This is it, the moment you have waited for! Meeting your new baby for the first time, face to face. Take the time
to marvel at how incredible your body has been, creating this entire person and then bringing them into your
arms. Those tiny eye lashes, that button nose, the perfect little hands and feet, the smattering of hair and the
blinking curious eyes, surveying the world for the first time.
The most wonderful way to greet your new baby is with immediate and uninterrupted skin-to-skin contact. This
skin-to-skin contact has so many incredible benefits for both you and your little one. It is important that your
baby is dried, but this can be done on your chest so there is zero separation from you. This is where they will
want to stay for as long as possible, ideally until well after their first feed.
Through this skin-to-skin contact, you will be flooded with oxytocin, the love hormone. Oxytocin is such a
magical hormone for new mothers and fathers and your new baby (babies if you’re having twins/multiples). For
you, this flood of oxytocin kicks off your nurturing instincts to protect and keep your baby safe. It is also a vital
hormone in the milk production process (more on this later). Your new baby will also be rapidly producing lots
of oxytocin in this skin-to-skin contact. This helps to regulate their heart rate, temperature and breathing. This
skin-to-skin contact also enables colonisation of your baby’s skin with your familial microbes (the friendly
bacteria in your environment), which begins to develop their immature microbiome to help protect against
infections (1). What better way to help them to adjust to life outside of the womb! The huge increase in
circulating oxytocin is also so pivotal to their brain development. At birth, your baby’s brain is 25% of its adult
size. By age 3, their brain has grown to 80% of adult size, then reaching 100% development by age 25 . This is
such vital information to remember in those early years with your children. All your nurturing and responding to
their needs and supporting them to regulate their emotions, will support this rapid brain development. We are
‘carry mammals’, this means that nature intended that we keep our babies close and stay responsive to all
their physical and emotional needs.
If you keep your baby skin-to-skin at birth, it is well recognised that they will go through 9 instinctive stages as
they seek out their first feed (2). This whole process can take 1-2 hours, so it is important to be patient and give
you and them the time to spend together.
Stage 1 – The birth cry, the most wonderful sound to the ears of all Midwives and new parents alike! This cry is
all about them expanding their lungs, pushing out the fluid from being in the womb and taking in their first
breaths of air.
Stage 2 – Relaxation – baby lays on your chest skin-to-skin, both of you taking a much-needed rest. Mothers
breathe in their beautiful newborn smell, stroke the soft skin, marvel at the perfect nails and eyelashes.
Stage 3 – Awakening – often within 5 minutes of being skin-to-skin, baby begins to open their eyes and start
gently shuffling their body a little.
Stage 4 – Activity – between 5-20 minutes post birth, they become more active in their movements. Their
mouth may be opening and tongue protruding and searching, hands moving to their mouth and head moving
around more in search of the breast.
Stage 5 – Rest – they may spend the next 20 minutes alternating between the activity in stage 4 and resting
and going still again for a while. This is your baby’s way of saying they need time to familiarise themselves and
suss out what to do.
Stage 6 – Crawling – this is where you see how incredible that instinct is to seek out the breast as your baby
pushes with their feet and their hands to move themselves up your body and towards the breast and nipple.
Stage 7 – Familiarisation – baby may be between 40-60 minutes old before they get to this stage and this
stage alone can take 20+ minutes. Baby has crawled their way closer to your breast and nipple and they will
begin licking, touching and moving their mouth around your breast as they search for the right position. This
tactile stimulation is so vital to your milk making hormones and so important for your baby’s learning as they
familiarise themselves with your breast
Stage 8 – Suckling – This stage often begins around an hour after birth, after lots of time nuzzling and
mouthing around the nipple and areola, baby will suddenly attach and begin to suckle.
Stage 9 – Sleeping – Around 90-120 minutes after birth and after their first lovely feed, your little one will be
tired out and they will be ready for a lovely snuggly sleep, ideally remaining in skin-to-skin contact with you.
What if this early skin to skin isn’t possible?
If either you or baby are needing medical attention immediately after birth, then this initial skin-to-skin contact
may be delayed. If you are needing the medical attention, then it can be wonderful for Dad/birthing partner to
be supported to have this early skin-to-skin contact with baby until you are able to. This will provide all the
wonderful benefits to baby in terms of regulating their heart rate, temperature, breathing and colonising their
skin with the familial friendly bacteria. As soon as you are well enough, baby can come back to you for ongoing
skin-to-skin and their first feed. They will still go through the instinctive stages, excluding the birth cry as this
only happens once. If your baby is the one needing immediate medical attention following birth, as soon as
they are stable you can begin to have skin-to-skin with them. This is known as kangaroo mother care, and
forms part of the daily care needs for all babies needing care in the neonatal unit (NNU). There is so much
evidence to demonstrate how beneficial this is for premature or sick babies to help with all areas of their growth
and development (3).
What if baby doesn’t feed within the first 2 hours?
Some babies are more exhausted from the birth than others, sometimes the medications used throughout
labour/birth can make them sleepier. If you have a long period of skin-to-skin after birth and your baby doesn’t
go through the 9 instinctive stages and have their first feed, the best thing you can do is to keep baby skin-to-skin and hand express some colostrum for them. Their tummy is tiny, so a few drops every 1-2 hours will be a
great start for them in these early hours post birth. Colostrum is the original superfood!
So, what’s so special about colostrum?
- It is deliberately in small volumes to help baby to learn to co-ordinate their suck/swallow and breathe cycles whilst also giving them the time to clear the additional fluid they have on board at birth (from floating in all that amniotic fluid for all that time).
- It has a laxative effect, so this helps to get their intestines up and running and clear out the thick black stool known as meconium.
- It has concentrated immunological properties that help to protect your baby against their first exposure to all the bacteria in the big wide world. It lines their gut wall to provide immediate protection against harmful bacteria and reduce allergic sensitivities (likelihood of becoming allergic).
- It has an acid level that encourages their gut to welcome the right mix of beneficial bacteria.
- It raises your baby’s blood sugar far better than formula can (and they will need smaller volumes to do this). The benefits of this were especially apparent when babies fed at the breast soon after birth (4).
No matter how your baby is born, the early and frequent skin-to-skin contact has so many benefits for your whole family unit. Keep baby close, keep them fed and keep your milk flowing (5) are the key things you can do to both welcome your new baby and get your feeding journey off to the best possible start.
Liz Farrant, March 2024
References
- Widström, A. M., Brimdyr, K., Svensson, K., Cadwell, K., & Nissen, E. (2019). Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatrica, 108(7), 1192-1204.
- Phillips, R. (2013). The sacred hour: Uninterrupted skin-to-skin contact immediately after birth. Newborn and Infant Nursing Reviews, 13(2), 67-72.
- Gupta, N., Deierl, A., Hills, E., & Banerjee, J. (2021). Systematic review confirmed the benefits of early skin‐to‐skin contact but highlighted lack of studies on very and extremely preterm infants. Acta paediatrica, 110(8), 2310-2315.
- Chertok, I. R., Raz, I., Shoham, I., Haddad, H., & Wiznitzer, A. (2009). Effects of early breastfeeding on neonatal glucose levels
of term infants born to women with gestational diabetes. Journal of Human Nutrition and Dietetics, 22(2), 166-169. - La Leche League International. (2010). The Womanly Art of Breastfeeding: Completely Revised and Updated 8th Edition. Ballantine Books.