Skin-to-skin contact helps newborns breastfeed

7 August 2020

Newborns who have prolonged skin-to-skin contact with their mother are more likely to breastfeed successfully. This is according to a recent World Health Organization (WHO) study, which found that 90 minutes of uninterrupted skin-to-skin contact, where a baby is dried and laid directly on their mother’s bare chest after birth, maximizes the chance for babies to be physically ready to breastfeed.

For Candice Alcayde, a woman from the Philippines who recently gave birth, skin-to-skin contact was very important. “After undergoing a stressful caesarean section, the skin-to-skin contact helped me and my baby relax and calm down. When he was laid on my chest, he immediately stopped crying and was able to find his way to breastfeed.”

With insights from eight countries in the Western Pacific Region, the study observed 1383 mothers and full-term newborns in 150 hospitals, including babies born by caesarean delivery.

Some newborns are missing out

Despite the benefits, the study found that many babies did not receive at least 90 minutes of skin-to-skin contact. “We observed that there is enormous pressure to separate mothers and babies for reasons that could be delayed or are medically unnecessary,” says Howard Sobel, Coordinator, Maternal Child Health and Quality Safety, WHO Regional Office for the Western Pacific. “We call on health workers and health facilities to allow newborn babies those special 90 minutes to naturally adapt to their new environment in the most natural place: in skin-to-skin contact with their mothers.”

Jianying Wang, the chief delivery room nurse at the Northwest Women’s and Children’s Hospital in Xi'an city, China, has observed the effects of skin-to-skin contact for several years. “Since 2016, our hospital has been practising at least 90 minutes of uninterrupted skin-to-skin contact in the delivery and postnatal rooms. The impact is clear when it comes to initiating breastfeeding: now roughly 90% of full-term babies are able to breastfeed exclusively.”

Breastfeeding is crucial for newborn survival and central to development

An estimated 380 newborns died every day in the Western Pacific Region in 2018. But exclusive breastfeeding for the first six months of life improves the chance of survival for babies in their first 28 days of life. It also creates long-term benefits for mothers and children.

The Western Pacific Region is undergoing rapid economic development. At the same time, we are seeing growing expenditure on infant formula and fewer people breastfeeding. Yet, breastfeeding saves money, prevents the need for hospitalization for common childhood illnesses, prevents cancer and is associated with increased intelligence. Increasing breastfeeding is not only important for babies and mothers, it is also important for countries’ development.

Cheap, easy measures

Prolonged skin-to-skin contact and exclusive breastfeeding are two crucial components of Early Essential Newborn Care (EENC), a package of practical, evidence-based intrapartum and immediate newborn care interventions. With support from WHO, countries in the Western Pacific Region have scaled up EENC widely since 2014 through on-the-job clinical coaching and the use of hospital quality improvement teams, which conduct routine self-assessments and initiate actions to improve clinical practices, policies and hospital environments.

“The beauty of these evidence-based practices is that they are simple and cheap and mothers love them,” says Dr Sobel. “Babies who get them are pink, warm and happy.”

Skin-to-skin contact should continue during the COVID-19 pandemic

WHO recommends continuing immediate skin-to-skin contact and early and exclusive breastfeeding during the COVID-19 outbreak, as the benefits substantially outweigh the potential risks of transmission and illness associated with the disease.

“Giving birth during the coronavirus pandemic is an added worry and stress for expectant mothers,” says Ms Alcayde. “I was able to experience 90 minutes of skin-to-skin contact with my baby. Having a doctor who supported skin-to-skin care, especially at this time, made all the difference.”

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After Candice Alcayde’s baby was delivered with a Caesarean section, he was immediately dried thoroughly per EENC clinical protocol, then put in skin-to-skin contact with Candice.