Skin-to-skin contact, also known as kangaroo care, is a practice where a newborn baby is placed unclothed, on their belly, directly onto the bare chest of a parent. This intimate contact allows both parent and baby to bond and learn about each other in a new world. While it might feel overwhelming, especially for first-time parents, embracing this time without excessive worry about specific durations or perceived perfection is key. Focus on what feels comfortable and practical for your situation.
For babies with medical needs that might complicate skin-to-skin contact, healthcare teams can provide tailored guidance. The practice of skin-to-skin contact began gaining recognition in the 1970s, initially in Neonatal Intensive Care Units (NICU) for premature babies. Today, it is widely acknowledged as beneficial for all newborns, regardless of whether they were born prematurely or at full term.
The Golden Hour and Immediate Post-Birth Benefits
Skin-to-skin contact can commence immediately after birth and continue at home. The first hour following a baby's birth is often called "The Golden Hour." During this critical period, the baby is placed directly onto the birthing parent's bare chest, skin-to-skin. Ideally, skin-to-skin contact after birth should be as long and uninterrupted as possible.
This extended contact offers numerous advantages, including promoting breastfeeding and facilitating the baby's ability to self-attach to the breast. For the breastfeeding parent, skin-to-skin contact helps release the hormone oxytocin, which can increase milk volume. The newborn can smell the milk and is naturally drawn to the chest to feed. Breastfeeding within the first few hours after birth ensures the baby receives colostrum, the initial stage of breast milk.
The benefits of skin-to-skin contact just after birth have been scientifically proven to help maintain or improve the infant’s body temperature, digestion, blood-oxygen levels, heartbeat, sleep patterns, and even the immune system, as mothers pass antibodies to their infants through their skin and breast milk.
Practicing Skin-to-Skin Contact at Home
Skin-to-skin contact is not limited to the hospital; it can be practiced at home anytime, and it's never too late to start. To create a comfortable environment at home:
- Remove clothing from your chest area.
- Remove clothing from your baby, though a diaper is acceptable.
- Place your baby on your bare chest.
- Cover yourselves with a blanket for warmth, ensuring your baby’s head remains free from the blanket.
Pro tip: Encourage the entire family to participate in skin-to-skin contact to foster bonding.
Recommended Duration and Flexibility
It is recommended to aim for approximately 60 minutes of uninterrupted skin-to-skin time with your newborn each day. However, if achieving a full 60 minutes in one sitting is challenging, break the time into smaller, manageable sessions. The most important aspect is consistency and connection, rather than adhering to a strict time limit.
When holding your baby in skin-to-skin contact, ensure they are clothed only in a diaper and held upright on your chest. Avoid interrupting this precious time with tasks like diaper changes. Consider practicing skin-to-skin time during breastfeeding, bottle-feeding, in the morning, or after a bath.
Stages of Newborn Behavior During Skin-to-Skin Contact
As you and your family engage in skin-to-skin contact immediately after delivery, observe your baby. Newborns typically go through several stages, though each baby is unique and may not experience all of them:
- Birth Cry: The initial cry immediately after delivery.
- Relaxation: The baby becomes calm with no mouth movements and relaxed hands.
- Awakening: The baby begins to show movement of the head and shoulders, along with some mouth activity.
- Activity: Rooting reflexes appear, and mouth and sucking movements become more pronounced.
- Crawling: The baby uses their body to move towards the nipple and breast.
- Familiarization: The baby begins to recognize and connect with the parent.
- Suckling: The baby latches onto the breast and begins to suckle.
Skin-to-skin contact is a vital component of UNICEF UK Baby Friendly Initiative standards. It is commonly understood as the practice where a baby is dried and placed directly on the mother’s bare chest after birth, covered with a warm blanket, and left for at least an hour or until after the first feed.
Skin-to-Skin Contact in Neonatal Units and Beyond
Skin-to-skin contact is also frequently employed in neonatal units, where it is known as ‘kangaroo care.’ It can be utilized any time a baby needs comforting or calming and can significantly help boost a mother’s milk supply. A growing body of evidence supports the positive impact of skin-to-skin contact on both babies and their mothers after birth.
When a mother holds her baby in skin-to-skin contact, it triggers strong instinctive behaviors in both. The mother experiences a surge of maternal hormones and is prompted to smell, stroke, and engage with her baby. Conversely, babies’ instincts after birth guide them through a unique process that, if uninterrupted, leads to their first breastfeed. Babies may detach from the breast after a period of suckling. Most healthy, full-term babies will naturally follow this process if it is not interfered with by external factors, such as being taken away for weighing or the mother taking a shower.
Interrupting this sequence before the baby has completed it, or attempting to rush them through the stages, may lead to difficulties with subsequent breastfeeds. Vigilance regarding the baby’s well-being is a fundamental aspect of postnatal care in the immediate hours following birth. Normal observations of the baby’s temperature, breathing, color, and tone should continue throughout the skin-to-skin contact period, similar to how they would be monitored if the baby were in a cot. This includes the calculation of the Apgar score at 1, 5, and 10 minutes after birth.
Safety and Monitoring During Skin-to-Skin Contact
Care must always be taken to ensure the baby remains warm. It is crucial to prevent the baby from falling onto the floor or becoming trapped in bedding or by the parent's body. Mothers are encouraged to adopt a semi-recumbent position to comfortably hold and feed their baby. Observations of the mother’s vital signs and level of consciousness should also continue throughout the skin-to-skin contact period.
Many mothers can continue to hold their baby in skin-to-skin contact during procedures like perineal suturing, provided they have adequate pain relief. However, a mother experiencing significant pain may not be able to hold her baby safely. All babies should be routinely monitored while in skin-to-skin contact with either parent. This monitoring includes checking that the baby’s position maintains a clear airway, observing respiratory rate and chest movement, and assessing color - looking at the entire body, as limbs can sometimes appear discolored first.