Much has been written about the importance of the first hour following delivery. Your infant encounters a new and previously unseen world. Sounds begin to take on new meanings and basic processes we take for granted such as breathing and eating begin. It is a time of heightened perception for both parent and infant. It is a time when every parent must be both a soldier and an ambassador as their child encounters and enter a potentially hostile world. Parents provide comfort and safety to the new infant.
Following delivery your infant experiences major physiologic changes that can cause imbalances in the respiratory, circulatory and metabolic systems. Your infant can become cold and glucose levels can drop. It is also a time when your infant is at increased risk for infection. To help deal with this turbulence hospitals and professionals have enacted and supported policies to make this transition safe and loving.
Your first act as a parent should be to provide skin to skin contact with your infant. Studies have shown such contact provides physiologic stability for your infant. Benefits include improved blood oxygenation and glucose levels and reduced stress hormone levels in your infant. Basic body functions including temperature regulation, respiratory pattern and blood pressure also improve. Your infant will cry less and more easily enter a quiet alert state.
Additional benefits include a fostering of a secure attachment between you and your baby. Skin to skin contact increases the release of maternal hormones that induce and encourage attachment between mother and baby. One of these hormones is oxytocin which has been shown to increase relaxation, facial recognition and maternal to child attraction. Such behaviors are essential for the care and protection of your infant. In this critical post delivery period these behaviors have been associated with an increase in touching, holding and positive speaking behaviors between mother and child as distant as 1 year following delivery.
In addition to attachment the skin to skin contact prevents the risk of stress induced by separation. Your infant has never been separated from you. It is well known that infants are able to sense physical separation from their mother. Harm from separation has been seen in animals. We must assume newborns are at risk for similar negative physiologic and brain affects. In addition, recent brain research supports the importance of early attachment for normal brain growth in terms of both myelination and synaptic development. Specific parts of our brain involved with our emotional responses are especially sensitive and reliant on both activation and modulation during this critical period. These effects impact our learning, memory and our sympathetic nervous system. Holding, carrying and caressing during the newborn period and infancy fosters and supports brain growth and the development of self regulation in your infant.
A final benefit of skin to skin contact is the fostering of breastfeeding. This type of contact initiates a cascade of events that results in successful breastfeeding. Skin to skin contact is the first step in a progression of stages that result in familiarization of the infant with the mother’s nipple which is then followed by self -attaching and eventual suckling. Sleep then follows soon thereafter. Early stages include crying, relaxation, awakening, increased activity and resting and crawling.
Skin to skin contact on the mother’s chest allows the infant to be closely monitored by both mother and staff. The infant should be positioned so the face and nares are visible and the infant’s color, skin perfusion and respiratory patterns can be followed closely.
Nursery routines such as weighing and bathing that interrupt skin to skin contact should be avoided. All nursery and post-partum activity should be directed to the immediate needs of the mother and infant. Actions that can be delayed until after the first breastfeeding include vitamin K injection, body measurements and eye ointment prophylaxis. Usually a hat is not required when mother and child are skin to skin and a diaper is often not needed except after a cesarean section. The cord can be initially clamped away from the infant so the clamp does not pinch the baby and mother during skin to skin contact. The cord can be re-clamped and trimmed at the first bath. The first bath should be delayed until at least 8-12 hours following delivery.