Skin-to-Skin Contact: A Valuable Start to Life for Mother and Child
Skin-to-skin contact (SSC), also known as "kangaroo care" (KC), is a well-established practice in the neonatal period and should be established as standard care for all newborns. Comprehensive evidence for SSC shows numerous benefits for both mother and child. According to the 2016 Cochrane Review “Early skin-to-skin contact for mothers and their healthy newborn infants,” immediate or early skin-to-skin contact supports breastfeeding. For the mother, benefits include earlier placental expulsion, reduced bleeding, increased breastfeeding confidence, and lower stress levels. The rise in oxytocin levels within the first hour after birth also contributes to mother-child bonding.
For the baby, SSC reduces the negative effects of birth stress, improves thermoregulation in the first few days, and reduces crying. Additionally, skin-to-skin contact promotes breastfeeding and decreases formula supplementation in the hospital, leading to more successful initial breastfeeding and better sucking. The evidence is so convincing that the 2018 updated WHO/UNICEF “Ten Steps to Successful Breastfeeding” initiative supports this practice. The Canadian Paediatric Society also highlights additional benefits of SSC, including better heart-lung stability, improved immunity, and positive effects on the microbiome.
In the first hours after birth, mother and newborn experience an especially valuable time, a sensitive phase biologically predetermined, particularly after a vaginal birth. This period is supported by high oxytocin levels in the mother and high catecholamine levels in the newborn. Skin-to-skin contact after birth triggers an internal process in the newborn, described through nine instinctive stages:
Phase | Behavior |
|---|---|
1. Birth Cry | Intense cry shortly after birth, transition to breathing air. |
2. Relaxation Phase | The baby rests. No activity of the mouth, head, arms, legs, or body. |
3. Awakening Phase | The baby shows signs of activity. Small head movements: up and down, side to side. |
4. Active Phase | The baby moves limbs and head, more determined movements. |
5. Resting Phase | The baby rests, with some activity such as mouth movements, sucking on the hand. |
6. Crawling Phase | The baby makes movements resembling crawling |
7. Familiarization | The baby reaches the nipple, positions the mouth to touch and lick the nipple. |
8. Sucking Phase | The baby has the nipple in its mouth and begins sucking. |
9. Sleeping Phase | The baby closes its eyes and falls asleep. |
Prolactin is the primary milk-producing hormone, while oxytocin plays a key role in maternal behavior and bonding immediately after birth. Animal studies show that separation of a mother and lamb after birth leads to the mother rejecting her lamb when reunited later. However, by simulating a birth during the reunion, oxytocin release in the mother sheep can be increased, leading to the acceptance of her lamb.
In humans, an oxytocin surge is released into the mother's bloodstream within the first hour after birth, helping the uterus contract, expelling the placenta, and reducing blood loss. This release of oxytocin is likely accompanied by intense activation of parvocellular oxytocin neurons in the brain, increasing maternal sensitivity to the newborn. This is evident by the mother’s desire to keep her child close during the hospital stay, especially when the newborn has nursed during the first hour at her breast.
The scent of the infant attracts the mother and facilitates chemical communication between the two. This highlights the importance of the mother having access to her newborn's bare head to smell the baby. This is an example of the early symbiotic biological relationship between mother and child.
The newborn has high catecholamine levels following a normal vaginal birth. These levels peak within the first 30 minutes after birth and enhance memory and learning. In newborns less than 24 hours old, the smell of breast milk increases oxygenated hemoglobin over the olfactory brain, as measured with near-infrared spectroscopy. The closer to birth, the more oxygenated hemoglobin was observed over the olfactory brain. This increased sensitivity to the smell of breast milk, especially shortly after birth, points to a physiologically based early sensitive phase in the newborn. This response aligns with biologically driven enhancements of the mother's breast odor through the enlargement of the areola surface and the secretions of the Montgomery glands at the same time. Therefore, the heightened early sensitivity to the smell of breast milk, in the presence of high catecholamine levels, indicates a physiologically based early sensitive phase in the newborn.
In summary, it becomes clear how valuable proximity is in the first 60 minutes after birth. During this time, a mother-child bond is established, directly linked to the mother's oxytocin levels. Several scientific sources emphasize the importance of skin contact between mother and child and the numerous benefits of this practice. For all parents, I highly recommend: cherish the time with your newborn skin-to-skin. The benefits speak for themselves and ensure the well-being of both mother and child.
Sources:
Canadian Paediatric Society. (2024). Skin-to-skin care (SSC) for term and preterm infants | Canadian Paediatric Society. Source
Moore, E. R., Bergman, N., Anderson, G. C., & Medley, N. (2016). Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, 11. Source
Widström, A.-M., Brimdyr, K., Svensson, K., Cadwell, K., & Nissen, E. (2019). Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatrica, 108(7), 1192–1204. Source
World Health Organization 2022. (2024). Nutrition and Food Safety. Source
World Health Organization & United Nations Children’s Fund (UNICEF). (2018). Implementation guidance: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised baby-friendly hospital initiative. World Health Organization. Source