Kangaroo Mother Care
The impact of early skin-to-skin contact (SSC) between the mother and her newborn baby offers many benefits for infant health, behavior and breastfeeding.
The baby must be touched and caressed immediately after birth. He must have the mother's warmth almost continually during this time; otherwise all the touch in the world will not be enough.
Dr. Arthur Janov, Imprints: The Lifelong Effects of the Birth Experience
The relationship between a mother and newborn baby at birth has a lasting effect on the baby and will affect all relationships from then on. It is from this relationship that all other relationships grow and the patterns of relating will be set for life.
The first moments after birth are "a sensitive period for programming future behavior."
Research (Klaus and Kennell, 1976) has also shown that the mother's interaction with her baby during the first few hours of its life, have a profound effect on her attitude towards that child for at least the next five years.
If a mother and baby have virtually uninterrupted contact during this sensitive period, hormones are released in her body, which cause a strong maternal-infant bond to be created.
1Research has shown that early skin-to-skin contact between a mother and baby at birth
- reduces crying
- improves mother-baby interaction
- keeps the baby warmer
- helps women breastfeed successfully and for longer
What is Skin-to-skin Contact?
SSC involves placing a baby, naked or wearing only a diaper and a cap for warmth, on the mother's bare chest immediately after birth.
The process of being born is a great upheaval for the newborn and so more than at any other time, the baby needs the comfort, security and warmth of being physically close to her mother, for the first few hours.
The baby is familiar with the sound of her heart beating and her breathing. They help to create a sense of continuity between the womb and the outside world to which the baby must adjust. Continuous early contact helps a baby to feel, "I AM SAFE. I can trust my mother to take of me and meet all my needs."
In many cultures, babies are generally placed naked on their mother's bare chest immediately at birth. Historically, this was necessary for the baby's survival.
Nowadays, modern hospital routines often involve initial separation, where babies are first dressed and undergo various routine procedures before being given to their mothers. This may significantly disrupt early mother-infant interactions - with harmful effects.
A baby knows instinctively that she is dependent on her mother to survive, and so if they are separated, the baby experiences distress and the mother does not experience the release of hormones that triggers her strong, protective 'mothering' instincts. Research has proven that SEPARATION IS HARMFUL to both baby and mother.
SSC should be possible for all mothers and babies, even after a cesarean while the mother is being stitched up and ideally hospital policy should allow for this. All non-essential routines should be performed at a later stage.
Dads Can Do It Too!
After a cesarean birth or a birth with complications, a father who holds his newborn on his bare chest offers the same calming and comforting benefits as a mother and this prepares the baby fully for being re-united with the mother.
A Swedish study showed that a father should be regarded as the primary caregiver if the mother is not immediately available as skin-to-skin contact with the father was more effective than placing the baby in a crib for the first two hours after birth.2
Benefits of Skin-to-Skin Contact (SSC)
Stabilizes Heart Rate and Body Temperature
If a newborn baby is dried off and placed on the mother's chest, they can both be covered to keep warm.
If anyone challenges your wish to have your baby on your chest, ask them for evidence-based research that shows that incubators stabilize newborns better than SSC. There isn't any!
If your baby needs any kind of assistance, the rule of thumb is to ADD technology to SSC and enjoy the best of both.
Incubators DE-STABILIZE babies as separation causes more stress.
Skin-to-skin contact has been shown to control the baby's body temperature more effectively than an incubator.
A mother's core temperature may rise by up to two degrees Centigrade if the baby is cold, and it may decrease by one degree if the baby is too warm.
Reduces Respiratory Distress
When a baby experiencing breathing difficulties is placed on the mother's bare breast, breathing becomes regular and stable, and is co-ordinated with her heart rate. If a baby needs oxygen, this can be given while ON THE MOTHER'S CHEST.
Initiation of Breastfeeding
Self-attachment refers to the phenomenon that full term undrugged infants, left on their mother's chest undisturbed, will breastfeed spontaneously within one hour, without any assistance.
However, skin-to-skin contact is required in order for this behaviour to succeed. Mothers and babies should not be separated at birth.
The newborn actually stimulates hormonal responses (oxytocin) in the mother, which trigger caregiving and protective behaviours from the mother.
By kicking on the mothers abdomen the baby helps the mothers uterus to contract strongly, preventing post-partum bleeding.
Babies that are placed on their mother's bare chest are more likely to latch on to their mother's breast and are likely to latch on well, compared to babies that are not immediately placed on their mothers.
Not only is breastfeeding initiated and more successfully established when there is early SSC, but the newborn is also better able to utilize of the mother's milk. The volume of mothers milk is greatly increased, and the frequency of feeds provided also increases with SSC. The baby's gut is also stimulated in such a way as to better able to utilize the milk provided, and subsequently the infant grows faster.
Babies that are placed on their mother's breast have improved immunity, even 6 months later. The SSC allows them to be colonized by the same bacteria as the mother, while in an incubator the baby's gut might be colonized by different bacteria from the mother's. SSC is therefore thought to be important in the prevention of allergies.
Since premature babies generally have poor immune systems, and are susceptible to allergies, infections and feeding problems in the first year of life, early SSC may significantly reduce the incidence of these problems.
Reduced Pain Response
Research has shown that preterm babies, born between 28 and 31 weeks, benefit from skin-to-skin contact with their mother before and during painful procedures such as a heel lance.3
Babies that were held skin-to-skin responded less dramatically to pain than those that didn't. Mothers should therefore hold their babies skin-to-skin during any painful procedure that may be required.
Stress and Psychological Development
Research has shown that separation from the mother causes a stress response in the brain of a newborn. A baby will cry to call the mother back as her presence is essential for the baby's survival.
At high levels, the hormones that are released by the protest-despair response can be neurotoxic to certain areas of the brain. Prolonged separation makes stress normal for the baby and may set an individual up to be prone to stress and disease later in life.
In contrast, SSC and kangaroo mother care promotes feelings of stability and trust.
I learned to trust in my mother's arms. - Psalm 22:9
Benefits to Preterm Babies
SSC offers many benefits to babies born prematurely. Not a single negative effect has been shown. As described above, the SSC helps to regulate the baby's heart rate, respiration and body temperature.
Preterm babies also sleep more deeply when placed on their mother's chests and this promotes their growth and development in many ways. Preterm babies that are kept skin-to-skin gain weight more quickly and are therefore able to be discharged from hospital sooner than babies who do not have the benefit of this ongoing "kangaroo mother care".
Babies that stay on their mother's chests also cry less and for shorter periods of time.
How to Ensure Skin-to-Skin Contact for Your Baby
Because SSC and kangaroo mother care are important for all babies, you need to find out long before your birth if this will be possible at your chosen birth venue.
- If you are planning to give birth in a hospital, ask if they have 'baby-friendly' policy. Discuss your wishes and your birth plan with the staff.
- You also need to make sure that your caregiver supports SSC and kangaroo mother care.
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1. Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003519. DOI: 10.1002/14651858.CD003519.pub2
2. Blackwell Publishing. "Paternal Skin-to-Skin Contact Offers Cesarean-Born Baby Same Calming & Development Benefits As Mom." ScienceDaily 12 June 2007. retrieved 5 September 2010 http://www.sciencedaily.com /releases/2007/06/070611113914.htm.
3. Celeste Johnston, Francoise Filion, Marsha Campbell-Yeo, Celine Goulet, Linda Bell, Kathryn J McNaughton, Jasmine Byron, Marilyn Aita, G. Allen Finley and Claire Dominique Walker. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial. BMC Pediatrics (2008, April 25)
4. Dr. Nils Bergman, http://www.kangaroomothercare.com/research.htm, retrieved 05 September 2010
5. Personal notes from seminars presented by Dr. Nils Bergman, Cape Town, 21 August - 6 November 2010.
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