Adriana continues her series on the “golden hour” with specifics on the benefits for your baby of having this undisturbed time right after birth.
Might parents, parents-to-be, and birthworkers: this is part two of a three-part series on the benefits of the golden hour. Listen to part one here.
What did you observe your baby do immediately after birth? Share your observations with our community on Instagram @birthfulpodcast.
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Related Birthful episodes:
- The Baby’s Birth Experience
- Third Stage of Labor
- [Postpartum] Hemorrhages Explained
- Shaking and the Primal Nature of Birth
- Why You Want to Do Lots of Skin-to-Skin With Your Baby
Related resources*:
- 7 Huge Benefits of An Undisturbed First Hour After Birth, BellyBelly
- Providing Evidence-Based Care During the Golden Hour, Nursing for Women’s Health
- The ‘golden hour:’ Giving your newborn the best start, Sanford Health
- The First Hour After Birth: A Baby’s 9 Instinctive Stages, The Magical Hour (Healthy Children Project)
- Step 4: Evidence – Based Care During the Golden Hour, Becoming Baby Friendly in Oklahoma webinar
- Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother, Baby, and Breastfeeding, The Journal of Perinatal Education
- Golden hour of neonatal life: Need of the hour, Maternal Health, Neonatology, and Perinatology
- Third stage of labour: delivering placenta and cord clamping, NCT 1st 1000 Days: New Parent Support
- Delivering the placenta, Tommy’s
- Holistic physiological care compared with active management of the third stage of labour for women at low risk of postpartum haemorrhage: A cohort study, Women and Birth
- Retained placenta after vaginal birth: How long should you wait to manually remove the placenta? MDEdge
- Postpartum Hemorrhage, Stanford Children’s Health
- Postpartum Hemorrhage, March of Dimes
- F is for Fundal Massage, Calming Waters Birth Services blog
- Delivery of a Newborn With Meconium-Stained Amniotic Fluid, ACOG Committee Opinion
- Updates to neonatal, pediatric resuscitation guidelines based on new evidence, American Academy of Pediatrics
- Your Baby’s First Cry – What Does It Signify?, First Cry Parenting
- Skin to Skin Contact, UNICEF UK: The Baby Friendly Initiative
- Benefits of Parent-Baby Skin-to-Skin Contact, VeryWell Family
- Kangaroo Mother Care website
- Kangaroo Care, The Cleveland Clinic
- Kangaroo Care, March of Dimes
- Kangaroo mother care started immediately after birth critical for saving lives, new research shows, WHO
- The life-saving benefits of kangaroo care, BBC Future
Transcript
Why the Golden Hour Matters for Your Baby
Adriana Lozada:
Hello, mighty parents and parents-to-be. I’m Adriana Lozada, and you’re listening to Birthful. Now, in my last episode, I started talking about the importance of the golden hour for the birthing person. So if you haven’t listened to that one, make sure you go back to it. Today I wanted to continue to focus on the golden hour, that time right after your baby is born, but this time to do it from the newborn’s point of view. And wow does it ever blow my mind when I look at the amount of complex physiological processes that babies go through in such an exquisite manner as they transition from life in the womb to life in the open air.
First of all, they have to start breathing, using their noses and engaging their lungs for breathing. They have to adapt to the new feeling of gravity now that they’re not floating. They have to take in the sensorial explosion of bright lights and sounds that are no longer muffled and new smells. And they’re also no longer in a temperature-controlled environment, so they have to start making some efforts towards regulating their temperature. And they do all that practically in a blink of an eye. But if they happen to need a few minutes, then there are a lot of protective mechanisms in place to help them support their transition and get them to stabilize. And the most well-known one of those is the continued attachment to the placenta that sends them oxygenated blood via the umbilical cord, which is one of the reasons you don’t want to clamp that cord right away. It’s letting your baby have oxygen in case they need a few minutes to figure out how to breathe on their own.
Now, when babies are born, they are pure instinct and those instincts are driving them towards the ultimate goal in this transition out of the womb, which is to get to the breast and latch so they can get food to survive. And the way they do that is through what has been identified as the nine instinctive stages of the newborn based on the research of Ann-Marie Widström and her colleagues. So let’s go through those. Okay.
So when babies are born, they come out blue and then they take that first breath, they pink up as their lungs expand and they give a first cry. That cry is the first of the nine instinctive stages. So they give the big cry, pink up. Then the second stage is relaxation, where they’re just hanging out with relaxed hands, without mouth movements and kind of just taking it all in. Then they start checking things out a little bit more in the awakening phase with small movements of their head and shoulders, and their eyes might be really wide open. And by this point, hopefully they’re already placed skin-to-skin with the birthing person, because that’s the space that’s going to be most supportive to these nine instinctive stages.
So then the next stage is one of activity, where they might start opening and closing their mouths, suckling, and rooting – moving their heads up and down as they look for the breast. And by being skin to skin, belly to belly with the birthing person, this allows for contact on different pressure points that the babies have on their bodies, which help guide them in this process and help them lift that head up as they take deep diaphragmatic breaths that help with the rooting.
Now, at any point, babies can take some periods of rest, which is a recurring instinctive stage because all of this is really hard work. So they might then take some rest, and once they’ve had their rest, get to the next stage, which is called the crawling stage. And this is when that stepping reflex gets going, helping the baby move up towards the breast and the nipple. They actually anchor their feet on your belly and step, step, step, scoot themselves up towards the breast. And this tends to happen around the 35-minute mark or so after they’re born.
Now once they get to the breasts, then they have to familiarize themselves with the space and they might start massaging it with their fists, maybe touching and licking the nipple because they use all their senses to understand what’s going on. We know that newborns see in black and white. And so the darker color of the areola is really making it a bull’s-eye for them to hone in towards. And also the areola has what are called Montgomery glands, which secrete a scent similar to amniotic fluid.
So really babies are using all their senses to get to their goal of latching at the breast. And this massaging of the breast with their fists is actually helping to give your body signals of, ‘Hey, you need to start getting ready to give me some colostrum.’ So even though it might feel that their hands are in the way, there’s actually a purpose to it. Now this stage of familiarizing themselves with the breast can take about 20 minutes or more.
Lozada: So at some point, then they will try to latch, which may take a few tries to be honest, to aim and coordinate. But when they get it, then they start sucking. They open wide and latch on, and then they finally fall asleep, which happens closer to the hour and a half, two-hour mark after birth.
So as you can see, the golden hour can take a lot more time than just an hour, and an important piece of these stages being able to happen is letting baby be skin-to-skin and take their time going through the process, because really it can take the whole hour or more to go through the stages, even when undisturbed, which is the goal.
If you want to watch these instinctive stages at play, I encourage you to Google “breast crawl” for a bunch of videos showing babies doing their thing. This can be a great way for you also to tune into the slowness that is required for it to happen. Grab a cup of tea when you watch these videos.
Now, this isn’t to say that if separation happens or interruptions happen during those first few hours that babies are not going to thrive, but allowing them to go through the stages is going to help them imprint their biological blueprint. Fortunately, this blueprint is like a computer program that wants to run and so you can allow the sequence to happen later when you’re able to recreate it if it didn’t happen right away, for example, if you had a surgical birth. Whenever it happens, your baby’s going to fire off those neurons and imprint the process, which is going to make it easier for them to latch again later.
Another thing that the research is showing is that going through these nine stages may enable self-regulation. So it’s not just about starting the chestfeeding relationship, going through these stages has a lot of benefits.
So then let’s back up and talk a little bit about the suck-swallow-breathe coordination that needs to happen before babies can feed, since that can impact the time that it takes for them to latch. If you’ve ever tried to drink through a straw while having a stuffy nose, you know it’s not pleasant or easy. So same for newborns. They can’t focus on latching and suckling if they can’t breathe properly through their nose. So it’s not uncommon for them to spend some of this time, clearing out their noses, getting stuff out of their nose and mouth with a few sneezes along the way to help out.
And you remember that I said there are a bunch of protective mechanisms in place to help this whole process? Well, let me tell you about the fetal Heimlich maneuver that occurs as the baby is born. During a vaginal birth, babies get a nice tight squeeze around their chest and bellies by the perineum as they are emerging, which gets amniotic fluid out from their bodies in a way similar to the Heimlich maneuver. How cool is that?
Another super cool protective mechanism that happens has to do with thermoregulation. Babies aren’t really great at regulating their temperatures just yet. And so when they aren’t kept warm, they spend a lot of energy and oxygen trying to stabilize their temperature, which can be taxing. So to minimize that stress, the birthing person’s chest creates a little warmer oven of sorts that is extremely responsive. To get specific, your chest easily regulates to half a degree to match your baby’s needs. And there’s even research where for a mom of twins, each side of her chest adopted a different temperature according to what each twin needed. So yeah, you are way better than a heat lamp.
Okay, so to recap. What babies need during that golden time is lots of skin-to-skin and the undisturbed opportunity to go through their nine instinctive stages in order to fire up those neurons, imprint breastfeeding, and bond with the birthing parent. This is going to help them stabilize. It’s going to lower stress levels. It’s going to lessen crying, reduce weight loss, boost their natural immunity and so many good things. The problem is that while baby is trying to respond to their instincts on their own time, they are also usually being rubbed down by caregivers to try to dry them up and get them to cry, and maybe are even being suctioned. All of which can be very disruptive and not necessarily physiological or evidence-based, which leads me to what we’re going to be doing next time when I’m going to be talking about what the providers are doing during this golden hour and how to navigate that time so that everyone involved –providers, you, your baby— can do what each of you need to do while supporting you and your baby’s physiological needs.
You can connect with Birthful on Instagram at Birthful Podcast. And to learn more about Birthful and my birth and postpartum preparation classes go to birthful.com. Let’s get you birth and postpartum ready.
Birthful was created by me, Adriana Lozada, and this episode was produced by LWC Studios: Paulina Velasco, Jen Chien and Kojin Tashiro. Thank you for listening to and sharing Birthful. Be sure to follow us on Apple Podcast, Goodpods, Amazon Music, Spotify, and everywhere you listen, and come back for more ways to inform your intuition.
CITATION:
Lozada, Adriana, host. “Birthful: Why the Golden Hour Matters for Your Baby.” Birthful, Birthful, March 9, 2022. Birthful.com.