It's Well Known That Skin-to-Skin Is Good for Mom and Baby — Why Do Folks Still Need Convincing?

 
Baby 15th December 2016

Skin-to-skin contact between a mom and baby immediately after birth leads to the healthiest, most secure postnatal outcomes, particularly when it comes to breastfeeding, says a new study.

Sound familiar? It should, as skin-to-skin contact has gotten strong recommendations from experts and studies, over and over again, for about 40 years now.

This latest study is actually a review of already-existing evidence from around the world and has been a long time in the making. It was prompted, says its lead author, Elizabeth Moore of the School of Nursing at Vanderbilt University in Nashville, Tenn., by her time as a lactation consultant in 2002. That's when she made this observation: The more time that had elapsed between birth and mother-baby contact, the harder it was to get breastfeeding up and running.

"When we initiated breastfeeding two hours after birth, after the babies had been cleaned and warmed and swaddled, the babies were exhausted, and they were very difficult to arouse," Moore tells Yahoo Beauty. "I got to thinking, Well, maybe if we started this earlier?" Immediately after babies are born, they are stressed out by the experience, and their bodies are coursing with stress hormones — which make them more sensitive to odor and more able to root out Mom's nipple and latch on. But after waiting too long, she says, "those stress hormones drop."

That was way back in 2002, and while now the idea of skin-to-skin being optimal is more widely accepted, that's not yet the case with women who have C-sections — which are at a national rate of 32.2 percent, according to latest Centers for Disease Control and Prevention stats. "In the OR, clinicians still have some hesitation," Moore says, which is usually based on a combination of factors, including fear of hypothermia for the newborn, as operating room temps are kept low for the comfort of medical professionals; concerns about maintaining sterility; the mom being a bit loopy from surgery drugs; and, probably biggest of all, staffing issues, which comes down to cost.

"Often it will be a nursery nurse who comes to the birth but can't stay," she says. And to have successful skin-to-skin that lasts long enough — at least an hour — you need a designated nurse in the room. "The hospitals just don't want to pay the extra money," Moore says.

The Cochrane Collaboration, an international organization that evaluates and reviews medical research, coordinated the review of evidence, which looked at 45 randomized controlled studies of a total of 3,850 women and their newborns from 21 countries.

"Babies are often separated from their mothers at birth," the review notes. "In standard hospital care, newborn infants can be held wrapped or dressed in their mother's arms, placed in open cribs or under warmers. In skin-to-skin contact (SSC), the newborn infant is placed naked on the mother's bare chest at birth or soon afterwards. Immediate SSC means within 10 minutes of birth while early SSC means between 10 minutes and 24 hours after birth. We wanted to know if immediate or early SSC improved breastfeeding for mothers and babies, and improved the transition to the outside world for babies."

It did: Compared with babies and mothers who were separated, those who received skin-to-skin contact immediately after birth were about 24 percent more likely to still be breastfeeding up to four months later. The SSC infants, in turn, were 32 percent more likely to successfully breastfeed on their first try. Other evidence showed that women who got SSC breastfed longer and were more likely to exclusively breastfeed after leaving the hospital — and babies had better heart and lung function.

The earliest studies that Moore and her team looked at were from the 1970s, when the idea of skin-to-skin contact was "really radical," she says, and the norm was to separate mom and baby for 12 to 24 hours.

And that's not to say it doesn't still happen. As part of an expansive 2015 interview series about women's upsetting and traumatic birth stories, "Exposing the Silence," many subject talked about being mysteriously separated from their newborns for long periods of time and never given a straightforward explanation.

"It's been the most traumatizing moment for everyone," Cristen Pascucci, a birth activist with Improving Birth and Birth Monopoly and a co-creator of "Exposing the Silence," told Yahoo at the time. "In one case, a doctor told the mom she'd have her baby back in 20 minutes, and [the other medical staffers] in the room laughed." When the doctor left the room, the others explained that "he always says that" and that, in reality, it would be several hours. One hospital, she added, had a policy of keeping babies away from moms for a full 12 hours.

In addition to preventing, to some extent, healthy hearts and ease with breastfeeding, keeping newborns separated from mothers adds to infant anxiety, a 2011 study found. "We knew that this was stressful, but the current study suggests that this is major physiologic stressor for the infant," John Krystal, MD, editor of Biological Psychiatry, where the study was published, had said of the findings at the time.

One way of counteracting the lack of skin-to-skin in operating rooms, Moore notes, is by letting dads and other co-parents step in. "It's not been studied as much as mother-baby skin-to-skin," she says. But the few researchers who have looked at it have found optimal results.

In the meantime, Moore believes hospitals will eventually need to update their policies as a result of all the findings on SSC. "I think there's going to be more and more consumer demand for skin-to-skin in the operating room," she says.



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