A new paper expanding on earlier research about the behaviors of the healthy, alert, full-term infant placed skin-to-skin with the mother during the first hour after birth following a noninstrumental vaginal birth written by Dr. Karin Cadwell and Dr. Kajsa Brimdyr in collaboration with clinicians from the Karolinska Institutet and Karolinska University Hospital in Stockholm, Sweden, appears in Acta Pædiatrica. The piece, which concludes that the first hour after birth is a sensitive period for both the infant and the mother, is titled “Skin-to-skin contact the first hour after birth, underlying implications, and clinical practice.”

Strong scientific research exists about the importance of skin-to-skin in the first hour after birth, which provides vital advantages to short- and long-term health, regulation and bonding. In fact, the evidence supporting skin-to-skin the first hour is so compelling that in the 2018 revision of the World Health Organization (WHO)/United Nations International Children’s Emergency Fund (UNICEF) Ten Steps to Successful Breastfeeding that form the basis of the Baby-Friendly Hospital Initiative, step four states ‘Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.’

However, clinical practice lags worldwide. To guide clinicians in their work to implement safe uninterrupted skin-to-skin contact the first hours after birth, the research integrates clinical observations and practice with evidence-based findings for enhanced understanding of the infant’s instinctive behavior and maternal responses while in skin-to-skin contact.

The paper explains how being in skin-to-skin contact with the mother after birth elicits the newborn infant’s internal process to go through what could be called nine instinctive stages: birth cry, relaxation, awakening, activity, rest, crawling, familiarization, suckling, and sleeping. It is organized around these nine developmental stages, expanding the understanding of each through the lens of the authors’ clinical expertise and research experience from direct observation of newborn infant behavior.

Expertise comes from experience as well as analysis of hundreds of hours of videotapes of newborn infants’ developing feeding behavior in skin-to-skin contact. Additionally, the authors had the opportunity to improve skin-to-skin care after birth, both in vaginal and cesarean delivery at 10 hospitals in Egypt and the United States according to a five-day video-ethnographic intervention.

Read the full paper here.

An online module based on this paper is available here. Earn 2 contact hours for RNs and CLCs, and 2L CERPs for IBCLCs for $14.00. Choose the module “Skin-to-Skin: Underlying Implications and Clinical Practice (Article)”.