First Hour After Your Baby is Born

Of course, the first thing to look forward to is the baby’s cry. Before they are born, babies get their oxygen through the placenta. It can take a short while for babies’ lungs to get the required blood supply. Doctors may also need to pull out excess fluid from the lungs by stroking the skin and suctioning the fluid through the nose and mouth. This is nothing to worry about.

Most babies become quiet and relaxed for a couple of minutes after their first cry. Next, come small movements of the hands and shoulders. The first hour or two after birth are crucial, as this is also when babies learn to self-attach (latch on to the breast) and breastfeed. This typically takes more than an hour after birth, so be patient.

Earlier, the mother-child bonding used to take a back seat while the nurses cleaned and weighed the newborn and gave him vitamin K shots. However, research now shows that the first 60 minutes after birth are crucial for strengthening the mother-baby bond, improving health outcomes for the new mom and baby and for keeping the baby warm.

The first 60 minutes are also known as the “golden hour”, and the emphasis is now placed on skin-to-skin contact rather than any other medical activity. Skin-to-skin contact between the newborn and new mom is also called "kangaroo mother care".

Studies show that new moms and babies have a physiological need to be together. Immediate and uninterrupted skin-to-skin contact for all stable mothers and babies provides more opportunities for breastfeeding and promotes excellent outcomes for maternal and infant health.

On the other hand, any unnecessary separation of healthy mothers and babies can be harmful. For one, infants can find it harder to latch on to the breast when breastfeeding is not initiated early. Second, unnecessary separation can reduce the mom's affective response to the new baby. (Remember that as a new mom, your body is dealing with a lot of changes. Skin-to-skin care gives new moms and babies the best chance to form a strong bond, even as it improves your baby's immunity and keeps him/her warm.)

Medical science now promotes the practice of uninterrupted skin-to-skin contact between all healthy mothers and their babies for at least an hour after birth - though this may be extended to two hours in some cases.

To give skin-to-skin care, the dried, unclothed newborn is placed on the mother’s bare chest, with light but warm blankets or towels covering the newborn’s back. All the medical procedures such as maternal and newborn analysis can be conducted during skin-to-skin contact or they may also be shelved until after the first hour, depending on the doctor’s advice.

The significantly increased levels of oxytocin, the maternal reproductive hormone, promote maternal/newborn attachment and reduce stress for both the mother and the newborn. The skin contact also helps the newborn adapt to postnatal life.

Disturbing or delaying skin-to-skin contact may repress a newborn’s natural behaviours and make latching and breastfeeding more difficult. “Lack of skin-to-skin contact and early separation disturbs maternal-infant bonding, reduces the mother’s affective response to her baby, and may even have a negative effect on maternal behaviour,” according to an article published in the Journal of Perinatal Education.

The World Health Organization (WHO) recommends that skin-to-skin care should begin within 10 minutes of birth if the mom and baby are healthy, and it can even start in the second or third minute after birth. WHO also recommends vigilance by medical personnel during this time, to take adequate safety precautions and intervene at the first sign of distress.

Babies are extremely sensitive to touch, smell, and heat when they are born. This "heightened response" helps them find the things that are most useful to them in their first few minutes on earth: heat and milk.

When a newborn is placed skin-to-skin on the new mom's chest, this heightened response helps the baby find the breast. Research shows that some babies can start looking for milk as early as 15 minutes after they're born. To be sure, it takes most babies a little longer than that.

The mother’s breast quickly adjusts in temperature to regulate her newborn’s body temperature and reduces the risk of hypothermia. Immediate skin-to-skin care enables colonization of the newborn to maternal flora and protects the newborn against infection.

This height sensory response also "activates neuroprotective mechanisms, enables early neurobehavioural self-regulation, and reduces stress", according to researchers. Here's how this works:

• Studies show that compared with newborns who do not get skin-to-skin care, newborns who have skin-to-skin contact in the golden hour tend to cry less.
• Their heart and respiratory systems are more stable than in babies who are separated from their mothers during the golden hour.
• Their oxygen saturation levels, blood glucose levels and thermal regulation are also enhanced. In other words, they can breathe better, their blood glucose levels are good and they can regulate their body temperature more successfully than infants who are separated from their moms in the first hour.
• Additionally, studies also show that babies who get skin-to-skin care have lower levels of stress: researchers checked the levels of cortisol, the stress hormone, in the babies' saliva to confirm this. Further, researchers found that the levels of cortisol continued to drop in babies when skin-to-skin care wass increased beyond 60 minutes, indicating a dose-response effect. Dose-response effect simply says that the higher the dose/exposure, the greater the benefit.

Newborn babies have only three demands: they want to feel warm in the arms of their mother, food from her breast and security in the knowledge of her presence. Breastfeeding satisfies all three. 

Early initiation of breastfeeding

The World Health Organization (WHO) and UNICEF encourage early initiation of breastfeeding. Research shows that infants who learn to breastfeed at this time are more likely to take breastfeed exclusively for the next six months. Plus, the first breastmilk or colostrum, a thick yellowish fluid produced during the first days after birth, is chock full of antibodies that protect the newborn from infections.

Breastfeeding also helps new moms lose weight. It also helps the uterus contract and reduces the risk of depression after giving birth.

Immediate and uninterrupted skin-to-skin care for a minimum of one hour is one of the most effective strategies for promoting exclusive breastfeeding.

After a cesarean delivery, skin-to-skin care for stable mothers and babies can begin in the operation theatre. A majority of mothers who undergo cesarean surgery are alert and responsive when spinal anaesthesia is used. Skin-to-skin care after a cesarean delivery has proved to be a meaningful experience for many new mothers - medical practitioners report that some new moms are not even “aware” of the rest of the surgical procedure because they focused on their newborn.

Following vaginal birth, direct skin-to-skin care for stable mothers and babies can begin immediately, prior to cord clamping, as a newborn is placed on the mother’s abdomen, dried, and covered with a blanket. Once the cord is clamped, the newborn then can be moved to the mother’s chest.

Skin-to-skin care should only be delayed if the mother and/or baby are in a recovery room or in the postanesthesia care unit.

The benefits of skin-to-skin care extend beyond the moment of birth. Togetherness develops better maternal instincts and the mother quickly learns about her baby’s needs. During each opportunity to breastfeed, maternal and newborn beta-endorphin levels rise - these are also known as the happiness hormones. Studies have shown that mothers who room-in with their babies have higher mothering confidence, and babies who room-in with their mothers sleep more soundly.

Rooming-in makes breastfeeding easier. Mothers who share a room with their newborns not only make more milk but they also breastfeed for longer durations. Skin-to-skin care while rooming-in reduces maternal physiologic stress and depressive feelings, even after mom abd baby have been discharged from the hospital. Studies show that skin-to-skin care has wide-ranging benefits including an increase in the amount of breastmilk new moms can produce, greater restfulness for baby and mom and better breastfeeding results.

Motherhood is definitely a one-of-a-kind experience. Skin-to-skin care during and beyond the golden hour can help you achieve important parenting milestones like bonding with your baby and initiating breastfeeding. So, plan it well and make sure your nurse or doula knows what you want.