Many things happen in that little moment in which the matron poses a baby, as soon as he arrives into the world, on his mother’s naked skin. This strategy, called skin-to-skin contact, is more than just a romantic letter of introduction between mother and child. There is science behind it and a lot of health at stake, especially for the little ones. One of Cochrane, the independent network of researchers that analyzes scientific evidence, has found that practicing skin-to-skin during the first hour after giving birth increases the probability of maintaining exclusive breastfeeding and helps you adapt to life outside the womb: specifically, by maintaining adequate body temperature, increasing blood sugar levels or improving your breathing and heart rate.
It doesn’t matter if the birth is natural or by cesarean section. Contact is beneficial and, in fact, the World Health Organization, even for premature babies, instead of taking them immediately after birth to the incubator. With the latest Cochrane review, science supports the benefits of this method, above all, to promote exclusive breastfeeding: according to the analysis, around 75% of babies who have skin-to-skin contact are exclusively breastfed at one month of age, compared to 55% of babies in the groups that did not have skin-to-skin contact.
The are critical for the newborn. There, in those moments, a hodgepodge of physiological processes take place to adapt to their new life outside the womb and immediate contact with the mother is essential. In the review, which has analyzed nearly 70 studies with data from more than 7,000 mother-child pairs, the authors confirm that this strategy not only improves exclusive breastfeeding. They also point out that “infants who experience skin-to-skin contact with their mothers probably have higher blood glucose levels” and, after analyzing a couple of trials with late preterm infants, they speculate that this strategy may help – for this profile of babies and also for those born at term – to stabilize cardiac and respiratory parameters.
The authors also highlight that “newborns probably maintain a normal body temperature during skin-to-skin contact.” They only found a temperature difference of 0.28 degrees Celsius in infants subjected to skin-to-skin contact and, although they do not consider it significant, they do send a message to health professionals: “You can be sure that infants who receive skin-to-skin contact do not present a greater risk of hypothermia.” The research also emphasizes that this strategy was “a positive experience for families and mothers would choose it for future births.”
Elizabeth Moore, retired professor at the Vanderbilt University School of Nursing and lead author of this research, recalls in a statement that “historically, babies have been separated from their mothers immediately after birth to carry out routine procedures such as physical examination, weighing and bathing, which has prevented immediate skin-to-skin contact.” However, depriving infants of that immediate contact, with everything that science now knows about its benefits, would no longer be justified even for clinical trials, the study concludes.
Ana Morillo, a neonatologist at the Sant Joan de Déu Children’s Hospital in Barcelona, who has not participated in this review, believes that separating the mother from the baby at birth “should be obsolete.” “We are mammals and it is skin-to-skin contact that nourishes us. The baby regulates the temperature on top of the mother much better and, at a cardiorespiratory level, giving it heat and placing it on top of the mother also improves,” he defends.
The neonatologist explains that in that first hour of life, the baby is “super awake” and “it is important to take advantage” of that window of opportunity to latch on to the breast before entering the drowsy phase of the first days, in which they sleep much more. “In that first hour when they come out of labor very awake, sometimes it is not even necessary to put them to the breast. They crawl there themselves,” he exemplifies.
In statements collected by Cochrane, Karin Cadwell, author and executive director of the Healthy Children Project’s Center for Breastfeeding in the United States, defends that preventing skin-to-skin contact right now would no longer be ethical. “Although the studies eligible for this review did not focus on survival, other studies from low-resource settings have shown that skin-to-skin contact can be decisive between life and death in low birth weight neonates. Large recruitment from Indian and African hospitals was stopped after preliminary data showed that skin-to-skin contact significantly improved survival,” he says.
Effects on the mother
The Cochrane review also analyzes the effects of skin-to-skin on the mother, but the evidence there is more limited. According to the research, this method was shown to have “little or no effect” on the delivery time of the placenta. And they also didn’t find a relationship between skin-to-skin and a decrease in postpartum blood loss—it’s the leading cause of maternal mortality.
“More research is needed on other aspects of childbirth,” the authors admit. Although they make an important note: “The trials did not report adverse effects for mothers, and there could be potential advantages for them in relation to decreased episiotomy pain.”
