Skin to skin has been found to be very important for baby in:

• Calming and relaxing both mother and baby
• Regulating baby’s heart rate and breathing, helping them to better adapt to life outside the womb
• Stimulating digestion and an interest in feeding
• Regulating temperature so your baby stays warm
• Providing protection from infection with friendly bacteria they pick up from your skin
• Developing the relationship between you and your baby and increasing your confidence in caring for your baby
• Encourages the release of the hormones involved in breastfeeding
• Helps your baby to develop their natural feeding behaviours, whether you are breast or bottle feeding
• Helping baby to be content and reducing stress levels in you both

If you have been unable to have skin to skin with your baby immediately after birth, we will encourage you to do this as soon as possible on the postnatal ward.

• Skin to skin is good for partners and other family members and baby too – calming them both, promoting bonding and giving them a really good way of comforting and soothing baby whilst mother rests
• If mum is unable to hold baby straight after birth, skin to skin provides a good alternative for keeping baby warm and comforted

For more information about the value of skin to skin go to the  Baby Friendly Initiative’s website.

The safety of your baby is important at all times. Here are some points to be aware of when holding your baby in skin to skin:

• There is lots of evidence that skin to skin benefits both mothers and babies. If you are both well we will encourage you to have skin to skin – we will observe you closely and perform some checks in the first few minutes after birth
• The checks used by your midwife to assess your newborn’s health can be carried out during skin to skin contact, but skin to skin may need to be interrupted briefly for this for some babies
• During skin to skin, your midwife will continue observations of mother and baby, and will let you know if either of you needs any additional care
• It is important that your baby is kept warm after birth – we will recommend that they wear a hat for the first few hours and that they are covered over the top with blankets to prevent heat loss
• A good position for you to hold and feed your baby in skin to skin is ‘semi-recumbent’, or ‘half lying, half sitting’ so that you can see your baby’s face at all times
• Your midwife will show you how to position your baby on their front with their head turned to the side and the chin away from the chest so that their airway is always clear and unobstructed.
• Your midwife will talk to you about watching for any changes in your baby’s condition – if you are concerned tell the midwife immediately so that she can respond straight away
• Some types of pain relief used in labour can make you drowsy and this may affect your ability to observe and care for your baby. Your midwife will discuss this with you.
• There are other circumstances which may increase risks during skin to skin. These will be discussed with you on an individual basis, but may include a raised Body Mass Index, or excessive drowsiness
• It is important to note any changes in your baby’s skin colour, muscle tone, temperature or breathing patterns and to urgently notify staff if you are concerned
• It is a good idea to avoid distractions such as phones during this special time, and for you and your partner to focus purely on your baby
• Consider safety each time you have your baby in skin to skin, including when you are at home with your baby

Having a caesarean section or an instrumental birth in theatre should not interfere with skin to skin contact provided you and baby are both well.

If you are having a planned caesarean birth you can talk to the midwife who will be in theatre with you and ensure that she is aware of your wishes. Having one arm outside of the theatre gown, or wearing your gown so it opens at the front can make skin to skin easier.

Your midwife may dry your baby and put on a nappy and name bands first before returning to you to begin skin to skin – this will prevent the need for interruptions once skin to skin has started.

If you have had a caesarean section it will not be possible for you to be in half- lying, half- sitting position whilst you are in the operating theatre. You are more likely to be lying flat until the operation is finished, although it may be possible to raise your head with a pillow if this is comfortable for you.

Your baby will be placed in a position where they can breathe easily and their nostrils are not covered.

Your baby will need to be observed constantly by someone else as you may not be able to do this easily yourself. The midwife will explain to you and your partner how to recognise good colour and easy, regular breathing in your baby. If you feel nauseous or unwell at any time alert a member of staff so that your baby can be removed if necessary. You partner can have skin to skin until you feel well enough.

Skin to skin will need to be briefly interrupted whilst you are moved from the operating table to a bed, but can be continued immediately afterwards and whilst you are moved into the recovery area and transferred to the postnatal ward. You will have drips and monitoring equipment attached to your hands or arms in the hours following your surgery, but your midwife can help you to hold your baby in a comfortable and safe position.

We will encourage you to continue with skin to skin beyond the first hours after birth, both on the postnatal ward and at home. It is a good way to continue to build a strong relationship with your baby, and to encourage feeding and milk supply if you are breastfeeding.

It is important to continue to ensure that your baby is safe at all times:

• If you holding your baby in skin to skin on the postnatal ward you may not have constant supervision. It is important that you are aware of your surroundings and of baby’s position at all times to avoid your baby falling to the floor, or becoming trapped by your body or by bedding. If your partner is present, ensure that you have shared these safety messages and that they are able to watch you and your baby should you become sleepy. Ensure that your partner tells a member of staff if leaving you alone with your baby in skin to skin.
• If you are unable to move around normally (for example after an epidural or caesarean section) take care to ensure that any pillows you are using to help you into a comfortable position are not placed where there is a danger of your baby’s face being covered.
• Once you are home with your baby it is important that both you and your partner remain aware of all safety considerations.
• You may wish to look at the Lullaby Trust’s website for further information about safe sleep in preparation for going home with your baby.
• Consider safety for co-sleeping, or bed sharing.

• The TICKS checklist can be used to check that your baby is in the correct position, whether you are holding in skin to skin or using a baby carrier/sling.

If you would like any more information about skin to skin with your baby after birth, please speak to your midwife.