Parent-Infant Skin-to-Skin Contact after Caesarean Section: Effect on Interaction and Breastfeeding

By Marianne Velandia,
RNM PhD-candidate
Department of Women’s and
Children’s Health, Stockholm
Karolinska Institutet, Sweden
Marianne.Velandia@ki.se

It is well known that parent-infant skin-to-skin contact leads to that the baby cries less, save more energy, become warmer and calm. It is also known that mother-infant skin-to-skin contact directly after birth facilitates the first breastfeeding. The healthy unmedicated newborn starts to move to the breast and try to catch the nipple, massage the breast and initiate the first breastfeeding within approximately one hour.
 

The newborn is guided by sensory cues as the mothers naturally breast odor and in addition the newborn can hear and recognizes the mothers voice. This fist mother-infant contact is easily disturbed by different care practices and especially mother-infant separation after Caesarean section. After giving birth by Caesarean section, the newborn first breastfeeding is often delayed due to immediate separation from the mother. The newborn is often placed in a bed or in an incubator instead of getting skin-to-skin contact with the mother or father.

In a recent study we have elucidated the parent- infant interaction in skin-to-skin during the first 30 minutes immediately after an elective cesarean section with spinal anesthesia. Thirty-seven infants born to first time mothers with Caesarean section were randomized to stay in skin to- skin contact with the mother immediately after birth or in skin-to-skin contact with the father. At birth the healthy newborn infant was gently dried and placed in skin-to-skin on the mothers or the fathers’ chest and then covered with a blanket. 

The parent-infant interaction was video taped and the time-in point for the first breastfeeding was registered. We found that there the new parents’ communication seems to stimulate the newborns vocalization as soon as 15 minutes after birth. This relates to how communication begins. The newborn initiated the communication by making specific sounds, called soliciting sounds, the parent with skin to- skin contact answered with soliciting sounds. When the newborn was put in skin-to-skin contact with the father the newborn cried less and the father communicated more with the mother and with the newborn infant, especially if the newborn was a boy.
 

Girls with uninterrupted skin-to-skin contact with their mother breastfeed significantly earlier than did girls engaged in skin-to-skin contact with their father during the first 30 minutes after birth. This knowledge may motivate very early parent-infant communication and breastfeeding immediately after Caesarean section and parent-infant skin to- skin contact may also have positive long-term effects on the parent interaction.
 

Application for practice

These findings give reason to support the importance of mothers in having skin-to-skin contact immediately after Cesarean section in order to facilitate the first breastfeeding encounter and, thereafter, to encourage skin-to-skin contact interactions between the father and the newborn as it has been shown to increase their vocal interaction. The parents should be informed about the newborns vital signs to achieve safe skin-to-skin contact.