remember your post from when Laura Keegan wrote, “Mothers Yearn for their babies at birth“. In an era when most women have their healthy babies routinely taken from them even after vaginal birth, it is so wonderful to hear that some mothers are able to have their babies born by C-section placed skin-to-skin while the surgery is being completed.

    Kathy

    August 5, 2010 at 1:47 pm

  4. Who (which nurse) assumes resposibility for the newborn? We have been very successful in implementing skin to skin in the last year for vaginal births but we are still working on c-sections. NICU usually attends the c-section and then takes the infant to the newborn nursery. Nursery is then responsible for assessing and returning the infant to the recovery room for bonding. How have you been able to win over the pediatricians?

    Mary

    November 2, 2011 at 1:27 am


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