Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Abstract

Aim This paper integrates clinical expertise to earlier research about the behaviours 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. Method This state‐of‐the‐art article forms a link within the knowledge‐to‐action cycle, integrating clinical observations and practice with evidence‐based findings to guide clinicians in their work to implement safe uninterrupted skin‐to‐skin contact the first hours after birth. Results Strong scientific research exists about the importance of skin‐to‐skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short‐ and long‐term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant's instinctive behaviour and maternal responses while in skin‐to‐skin contact. Conclusion The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.

Newborn’s first bath: any preferred timing? A pilot study from Lebanon

“…Evidence supporting the practice of post-birth skin-to-skin contact (SSC) is strong, suggesting multiple benefits for both mother and child. Advantages for the mother include early elimination of the placenta, reduced bleeding, improved self-efficacy of breastfeeding, and decreased maternal stress [9]. Advantages for the infant include a reduction in the negative consequences of "stress of birth", more appropriate thermoregulation, persisted even in the first days and less crying [9].…”

“…Advantages for the mother include early elimination of the placenta, reduced bleeding, improved self-efficacy of breastfeeding, and decreased maternal stress [9]. Advantages for the infant include a reduction in the negative consequences of "stress of birth", more appropriate thermoregulation, persisted even in the first days and less crying [9]. Another factor is incubator time defined as the amount of time in the incubator needed to achieve thermal stability [10].…”

Infant behaviour and maternal adaptation after uninterrupted skin-to-skin contact for 1 hour following birth in northern Uganda

“…It has been reported in other studies that it takes at least 1 hour for newborn infants in skin-to-skin contact to locate the nipple and start suckling (Widström et al, 1987;. During this hour, the infant gets acquainted with the mother (Widström et al, 2019) and prepares the mother to produce milk (Matthiesen et al, 2001). In another study by the same group, it was found that ReseaRch © 2020 MA Healthcare Ltd breastfeeding occurred around 70 minutes after birth in an unmedicated group of infants (Nissen et al, 1995), suggesting that infant-directed initiation of breastfeeding may take longer than 1 hour.…”

Highlights in this issue

“…Widström et al. bridge the gap between research knowledge and clinical practice about skin‐to‐skin contact between mothers and infants during the first hour after birth. They report that this elicits the infant's internal process as they go through nine instinctive states and contributes to early coordination of the infant's five senses and movement.…”