I recently had the privilege of assisting a mother breastfeed her baby shortly after birth. When I came into the mom's hospital room, her baby was already placed on her chest skin-skin and looking ready to breastfeed. We used the baby-led latching technique and after about 20 minutes of attempting, got the baby latched on and the breastfeeding journey had begun. This made me think that we as health care providers really need to examine the way we respect the mother-baby dyad within the 'Golden Hour' after birth. Hence my latest blog!!!
The way your baby is cared for and nurtured immediately after birth significantly impacts their transition from the womb to life outside. In a culture that commonly separates mothers and babies for routine procedures such as cleaning, weighing and measuring, most babies are missing that critical time of being skin to skin with their mothers, which has short and long term consequences for all. As these procedures are not necessary to maintain or enhance the well being of either mother or baby, there is no reason why they cannot be delayed beyond the first critical hour.
The first hour should be focused on baby’s first breastfeed and mother-baby and family bonding. Unless mother or baby is in need of medical assistance, hospital protocols should support this time of new beginnings for both vaginal and caesarean births.
What Is An Undisturbed First Hour or sometimes referred to as the 'GOLDEN HOUR'? Babies are born and immediately placed tummy down on their mother’s stomach. A warm blanket should be placed over both mother and baby, to keep mother warm. This slows the production of adrenaline hormone in her so as to not interfere with oxytocin and prolactin hormones being produced (essential for bonding and breastfeeding). - At this time, the mother’s needs are simple: warmth and a quiet, calm environment. It is important to remember that she is still in labour – the placenta and membranes are still to be birthed, and her uterus needs to contract down.
Here are 7 important reasons why the first hour after birth should be undisturbed:
#1: Baby-Led Initiation of Breastfeeding It is quite common these days for hospital staff to want baby to begin breastfeeding within the first hour. In addition to the importance of early feeding for mother-baby attachment and bonding, it also helps to expel the placenta more quickly and easily, reducing the risk of postpartum hemorrhage. Read more about the benefits of a natural third stage here. It’s common for caregivers to assist baby to latch onto the nipple, which is unnecessary in most cases. When babies who have not been exposed to medications are placed skin to skin with their mothers and left undisturbed, they will instinctually crawl to their mother’s breast and attach themselves to the nipple. This is now known as the ‘breast crawl’ and was first observed by Swedish researchers in the 1980s. Further observation discovered that babies are born with innate instincts that assist them in finding their mother’s nipple, like all newborn mammals.
#2: Body System Regulation Babies who are left skin to skin with their mothers for the first hours immediately after birth are better able to regulate their temperature and respiration. Newborns aren’t able to adjust their body temperature as well as older children and adults as they don’t have the same insulating fat levels. They have spent nine months in an environment that is perfectly temperature controlled. If babies lose too much heat, they have to use more energy and oxygen than they can spare to try and keep their temperature stable. An undisturbed first hour with skin to skin also reduces the risk of hypoglycemia (low blood sugar levels). Newborn babies can produce glucose from their body stores of energy until they are breastfeeding well and are more likely to do so when they remain skin to skin with their mothers.
#3: Promotes Delayed Cord Clamping Leaving the umbilical cord intact while it is still pulsating allows babies to receive oxygen still via the placenta, while adjusting to breathing through their lungs. Being skin to skin with their mothers helps babies to stabilize respiration, meaning that their cord will remain intact for longer and giving them more chance to receive vital red blood cells and reduce the risk of iron deficiency anemia. Even if you have a c-section, delayed cord clamping is possible, but not in all cases. Ultimately it depends on the willingness of your chosen care provider and your unique situation. Speak to your care provider to see if he or she supports delayed clamping during straight forward c-sections. It’s an important question to ask when interviewing your care provider.
#4: Promotes Mother-Baby Attachment Prolonged skin to skin after birth allows mother and baby to get to know each other. Mothers who have skin to skin contact after birth are more likely to feel confident and comfortable in meeting their babies’ needs than those who had none. Attachment is critical to newborn survival and mothers are hard wired to look after their young. Oxytocin receptors in a woman’s brain increase during pregnancy, so when her baby is born, she is more responsive to this hormone that promotes maternal behaviour. Oxytocin is produced in large amounts when breastfeeding and holding babies close skin to skin. Mothers who had early skin to skin with their babies are more likely to demonstrate bonding behaviours later in their child’s life, such as kissing, holding, positive speaking and so on.
#5: Improves Breastfeeding Success Rates Breastfeeding initiation and duration is likely to be more successful with babies who have early skin to skin contact. This is particularly important in countries where breastfeeding rates significantly drop a few months after birth, such as Australia, America and the UK. The World Health Organization recommends exclusive breastfeeding for babies in the first six months to achieve optimal growth, development and health. Creating the right conditions for the initiation of breastfeeding would help promote longer durations of breastfeeding for many women. Babies who are left to self attach usually have a better chance of proper tongue positioning when latching. This can increase long term breastfeeding as mothers experience more ease and fewer problems when latching is not an issue.
#6: Protects Against The Effects of Separation Babies are born ready to interact with their mothers – a newborn baby who has not been exposed to excessive medication will be very alert and gaze intently into their mother’s face, recognizing her smell, sound of her voice and the touch of her skin. Remaining with their mother is key to a baby’s survival and separation is life threatening. Babies are born with a mammal’s primal instinct to stay within the safe habitat of mother, where there is warmth, safety and nourishment. When babies are separated from their mother they will protest loudly, drawing their mother’s attention to their distress. Babies undergo what is literally a cold turkey withdrawal from the sensory stimulation of their mother’s body. If they are not reunited with their mother despite their protests, they will go into a despair state – essentially giving up and becoming quiet and still. This is partly a survival instinct to avoid attracting predators, and their body systems slow down to preserve energy and heat.
#7: Boost Your Baby’s Immunity Naturally When babies are born, they emerge from a near-sterile environment in the uterus and are seeded by their mother’s bacteria. This essentially trains the baby’s cells to understand what is ‘good’ and ‘bad’ bacteria. This kicks tarts their immune system to fight off infections and protects from disease in the future. Research indicates that if babies aren’t given this opportunity to be exposed to their mother’s bacteria, either because they are not born vaginally, held skin to skin or breastfed, then the baby’s immune system may not reach its full potential and can increase the child’s risk of disease in the future. Skin to skin contact and early breastfeeding is an excellent way to help increase your baby’s exposure to bacteria if you need a cesarean section for medical reasons. Find out more ways to boost your baby’s immune system here.
Tips For Planning An Undisturbed Hour After Birth A better understanding of how an undisturbed hour after birth impacts breastfeeding, mother well being and newborn development, helps make it possible for us to make informed choices about this critical period: Choose your birth carer and setting to increase your chances for an undisturbed natural birth and first hour. Caregivers should support you having an undisturbed first hour and leave routine baby checks until you are ready. Create an optimal environment for birth (warm, dim lighting, quiet, private, supported). This boosts the right hormones for natural birth, which reduces the need for interventions that could cause separation from your baby. Ensure your caregivers understand the important of leaving the umbilical cord intact until it has stopped pulsating, so baby cannot be separated from you. To promote production of oxytocin and prolactin, make sure your environment after birth remains warm and calm.
I hope you enjoyed this latest Nourish Blog. As always, please feel free to post any comments or questions.
Credit to Sam McCulloch