The benefits of skin-to-skin contact at birth: it promotes breastfeeding and stabilizes the baby's temperature and breathing.

A lot happens in that brief moment when a midwife places a newborn , just after birth, on the bare skin of its mother. This strategy, called skin-to-skin contact, is more than just a romantic introduction between mother and child. There's science behind it, and a lot of health is at stake, especially for the little one. A Cochrane review , the independent network of researchers that analyzes scientific evidence, has found that practicing skin-to-skin contact during the first hour after birth increases the likelihood of maintaining exclusive breastfeeding and helps the baby adapt to life outside the womb: specifically, by maintaining an adequate body temperature, increasing blood sugar levels, and improving breathing and heart rate.

It doesn't matter whether the birth is natural or by cesarean section. Skin-to-skin contact is beneficial, and in fact, the World Health Organization recommends it even for premature babies, instead of transferring them to an incubator immediately after birth. With the latest Cochrane review, science supports the benefits of this method, especially in promoting exclusive breastfeeding: according to the analysis, around 75% of babies who have skin-to-skin contact are exclusively breastfed at one month of age, compared to 55% of babies in the groups who did not have skin-to-skin contact.

The first hours of life are critical for the newborn. During these times, a myriad of physiological processes occur as the newborn adapts to its new life outside the womb, and immediate contact with the mother is essential. In the review, which analyzed nearly 70 studies with data from more than 7,000 mother-infant pairs, the authors found that this strategy not only improves exclusive breastfeeding. They also noted that "infants who experience skin-to-skin contact with their mothers likely have higher blood glucose levels." After analyzing a couple of trials with late preterm infants, they speculate that this strategy may help—for this type of infant, as well as for those born full-term—stabilize cardiac and respiratory parameters.

The authors also emphasize that "newborns likely maintain a normal body temperature during skin-to-skin contact." They found only a 0.28 degree Celsius temperature difference in infants receiving skin-to-skin contact, and while they do not consider it significant, they do send a message to healthcare professionals: "You can rest assured that infants receiving skin-to-skin contact are not at increased risk of hypothermia." The study also emphasizes that this strategy was "a positive experience for families, and mothers would choose it for future births."

Elizabeth Moore, a retired professor at Vanderbilt University School of Nursing and lead author of this research, recalls in a statement that "historically, babies have been separated from their mothers immediately after birth for routine procedures such as physical examination, weighing, and bathing, which has prevented immediate skin-to-skin contact." However, depriving infants of that immediate contact, given all that science now knows about their health, would no longer be justified even in clinical trials, the study concludes.

Ana Morillo, a neonatologist at the Sant Joan de Déu Children's Hospital in Barcelona, ​​who was not involved in this review, believes that separating the mother from the baby at birth "should be obsolete." "We are mammals, and skin-to-skin contact is what nourishes us. The baby regulates its temperature much better on its back, and on a cardiorespiratory level, keeping it warm and placing it on top of the mother also improves," she argues.

The neonatologist explains that in that first hour of life, the baby is "super awake" and "it's important to take advantage" of that window of opportunity to get them to latch on to the breast before entering the sleepy phase of the first few days, when they sleep much more. "In that first hour after birth, very awake, sometimes it's not even necessary to put them to the breast. They crawl there themselves," she exemplifies.

In statements reported by Cochrane, Karin Cadwell, author and executive director of the Healthy Children Project's Center for Breastfeeding in the United States, argues that preventing skin-to-skin contact right now would not even be ethical. "Although the studies eligible for this review did not focus on survival, other studies from low-resource settings have shown that skin-to-skin contact can be a life-or-death decision for low-birth-weight infants. Recruitment for a large trial of Indian and African hospitals was halted after preliminary data showed that skin-to-skin contact significantly improved survival," she says.

Effects on the mother

The Cochrane review also analyzes the effects of skin-to-skin contact on the mother, but the evidence there is more limited. According to the research, this method was shown to have "little or no effect" on the time to placental delivery. They also found no relationship between skin-to-skin contact and a decrease in postpartum blood loss— postpartum hemorrhage is the leading cause of maternal mortality.

“More research is needed on other aspects of childbirth,” the authors admit. However, they make an important point: “The trials reported no adverse effects for mothers, and there may be potential advantages for them in terms of reduced episiotomy pain.”