Skin to Skin Positioning

After your precious little baby is born, it is the responsibility of skilled hospital staff to instruct mothers, when willing, to conduct skin to skin positioning and benefits. The process should go something like this...

How to initiate skin to skin?

When the baby is ready for skin to skin contact (SSC), decide a time with Mom that is convenient for her and the baby. The first session is important and requires time and undivided attention. Mom should be wearing light, loose clothing in a private room, warm enough for a small baby (WHO, 2003). It is best if Mom has some type of support, either her partner or family member of choice for reassurance. 

Mom should hold her baby, and have each step of SSC described to her, then have them demonstrated, and then let Mom go through all the steps by herself. 

Mom should have each gesture explained why it is important and what it is good for. 

Emphasize that skin-to-skin contact is essential for keeping the baby warm and protecting him from illness (WHO, 2003)

Skin to Skin Contact Position:

Place the baby between the mother's breasts in an upright position, chest to chest (as shown below: WHO, 2003)

WHO Kangaroo Care position

 

After baby is position corrected, make sure that the baby's head is turned to one side and in a slightly extended position and secure by Moms hands, a binder, cloth, wrap etc. The slightly extended head position keeps baby's airway open and allows eye to eye contact between Mom and baby. The hips should be flexed and extended in a "frog" position, the arms should also be flexed (see above image).

Baby's abdomen should not be constricted and should be somewhere at the level of the mother's epigastrium. This way baby has enough room for abdominal breathing. Mother's breathing stimulates the baby (WHO, 2003).

 KMC position WHO, 2003

Mom should be shown how to remove and place baby in SSC. As Mom gets familiar with the technique, the fear of hurting or doing something wrong will disappear. 

Breastfeeding:

Mom can breastfeed in skin to skin contact position and SSC actually makes breastfeeding easier (WHO, 2003). Furthermore, holding a baby near the breast stimulates milk production (WHO, 2003). 

 EXTRA:

After positioning the baby in SSC, let Mom rest with baby. A skilled hospital staff member should stay with Mom and check back in for position. Mom should understand how to observe her baby, what to look for. Encourage Mom to rest but also move around*. Mom should be introduced also about the possible difficulties. For example, for some time of her life will now revolve around baby and this may disturb her daily routine. 

Babies must be removed from SSC for:

- changing diapers, hygiene, cord care; and

- clinical assessment, according to hospital schedules or when needed

 

During the day, Mom can carry her baby in SSC position and continue whatever she likes; she can walk, stand, sit or engage in different recreational, educational or income-generating activities (WHO, 2003). 

When Mom and baby are comfortable, SSC can continue for as long as possible, first at the hospital, then at home. Baby's eventually outgrow the need for SSC, the baby may start to wriggle or show that she is uncomfortable, pulling her limbs out or fussing. Then of course it is advised for Mom to wean a baby gradually from SSC. Breastfeeding of course should continue. Mom can continue with SSC after giving a baby a bath, during cold nights, or when the baby needs comfort. 

 IMPORTANT:

*For on the go SSC or fear or falling asleep unattended, baby must be secured.

Please consider the following aids for securing your newborn in skin to skin:

https://blogs.babycenter.com/products_and_prizes/10082015-new-and-interesting-2-skin-to-skin-helpers-for-kangaroo-care/

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Images:

WHO, 2003

Yahoo article "Its Well Known That Skin-to-Skin is good for Mom and Baby - Why Do Folks Still Need Convincing?" link