If a newborn is allowed to cuddle with its mother immediately after birth, this promotes its health in many ways. Direct skin contact stabilizes body temperature, blood sugar, breathing and heart rate and promotes breastfeeding. These are the results of a large overview study by the Cochrane Institute, which evaluated 69 studies with more than 7,000 mother-child pairs.
More and more studies are showing how important direct physical contact is for newborns. The World Health Organization (WHO) recommends that babies be placed naked on the mother’s uncovered skin immediately after birth. If possible, the infant should spend the first hour of its life there and ideally feed at the breast for the first time. Even with caesarean sections, some clinics now offer to allow the baby to lie on the mother’s chest before the operation is completed.
“In many facilities, however, it is common practice to separate newborns from their mothers, dress them or place them in open beds or under radiant heaters,” reports a team led by Elizabeth Moore from Vanderbilt University in Tennessee. Routine procedures such as physical exams, weighing, and bathing immediately after birth also prevent immediate skin-to-skin contact. “Even in countries with very good care, this free and easy-to-implement measure is not common practice,” says Moore.
Benefits for breastfeeding and health
For a Cochrane meta-analysis, Moore and her colleagues have now evaluated 69 studies with a total of 7,290 mother-child pairs that examined how skin-to-skin contact after birth affects various health parameters and breastfeeding. “Skin-to-skin contact likely increases the rate of children who are fully breastfed,” reports the team of authors. According to the studies evaluated, of the infants who were allowed to cuddle with their mother immediately after birth, around 82 percent were fully breastfed for at least six weeks. For babies without direct skin contact, it was only 59 percent.
In addition, several studies have shown that the vital parameters of newborns stabilize when cuddling: their body temperature and blood sugar levels were higher than in children who had to forego maternal skin contact in the first minutes and hours of their lives. The heart rate and breathing could also stabilize through cuddling. However, according to Moore and her team, there are so far too few high-quality studies to make reliable statements. There are also insufficient studies to determine whether skin-to-skin contact with the baby has an influence on the mother’s blood loss or the timing of placenta birth.
Vital skin-to-skin contact
But although individual questions are still unanswered, the researchers advise against carrying out further randomized studies in which the mothers and children in the control group are not allowed to have skin-to-skin contact. “Withholding skin-to-skin contact would be considered unethical today, as there is sufficient evidence that direct contact improves the health and survival of newborns,” says co-author Karin Cadwell of the Healthy Children Project in Massachusetts. “Our review study supports immediate skin-to-skin contact after birth, regardless of the type of delivery.”
Only studies from high- and middle-income countries that examined mothers and their healthy, full-term babies were included in the current analysis. But according to other studies, cuddling after birth also plays a crucial role in low-income countries and for premature babies. “While the studies eligible for our review did not look at survival, research in low-resource settings has shown that this direct contact can make the difference between life and death in low birth weight newborns,” Cadwell reports. “A large study in hospitals in India and several African countries was stopped early when preliminary data showed that skin-to-skin contact significantly improved survival.”
Source: Elizabeth Moore (Vanderbilt University, Tennessee, USA) et al., Cochrane Database of Systematic reviews, doi: 10.1002/14651858.CD003519.pub5