Over the last year, the hospital that I work with has been making strides towards achieving the Baby-Friendly designation.

The Baby-Friendly Hospital Initiative is a program that was started by the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) to encourage practices that promote breastfeeding and maternal/newborn bonding. This, in turn improves outcomes for both mothers and newborns.

In order to receive the Baby-Friendly designation, a hospital or birth center must prove that they are providing evidence-based care and following strict the guidelines for best practices, as laid out by WHO and UNICEF. These practices are all focused on early initiation of breastfeeding and maintenance of lactation beyond the hospital stay.

Continue Reading

One of my favorite things about striving for the Baby-Friendly Hospital Initiative is the promotion of immediate skin-to-skin contact between a mom and her newborn after birth.

Long supported by midwives, the practice of putting a baby on his mother’s bare chest immediately after birth is not a new idea. But for years, hospitals insisted on whisking the baby away to clean, dry, warm, and assess him. Growing research, however, is now proving the benefits of immediate and ongoing skin-to-skin contact between a mother and her infant.

Evidence has shown that skin-to-skin contact immediately following birth promotes a faster and easier transition from fetal to newborn life. These babies have better temperature, respiratory, and glucose regulation and show an overall lower stress level than babies that are separated from their mothers.

On the maternal side, mothers who have their newborns skin-to-skin after birth tend to breastfeed for a longer period of time, have improved maternal bonding behaviors, and less anxiety.

This practice should not be limited to vaginal deliveries. Whenever possible, newborns delivered by cesarean section should be skin-to skin with the mother as soon as possible. This may be more difficult for hospital staff and nurses, because the operating room tends to be crowded and everyone has a designated assignment.

Personally, when I attend one of my patient’s cesarean births, I am there purely for the emotional support of the mother, so I am the perfect person to assist with skin-to-skin in the OR.

Every time I’ve placed a newborn on his mother’s skin after a cesarean, I see a remarkable transformation that seems to be more dramatic and pronounced than skin-to-skin after a vaginal birth. Not only does the baby quiet down, open his or her eyes, and begin rooting behaviors, there is an immediate change in the mother. Her continuously monitored heart rate and respirations slow, she relaxes, and becomes less worried about the surgery. She is usually completely focused on her baby. 

As long as the mom and newborn are healthy, the practice of skin-to-skin has no risks, and only benefits. In fact, WHO recommends that all newborns receive skin-to-skin care, regardless of the infant’s gestational age, birth weight, or clinical condition.

Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.