Updated: Dec 20, 2021
Ahhh the golden hour. The blissful period of time where your newborn is placed on your chest and you begin to learn one another, quietly exchange communication, relax in an oxytocin-induced state of hypnosis, and begin the process of breast (or chest) feeding, all aglow in the warmth of each other's embrace--- (record scratch)... just kidding. You're laying there in agony and you can't tolerate the pain of uterine contractions induced by suckling on top of the already excruciating pain of your bodily trauma. Or your baby is 32-weeks premature and was whisked to the NICU to be hooked up to machines and lines and tubes, robbing you of that "golden hour" experience.
When my first daughter was in the NICU, I had this instinctual need to perform skin to skin with her, even when she was several weeks old. Even when nurses were scoffing at me when I requested to do so. (YEAH...that happened.) My drive was biological in nature. My body told me to do it (and so did my lactation consultant). I had a really hard time bonding with my preemie. I felt disconnected, guilty, weird, shy, and awkward. It felt odd with people referring to me as "mommy"; it was a title I hadn't yet earned or an identity I didn't yet embody. I didn't have that immediate connection to my child. It took work, time, and conscious effort to build. One way I did this is with repeated skin to skin sessions.
If you didn't yet read it, go back and check out my post on some of the amazing short- and long-term benefits of skin to skin in the hours immediately following birth.
If you’ve experienced birth trauma or had or have a NICU baby, I see you. I’ve been there. Two out of my three births saw the interruption of this golden hour experience due to the need for medical intervention. This interruption can make bonding and connecting with your infant difficult and complicated. It can cause ALL kinds of feelings, from anger and resentment to sadness and grief. And it can contribute to difficulty establishing a breastfeeding relationship.
If this is you, I have great news. It’s not too late for you. Widström et al (2019) write, “Humans are resilient, and there are opportunities to bond and breastfeed even when the experience immediately after the birth is less than optimal.” Ha. ‘Less than optimal’…certainly a gentle way of describing what some of us have endured. However, the important point here is that while ideally we’d always be able to experience that lovely uninterrupted golden hour, in reality… shit happens. And when it inevitably does, there are opportunities for do-overs, even days and months later.
Skin to skin can be highly effective in overcoming early breastfeeding problems.
According to the authors, infants exhibit instinctive breastfeeding behaviors and when given the opportunity, will mimic the same patterns as in the hour after birth. This offers families multiple chances to try again with the potential to overcome early breastfeeding problems. By providing uninterrupted, quiet skin to skin time, the infant should use its innate reflexive and instinctual movements, enhanced by unfettered sensory experiences to recreate the ritual that is the first feeding.
I use the word ritual because the steps and biological processes that occur are repetitive and reproducible. They occur for the reason all biological processes occur: to ensure survival. In other words, we are hard-wired to perform this ritual. If your desire and choice is to have a breastfeeding/chestfeeding relationship with your child, and you get off to a rocky start, this is a great way to get back on track. Skin to skin can be highly effective in overcoming early breastfeeding problems.
The only thing the parent really needs to do is ensure that the baby is in a stable position.
Infant-led breastfeeding initiation can sometimes correct latch problems, as often it is the interference and well-intentioned "help" we provide or staff provide during early feeding attempts that throw a bit of a wrench in things. The infant, however, is born knowing exactly what to do to achieve an effective latch, and in the absence of restrictions, whether intrinsic (tethered oral tissues, congenital torticollis, tone, etc) or extrinsic (oxygen, leads, other people's hands in the way, etc), they very well may be able to elicit the "perfect" latch all by themselves. The only thing the parent really needs to do is ensure that the baby is in a stable position - belly down, airways clear, hands free to move and feet grounded (in contact with your belly or supported by your hands if needed).
It is for these reasons that dyads that have had a less than ideal or unsatisfying breastfeeding experience early on can help to resolve feeding issues or heal from trauma by going "back to basics" and repeating this golden hour ritual. Skin to skin helps babies who are having difficulty achieving rhythmic sucking, a comfortable latch, or who are generally fussy or stressed. All of those sensory experiences that happen during skin to skin bring the baby's nervous system into a calmer, readier state where they are open to new motor patterns and the brain learns and remembers these sensations. Struggling with feeding and the after-effects of birth trauma can create tons of stress for both parties, but those wonderful neurotransmitters and hormones released with skin to skin can help mitigate the stress responses in the dyad.
Source: Widström, A.-M., Brimdyr, K., Svensson, K., Cadwell, K. and Nissen, E. (2019), Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatr, 108: 1192-1204. https://doi.org/10.1111/apa.14754