Early skin-to-skin contact for mothers and their healthy newborn infants

RHL practical aspects by Saloojee H

The findings of the systematic review provide some support for current initiatives to implement skin-to-skin contact (SSC) as a standard of care for healthy full-term infants. Methodological flaws within the included studies prohibit firm conclusions being reached with regard to the effect of SSC on the duration of breast feeding, and maternal-infant behaviour and physiology. This also hinders the development of clear recommendations. The recommendations offered below are consistent with what is referred to as “very early skin-to-skin contact” (SSC beginning within approximately 30 to 40 minutes of birth).

FIRST CONTACT (PRIMARY CARE) LEVEL

In implementing this intervention the following should be noted:

  • Within the first 30 minutes of birth dry and place the naked infant, with or without a cap, upright on the mother's bare chest between the breasts.
  • The mother may wear a gown that opens in front. The baby should be placed inside the gown so that only its head is exposed.
  • What the mother wears and how the baby is kept warm and what is placed across the baby's back may vary (depending on climate and culture).
  • What is most important is that the mother and baby are in direct ventral-to-ventral (tummy-to-tummy) SSC and the infant is kept dry and warm.

Thermal protection

The temperature of a healthy newborn will remain in a safe range provided ventral-to-ventral SSC is uninterrupted and the infant is thoroughly dried and covered across the back with a pre-warmed blanket (or other material) and the head is kept covered with a dry cap.

Breastfeeding

Early and exclusive breast-feeding can be encouraged by:

  • placing the infant on the breast as soon as the newborn is receptive (ideally within 30 minutes of birth);
  • health-care staff offering to help the mother initiate breastfeeding;
  • frequent feeding on-demand day and night; and
  • not offering prelacteal feeds.

Mothers should be free to decide whether or not to keep their baby in SSC and to decide when to end the period of contact. However, health-care staff should encourage mothers to have a prolonged period of SSC with their babies in an unhurried environment. They should also ensure that any decision not to do this is made after mothers are fully informed of the possible benefits of SSC.

REFERRAL HOSPITAL (SECONDARY CARE) LEVEL

Same as above.

AT HOME OR IN THE COMMUNITY

Same as above.


Acknowledgment: Nil

This document should be cited as: Saloojee H. Early skin-to-skin contact for mothers and their healthy newborn infants: RHL practical aspects (last revised: 4 January 2008). The WHO Reproductive Health Library; Geneva: World Health Organization.

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