Skin-to-skin has become a birth plan buzzword. The term has penetrated birthspeak and, in my view, is at risk of being treated as a trend that is only paid lip service in the immediate postpartum period. I did just this with my first child! I knew skin-to-skin was something I *should* be doing but didn’t really know why or what it should look like.
I mention skin-to-skin A LOT in my professional and voluntary practise supporting mothers, the evidence shows it is something of a panacea for mother-baby pairs. I wonder if it is sometimes overlooked as a suggestion because it is such a simple idea; putting your bare skin to your baby’s bare skin is not difficult, radical or revolutionary.
You won’t often find me citing research in this blog but I think these are important in understanding the value of skin-to-skin and how we can make it work for us. It’s absolutely not just for mothers having a natural, vaginal birth, it doesn’t need to be discarded from your birth plan if labour doesn’t progress as you’d hoped and it doesn’t need to be forgotten after the first hours of your baby’s life. It is a valuable mothering tool and at the very least, it can do no harm. Below is a small sample of the research on skin-to-skin, I have included links at the bottom of this post that will lead you to many more. So here comes the science…
Research showed that skin-to-skin contact, early suckling, or both, in the 2 hour period following birth had a positive affect on the mother-baby relationship when the baby reached 1 year old, when compared with mother-baby pairs who had been separated. NHS care in the UK should now reflect the importance of keeping mama and baby together after birth. Also consider that this study showed that swaddling reduced the mother’s responsiveness to her baby. (1. Bystrova K et al., 2009)
A Polish study showed that skin-to-skin contact for longer than 20 minutes after birth increased the duration of exclusive breastfeeding. (2. Mikiel-Kostyra et al., 2002)
You may have heard of the ‘gentle caesarean’ where some skin-to-skin time can still be enjoyed by the mother-baby pair, in contrast to traditional caesarean procedures. A study has shown that the complications rates in 144 ‘gentle caesareans’ were similiar to or lower than those for traditional caesarean births. Not directly related to the value of skin-to-skin but helpful for mothers who have a c-section to be aware that this is not necessarily a reason to forego the known benefits of skin-to-skin contact. If you are in a position to do so, agree this with your caregivers beforehand. (3. Magee S. R. et al., 2014)
We shouldn’t forget the value of skin-to-skin with dad where it isn’t possible with mum. A small 2007 study showed babies cried less and calmed quicker on spending skin-to-skin time with dad whilst mum was in recovery post c-section, compared to babies kept in a bassinet for this time. My personal opinion is that the results would be the same with any loving, caring, warm-bodied adult for eg. mother’s partner who is not the baby’s father, grandparent, other relative or friend. (4. Erlandsson K et al., 2007)
A Swedish study looked at slightly older babies (1-16 weeks) with severe problems latching on to the breast. It investigated if skin-to-skin contact could positively affect the baby’s ability to latch, compared to a group where the baby was clothed. The skin-to-skin babies were more able to latch correctly and successfully suckle at the breast and their mothers felt more positive and experienced less pain. I love that this shows us how something as simple as closeness and bare skin cuddles with our baby can help get the nursing relationship back on the right track and that even severe latch problems are fixable. (5. Svensson KE et al., 2013)
So now you know how awesome skin-to-skin can be…BUT it is only an option, maybe skin-to-skin doesn’t feel right for you? I believe that the process of labouring, birthing and feeding your baby is a robust one, we are meant to survive. Somewhere in between all the research, information and options there is something for you and your family.
I also talk often about Biological Nurturing, aka laid-back breastfeeding. Suzanne Colson studied the positions in which the innate breastfeeding behaviours of the mother-baby pair worked best. There is a lot of information on her website about how you can make her findings work for you. In her book, An Introduction to Biological Nurturing: New Angles on Breastfeeding (2010), she acknowledges that not all mothers will feel comfortable with skin-to-skin and states that these positions can be effectively used when clothed.
When birth doesn’t go to plan, do what you can, when you can. This is no time for guilt, sometimes circumstances get in the way of our best-laid plans. I will repeat, I believe the process of labouring, birthing and feeding your baby is a robust one and can survive a veer off course. Start skin-to-skin as soon as you and your baby can manage, some medications might affect you and your baby’s innate behaviours. Be patient, have faith and seek skilled help for your particular situation early.
I wish I’d known all of this during my first pregnancy, my last baby is growing up fast and I am making the most of every bare skin cuddle opportunity. Based on a very small sample of 1 toddler, I can also tell you that 19 month olds crave skin-to-skin and may indicate this by taking their clothes off and climbing inside your jumper. (See picture at the top of this post for scientific proof!)
Did skin-to-skin work for you? How did it fit your unique birthing and postnatal situation? Did you have skin-to-skin following a c-section? I’d love to hear your experience!
Further Reading
Skin-to-skin contact information from the ICEA (International Childbirth Education Association)
PDF about the application of Biological Nurturing
The Magical Hour is a description of the stages babies go through when skin-to-skin on the hour post-birth
1. Bystrova, K., Ivanova, V., Edhborg, M., Matthiesen, A.-S., Ransjö-Arvidson, A.-B., Mukhamedrakhimov, R., Uvnäs-Moberg, K. and Widström, A.-M. (2009), Early Contact versus Separation: Effects on Mother–Infant Interaction One Year Later. Birth, 36: 97–109. doi: 10.1111/j.1523-536X.2009.00307.x
2. Mikiel-Kostyra, K., Mazur, J. and Boltruszko, I. (2002), Effect of early skin-to-skin contact after delivery on duration of breastfeeding: a prospective cohort study. Acta Paediatrica, 91: 1301–1306. doi: 10.1111/j.1651-2227.2002.tb02824.x
3. Magee, S. R. et al (2014) Promotion of family-centred birth with gentle caesarean delivery. Journal of the American Board of Family Medicine, doi: 10.3122/jabfm.2014.05.140014
4. Erlandsson, K., Dsilna, A., Fagerberg, I. and Christensson, K. (2007), Skin-to-Skin Care with the Father after Cesarean Birth and Its Effect on Newborn Crying and Prefeeding Behavior. Birth, 34: 105–114. doi: 10.1111/j.1523-536X.2007.00162.x
5. Svensson KE, Velandia MI, Matthiessen AST, Welles Nystrom BL, Widstrom AME (2013) Effects of mother-infant skin-to-skin contact on severe latch-on problems in older infants: a randomised trial International Breastfeeding Journal, 8:1, doi: 10.1186/1746-4358-8-1
