Lean Back

Skin to skin contact is something that many moms desire to have with their baby after birth. We know it is healthy. We know we want to warm the baby with our body. We want to bring the milk in soon. At almost every birth I attend, moms and babies do enjoy some immediate skin to skin contact. Yet sometimes after I leave the hospital, I hear from the new parents that breastfeeding is not going that well.

What do we not know about skin to skin contact? Sometimes it seems like just another item to check off on a birth plan. How can we move beyond treating it as a ritual that lasts a bare minimum number of minutes before we start providing “real care” to the newborn. I spent some time at the Partners In Perinatal Health Conference learning more from Debbie M. Norris, a lactation consultant at Newton-Wellesley Hospital. She inspired me re-envision skin to skin contact as the best medical care for newborns and moms.

Skin to skin contact between mother and newborn has almost the same benefits as breastfeeding with none of the effort. Babies are often birthed onto the mother’s abdomen. Sometimes before we move them up to the vertical position between the mother’s breast, we cover them and wrap them with layers and layers of blanket. We take them away sometimes – just for a minute – and then bring them back bundle and ready to nurse. Then the babies are sleepy, and mothers are sleepy. Mothers are also hungry and sore. The first few days of motherhood are all about taking in the experience. Reva Rubin’s research on postpartum emotional adjustment shows us this time is for her meet her own needs, talk about her birth, and care for her body.

Often at the hospital we sit mothers right up in bed. In an effort to support her and the baby, we surround them with pillows and blankets. We want to get their babies as close to them as possible for a good latch. We want to prevent neck and shoulder injury pain. So we prop up more pillows. She sits on her sore perineum. 24 hours later she often complains that breastfeeding is uncomfortable and not going particularly well. Maybe she says, “I don’t know if I can do this.” Already feelings of failure are creeping into this sacred time. We might strip the baby down to the diaper for a few minutes, but visitors come and go. The door opens and shuts. Moms cover up their breasts. It is our system that is failing this nursing pair.

What are we missing? Skin to skin contact provides the newborn with temperature stability. The mother’s chest can cool a hot baby and warm a cool one. (It can even cool one warm one and heat one cold one if you happen to have twins!) This provides the energetic conservation. the newborn needs so he has more energy to feed. Skin to skin contact on the mother’s chest reduces incidences of dropping glucose levels, something that concerns hospital staff when babies are not yet feeding. The mother’s chest is the natural and safe habitat for babies. While the newborn receives this benefits, the mother can lean back and rest. We can take her own weight off her perineum.

Donna Norris, RN, IBCLC, sung her theme song of the benefits of skin to skin contact and helped a room full of nurses, doula, midwives and childbirth educators think creatively about how to teach new mother’s about it. We must stop acting like this is another intervention, another thing to check off our list of birth wishes. We cannot check it off. No one can tell you how long to do it. Your baby benefits for as long as you are establishing this breastfeeding relationship. The first 24 hours are for taking in, taking in your infant, taking in your experience, taking in the emotions.

When I help you breastfeed at the hospital, I will show you how to lean back and place your baby skin to skin on your chest and let him or her find the breast. You will see how your baby bobs his head up and down and latches on in his own time. When your baby’s body is prone on yours, feeling safe and connected to you, you will want to sleep – and you should. Your baby will latch on and nurse, probably in the first 24 hours. Your job is to create and maintain his natural habitat. It is your baby’s job to breastfeed. You should lean back and relax.

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