What is “skin-to-skin” and why is it important?
I am going to predict up front that I will be talking a lot about skin-to-skin on this site.
Here’s why: we know it helps. I promise to dig into the gray areas of thickeners, tongue ties, and the like as research comes out, but my intention is to give the most space to the most important things that we know the most about.
And we know a lot about skin-to-skin.
It helps babies’ bodies regulate
What we know is that skin-to-skin helps babies regulate. Studies have repeatedly shown that holding a naked baby against a caregiver’s naked chest supports heart rate, respiratory (breathing) rate, oxygen saturation levels, temperature, production of digestive hormones, and feeding outcomes. It also appears to reduce infection and even mortality rates. When held against a parent’s chest with a wrap around both parent and baby, a preterm baby is warmer than when placed in an incubator. In fact, when twins are held against a mother’s breasts, each breast changes temperature according to the needs of the individual twin. When used as a treatment approach in the NICU, babies who receive “kangaroo care” tend to be discharged earlier, gain more weight, and cost the NICU less. Their mothers tend to have increased breast milk production and are more likely to exclusively breast feed. The more a baby is held skin-to-skin, the better the outcomes tend to be.
When a baby is warm, feels safe, and isn’t having to work extra hard to breathe or keep her heart rate steady, she is better able to eat.
Lactation professionals often recommend skin-to-skin for around 20 minutes before trying to latch on a baby. In many cases, the baby will try to latch on their own before that 20 minutes is up. This is why if you come to me for lactation counseling, I’ll ask you to bring a cozy cardigan or bathrobe and we will chat for a bit while you and your baby snuggle.
Not just breastfeeding babies
But here’s the thing: skin-to-skin is not just for breastfed babies! While there is much less research on the impact of skin-to-skin on feeding outcomes with bottle-fed infants, there is plenty of research showing that calm babies eat better. And skin-to-skin helps babies calm. So if you come to me for bottle feeding support, you may also be asked if you’re comfortable changing into a cardigan :)
How to do it
1) Grab a cardigan, blanket, shawl, or something you can wear that is largish and open in the front.
2) Expose the skin of your chest while making sure you are warm with whatever you grabbed in step 1.
3) Take off all your baby’s cloths (you can leave on a diaper) and hold them belly to your chest. Support their arms and legs to be tucked up. Wrap the edges of your cardigan/blanket around both of you, making sure you can see your baby’s face and they have enough freedom to move their head so they can breathe. You can also use a wrap/carrier for a hands-free version.
4) Breathe. Snuggle. As long as you have the time.
5) Repeat.
References:
Bergman, N. J. (2024). New policies on skin-to-skin contact warrant an oxytocin-based perspective on perinatal health care. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1385320
Charpak, N., Montealegre‐Pomar, A., & Bohorquez, A. (2020). Systematic review and meta‐analysis suggest that the duration of Kangaroo Mother Care has a direct impact on neonatal growth. Acta Paediatrica, 110(1), 45–59. https://doi.org/10.1111/apa.15489
Feldman, R., Rosenthal, Z., & Eidelman, A. I. (2014). Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biological Psychiatry, 75(1), 56–64. https://doi.org/10.1016/j.biopsych.2013.08.012
Ferber, S. G., & Makhoul, I. R. (2004). The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: A randomized, controlled trial. Pediatrics, 113(4), 858–865.
Lamy-Filho, F., Goudard, M. J., Marba, S. T., Santos, A. M., Lima, G. M., Costa, R., Azevedo, V. M., & Lamy, Z. C. (2024). Skin-to-skin contact and late-onset sepsis in newborns weighing up to 1,800g: A cohort study. Revista Brasileira de Saúde Materno Infantil, 24. https://doi.org/10.1590/1806-9304202400000168-en
Ludington-Hoe, S. M., Lewis, T., Morgan, K., Cong, X., Anderson, L., & Reese, S. (2006). Breast and infant temperatures with twins during shared Kangaroo Care. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN / NAACOG, 35(2), 223–231. https://doi.org/10.1111/j.1552-6909.2006.00024.x