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Factsheet – Skin-to-skin contact

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Factsheet – Skin-to-skin contact

Dr Jeni Stevens
Clinical Midwifery Consultant in Infant Feeding and Researcher, New South Wales Health
Adjunct Fellow for Western Sydney University
@JeniStevensS2S

Summary

Image credit: www.vanessamendezphotography.com

Skin-to-skin contact (SSC) is when a naked baby is placed chest-to-chest on their mother/father/partner’s bare chest. SSC is often called Kangaroo Mother Care when SSC is provided with premature babies. We now know there are many advantages to SSC and this factsheet will help you understand its value and how it can be used for the benefit of both the baby, mother and family.

 

What we know:

SSC between a mum and baby has been shown:

  • To reduce mums’ risk of increased bleeding after birth1
  • To reduce the stress of birth2,3
  • To trigger the hormone oxytocin in both mum and baby, which helps mum and baby bond (also in your partner!)4
  • To maintain the baby’s temperature5 and increase their blood sugar level6
  • To help a baby to go through nine instinctive stages to search for the breast and breastfeed5,7
  • To increase breastfeeding initiation8 and duration4,6
  • To reduce the incidence of excessive baby weight loss5
  • To increase the good bacteria in the baby’s gut5,10
  • That medications during birth can affect baby’s ability to successfully go through the 9 instinctive stages of SSC9
  • That most mother’s want SSC with their baby11

What we don’t know:

  • How much SSC women should have with their baby to get the optimal benefits from providing this care
  • If SSC increases long term breastfeeding
  • The importance of SSC for long term health outcomes
  • If the benefits of SSC are equal when comparing normal and medicalised births
  • What, if any, birth interventions affect the baby’s ability to go through the nine instinctive stages of SSC
  • That further high-quality SSC research is recommended
  • A tool that can facilitate evidence integration is the Healthy Children Project’s Skin-to-Skin Implementation Algorithm12

Mothers and families: how to use the evidence

  • Find out more about the 9 instinctive stages of SSC 
  • Find out more through these FAQ 
  • Request SSC with your baby immediately after birth, even if it is not normally practiced
  • If the health practitioner/s are not educated on how to provide safe SSC, encourage them to look at the information below
  • Enjoy your first SSC cuddle and see what your baby does!
  • Continue to provide SSC with your baby as much as possible.
  • Encourage your partner to also provide SSC – it is good for both of them.

Midwives and birth workers: how to use the evidence

  • Find the evidence for SSC, check the links to resources below
  • Encourage SSC as recommended by the World Health Organization – all mothers and their babies should have immediate SSC if they are well at the time of birth.
Implement the recommended SSC by:
    • Providing education to both the woman and her partner/support person about the benefits of SSC (see above) and how to ensure the safety of the baby when providing SSC before birth:
      • Is your baby’s nose free to breathe?
      • Can you see/feel your baby breathe?
      • Are your baby’s lips pink?
      • Is your baby active (not floppy)?
      • If you are concerned get some help
      • If you are sleepy and no one can watch your baby, place them on a safe sleeping surface
    • Encourage immediate SSC after birth, unless emergency care is needed then encourage it as soon as possible
    • Encourage continuous SSC for at least an hour, or until after the first breastfeed
    • Encourage uninterrupted SSC (hands off, no putting babies on the breast!)
    • Encourage safe SSC as much possible in the first months after birth
    • Video of ideas on how to safely transfer a mother and baby together in the operating theatre, to ensure continuous and uninterrupted SSC.

References

  1. Saxton A, Fahy K, Rolfe M, Skinner V, Hastie C. Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: Results of a cohort study. Midwifery. 2015;31(11)1110-1117
  2. Bystrova K, Widstrom, AM, Matthiesen, AS, et al. Skin-to-skin contact may reduce negative consequences of “the stress of being born”: a study on temperature in newborn infants, subjected to different ward routines in St.Petersburg. Acta Paediatrics. 2003;92(3):320-326.
  3. Ferber SG, Makhoul IR. The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: A randomized, controlled trial. Pediatrics. 2004;113(4 Part 1):858-865.
  4. Mercer, JS, Erickson-Owens DA, Graves B, Haley MM. Evidence-based practices for the fetal to newborn transition. Journal of Midwifery & Womens Health. 2007;52(3):262-272.
  5. World Health Organization (WHO), & United Nations Children’s Fund (UNICEF). Implementation Guidance: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: The revised Baby Friendly Hospital Initiative. http://www.who.int/nutrition/publications/infantfeeding/bfhi-implementation/en/ Published 2018. Accessed April 17, 2020.
  6. Moore ER, Anderson GC, Bergman N, Dowswell T. (2012). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews. 2012:(5). https://www.cochrane.org/CD003519/PREG_early-skin-skin-contact-mothers-and-their-healthy-newborn-infants Published 2012. Accessed April 17, 2020.
  7. Widstrom AM, Lilja G, Aaltomaa-Michalias P, Dahllof A, Lintula M, Nissen E. Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation. Acta Paediatrics.2011;100(1)79-85.
  8. Chaparro, C., & Lutter, C. (2009). Incorporating nutrition into delivery care: Delivery care practices that affect child nutrition and maternal health. Maternal and Child Nutrition, 5(4), 322-333.
  9. Brimdyr, K., Cadwell, K., Widström, A. M., et al. The Association Between Common Labor Drugs and Suckling When Skin‐to‐Skin During the First Hour After Birth. Birth. 2015;42(4):319-328.
  10. Matamoros S, Gras-Leguen C, Le Vacon F, Potel G, de La Cochetiere MF. (2013). Development of intestinal microbiota in infants and its impact on health. Trends in Microbiology. 2013;21(4):167-173.
  11. Stevens J, Schmied V, Burns E, Dahlen HG. (2019). Skin-to-skin contact and what women want in the first hours after a caesarean section. Midwifery. 2019;74:140-146.
  12. Brimdyr K, Cadwell K, Stevens J, Takahashi Y. An implementation algorithm to improve skin-to-skin practice in the first hour after birth. Maternal & Child Nutrition. 2017:14(2):e12571

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