Adriana explains all the remarkable benefits of doing skin-to-skin with your baby—immediately after they’re born and through the first months of life—and how such a simple practice can bring your whole family closer together.
Did you have a partner who did skin-to-skin with your baby (or babies)? Give them a shout out on Instagram @birthfulpodcast.
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Related Birthful episodes:
- Immediate “Kangaroo Mother Care” and Survival of Infants with Low Birth Weight, New England Journal of Medicine
- Kangaroo Mother Care
- Whose Choice? Advocating Birthing Practices According to Baby’s Biological Needs, The Journal of Perinatal Education
- Early skin-to-skin contact for mothers and their healthy newborn infants systematic review, WHO
- Skin-to-skin contact, UNICEF
- Immediate and Sustained Skin-to-Skin Contact for the Healthy Term Newborn After Birth: AWHONN Practice Brief Number 5, Journal of Obstetric, Gynecologic, and Neonatal Nursing (JOGNN)
- Evidence on: Skin-To-Skin After Cesarean, Evidence Based Birth
- Skin-to-Skin Contact with Other Parent May Help Infants After C-Section Delivery, VeryWell Family
- Skin-to-skin contact by fathers and the impact on infant and paternal outcomes: an integrative review, Midwifery
- Newborn infants who received skin-to-skin contact with fathers after Caesarean sections showed stable physiological patterns, Acta Pædiatrica
- Skin-to-skin contact the first hour after birth, underlying implications and clinical practice, Acta Pædiatrica
- Give ‘Em Some Skin, Stanford Children’s Health
- The importance of skin-to-skin with baby after delivery, Sanford Health
Why You Want to Do Lots of Skin-to-Skin With Your Baby
I’m Adriana Lozada and you’re listening to Birthful, and today, we’re gonna dive deep into a perinatal topic that is fascinating. This week, it’s all about skin to skin and why it’s a fabulous thing for you and your partner to do. So, first of all, let’s define what is meant by skin to skin, although the name definitely gives it away. Skin to skin is the action of taking your baby, fully naked or in a diaper, and placing them in direct contact with a naked torso, and often then covering the baby with a blanket. One of the great things about skin to skin is that any caregiver can do it. You, your partner, the baby’s grandparents, adoptive parents can also do it, older siblings, really anyone. And the thing about skin to skin is that there has been extensive research on its benefits, which is why it’s become widely recommended as the preferred thing to do immediately after birth.
What are some of those benefits, you may ask? Well, skin to skin helps babies transition and stabilize to the outside world. It does that by helping them regulate their heart rate, their breathing, and their temperature. It also stimulates digestion, helping them better absorb nutrients, have less colic, improve weight gain and increase their interest in feeding. It can help with the colonization of babies’ microbiome, which protects them against infection and allows them to have a stronger immune system, and it can also help babies be calmer, and cry less, and have better blood sugars, and better sleep.
Skin to skin promotes essential brain development, which is required for bonding, and it also may lessen pain as babies have reduced responses to painful stimuli while doing skin to skin, which is why it’s a good idea to do that skin to skin when they’re getting shots, or getting blood samples, basically any procedures that have to be done to your baby, have them do it while your baby’s on you.
Now, uninterrupted skin to skin during that first hour after your baby is born also allows for the unhurried unfolding of your baby’s nine instinctive stages, which are stages they go through during that first hour of birth that lead to self-attachment so they can initiate breastfeeding and increase bonding.
Now, those are the benefits for the baby. If you are breastfeeding, there are a bunch of other benefits which skin to skin allows for an earlier exposure to start breastfeeding and also a shorter time to that first successful breastfeeding session. Babies are gonna have better suckling competence. There’s gonna be higher rate of breastfeeding after having a cesarean and also a higher incidence of exclusively breastfeeding and overall longer duration of breastfeeding if you do skin to skin right after birth. But those are not all the benefits. Skin to skin initiates an instinctive caregiving behavior, helping the birthing person connect and bond with the baby, and it also helps release hormones that support breastfeeding while also calming and relaxing the person doing the skin to skin through surges of oxytocin. Skin to skin lowers the risk of depression and physiological stress during postpartum and increases parental sensitivity to all of the infant’s signals. It also increases confidence and maternal satisfaction. It reduces postpartum bleeding, encourages a faster recovery from delivery regardless of how you give birth, and there’s a whole lot of amazing benefits for something that is so simple.
In the hospital, the practice of skin to skin is done by taking the baby right after they’re born and putting them directly on the birthing person’s chest, then drying them there and covering baby and parent in a warm blanket, and then leaving them to do this, ideally without interruptions and no pressure to hurry up and breastfeed for at least an hour or until that first feed is completed, which can often take about that much time or longer to happen.
Now, the good thing is that aside from measuring and weighing your baby, most other newborn procedures can take place with them on your chest. So, feel free to delay those routine care practices as much as possible or have them happen while your baby’s still on you. By now, you might be thinking that skin to skin is only for that first hour after birth, but oh no, you can continue to do it for weeks or months after birth. The specifics of when and for how long haven’t been researched as much, but the consensus is to do frequent, uninterrupted skin to skin while in the hospital and after discharge, with AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses, recommending sessions of at least 60 minutes, going up to as much as five hours per day for the first week of life, and the American Academy of Pediatrics recommending to do it as long and as frequently as possible during the first three months for a full-term baby and six months for a preemie.
They recommend at least 60 minutes in order so that the baby can get the hormonal benefits of decreased stress hormones, but that does not mean that you have to do skin to skin lying down. You or your partner can do skin to skin with baby in a carrier. Just make sure the baby’s naked body or in a diaper is exposed to your bare torso and that they are secure, supported, and well positioned belly to belly at a height where you can kiss their heads and they can breathe freely. Also, you don’t have to be chest feeding to do skin to skin, but if you are having milk supply issues, spending 24 hours in bed naked with your baby feeding on demand while people support your hydration and nutrition needs can be a great way to reset that breastfeeding relationship and increase your supply.
Now, in case of a surgical birth, some hospitals do allow for skin to skin in the OR, so ask for it, but if they don’t, prioritize doing skin to skin as soon as you can in the recovery room. And you remember I said anyone could do it, right? So, if for some reason you, the birthing person, doesn’t feel that you can hold the baby, or there’s a need for separation, the dad or partner can unbutton or take off that shirt and do some skin to skin. In fact, it’s good practice for partners to have a button-down shirt to wear in case of a cesarean specifically for this reason.
Some very recent research from January of this year observed babies that were born via cesarean with one group of babies being placed in a cot, a second group being held in arms by their fathers, and the last group doing skin to skin with their dads starting at 45 minutes after birth and continuing until two hours after. The babies that had skin to skin had better heart rates and stability over time and were more alert. In fact, they followed a wakeful pattern that was very similar to that of babies born vaginally. The skin to skin also allowed for the newborns’ pre-feeding behavior to show up so they were ready for that first breastfeeding session when reunited with their moms. To top it all off, the research also showed that the dads that did skin to skin were more engaged fathers in the long run. Other research around skin to skin and dads also showed that for dads, they also had less stress and anxiety thanks to the skin to skin they did with their baby.
And if skin to skin is good for full-term babies, it’s even more important for preemies. So much of the research that has been done has been done around what’s called kangaroo care, which includes doing continuous skin to skin and exclusive feeding of breastmilk for preemies. Now, traditionally if a preemie baby is unstable, the protocol has been to stabilize them first separately from the birthing parent, usually in an incubator in the NICU, and then once stable, allow kangaroo care to happen.
It turns out, though, that immediate skin to skin first is even better. A recent study from May 2021 looked at over 3,000 preemies, itty bitty preemies, averaging 32 weeks and weighing under three pounds, and those who receive immediate kangaroo mother care had lower mortality at 28 days than those that had kangaroo care after being stabilized. Now, these babies in the study were held pretty much most of the day, up to 17 hours, compared with one and a half hours for the group that spent the rest of their day in an incubator or radiant warmer, but the improved results of doing skin to skin even when babies hadn’t yet stabilized were so clear cut that the trial was stopped early so that all future preemies could receive the improved outcomes of doing immediate kangaroo care.
This research is just one more in a huge pile that confirms that the absolute best place for your baby, pretty much regardless of complications, is naked, right there, skin to skin, on you or your partner’s chest, for as long and as often as you want or can.
You can connect with Birthful on Instagram @BirthfulPodcast and share with me how your skin-to-skin experience went. To learn more about Birthful and my birth and postpartum preparation classes, go to birthful.com.
Birthful was created by me, Adriana Lozada, and is a production of LWC Studios. The show’s senior producer is Paulina Velasco. Jen Chien is executive editor. Cedric Wilson is our lead producer. Kojin Tashiro is our associate sound designer and mixed this episode. Thank you for listening to and sharing Birthful. Be sure to subscribe on Apple Podcasts, Goodpods, Amazon Music, Spotify, and everywhere you listen, and come back for more ways to inform your intuition.
Lozada, Adriana, host. “Why You Want to Do Lots of Skin-to-Skin With Your Baby.” Birthful, LWC Studios, Nov 17, 2021. Birthful.com.
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