Katrine Johansen is a doula studying to become a midwife. She lives in Aarhus, Denmark, with her partner Mirko, her seven year old Gaya and one year old Kai. We got the opportunity to talk to her about a topic close to both of our hearts - the skin. She tells us about the function of skin to skin contact and the biochemical and physiological effects it has on both mothers and babies. 

Hi Katrine! We are so happy to get the chance to talk to you about skin to skin contact and get some of your brilliant expertise in this!

So am I!  

 

Commonly, right after delivery the midwife, doctor or whomever receives the baby puts it on the mothers bare chest. Why has this become such a widespread routine? 

 

When the baby is in the uterus it is surrounded by amniotic fluid which gives the baby a feeling of warmth and light pressure of the skin. Even though the baby might not have a clear understanding of where its body starts and ends it senses the edges, the contours of its skin because of this light pressure. When it is born it suddenly loses this feeling of safety with the surrounding world and by putting the baby on the mother or fathers chest the contact is reestablished. 

Via skin to skin contact the mother provides warmth to the newborn. The skin of the mothers chest radiates heat and provides the baby with energy. The warmth the babies receive helps them increase their own temperature and prevents them from getting too cold,

Additionally, skin contact  also stabilizes the baby’s glucose levels. Glucose is very important for survival since it is our main source of energy. Newborns mirror their mothers by increasing the blood flow in the blood vessels of their skin and mother and baby synchronize their skin temperature, as if they were still one unit. I find that so amazing. 

 

The warmth from the mother awakens the baby and triggers it to do some very instinctive movements known as the breast crawl. That is, if the mother and professionals do not interfere in this unique time after birth. The baby will slowly start to crawl towards the mothers breast, guided by smell and partly vision. As it makes its way to the breast it will carry out crawling movements, massage-like movements on the mothers chest as well as licking and touching the nipples. It will find the breast and start to feed before falling asleep. The whole series of events takes about 90 minutes. Of course, this is not what happens normally, often the mother or midwife puts the baby to the breast. But it is interesting and something worth trying, when given the time and space for it to happen. If I will have a third kid, I would really like to experience this. 

 

 

Yes, that is such a fantastic instinct in babies! The midwives during my first labor did this to me and my daughter. It was amazing to see her crawl up to my breast. Do you know why this mechanism exists? 

Yes, so these massage-like-kitten movements and skin-to-skin contact are very important factors for the interaction between mother and baby because they increase the mothers release of the hormone oxytocin. After birth oxytocin helps the uterus to contract to prevent postpartum bleeding. Furthermore it plays a big role in breastfeeding, since it is the hormone that signals to the brain to make the milk flow. 

The increase of oxytocin as a result of skin-to-skin contact will heighten the mothers attention and interaction with the newborn and increase the mothers sensitivity towards the baby's needs, it is a very important hormone for the bonding between mother and baby. A birth is a stressful event for both mother and baby.The skin to skin contact after birth is linked to an immediate stress reducing effect for both, if mother has a calm nervous system, the baby will mirror it. Skin to skin makes the transition from the womb to the outside world soft and safe.

 

 

That is so beautifully put. So oxytocin is important for the mother on both a physical and emotional or mental level. Tell us more about the biochemistry of skin to skin contact!

 

Being skin to skin involves warmth, touch and light pressure between mother and baby. When the baby will do its kitten-kind-of crawls a sort of stroking between mom and baby is established. This will activate sensory nerves on both the mother and the baby's skin which signals to the brain to release oxytocin. 

The mom will also touch other parts of the baby's body, the back, the neck, maybe she will kiss the head. Also here the sensory nerves will be activated as well as in the fingertips and palms of the mothers hands. The release of oxytocin is known to decrease stress levels and activate the vagus nerve. 

The vagus nerve is a major component of the parasympathetic nervous system. It is our “rest and digest” system, it helps us calm down. The parasympathetic system lowers our heart rate and blood pressure, relaxes our mind, makes us sleepy and redirect blood flow away from our “locomotive” muscles and towards our digestive and reproductive organs. Skin is our largest organ and it is clear how important it is for us in the process of regulating stress. Closeness, being touched and held is a basic need for all of us. We have food hunger, but also very importantly skin hunger, I believe.

 

So does skin to skin contact also have equally positive benefits for father- baby? 

Yes! Dads can also pass the same benefits as moms do in terms of helping to regulate their baby's temperature and heartbeat after birth as well as the baby’s feeling of safety. Being skin to skin will activate dads oxytocin system and decrease the level of testosterone. This shift in hormones will increase the dads sensibility towards the baby and the social competence of parenting. Of course the father does not produce milk, so for that the benefits are not equal. 

 

Most of the benefits seem to be mainly for the moment. But can it also have an impact on the child's future development?

The effect that skin to skin has on the social interaction and bonding between mother and baby is shown to have long term effects as well as the baby's ability to handle stressful situations. 

The Canadian psychologist Anne Bigelow has done studies around skin-to-skin contact where she found that social competence and reduced stress levels have been documented in mothers and babies up until 9 years after birth. Studies show that people who are characterized as securely attached tend to have had a childhood with a lot of closeness and on the other hand people who are insecurely attached tend to have had less of that closeness. 

It seems very likely that the development of secure attachment starts immediately after birth. The skin to skin will boost the baby’s oxytocin system, making it feel safe and calm, helping the baby to grow a regulated nervous system. The practice of closeness will,yes, last a lifetime. I even want to go that far and say that this feeling of safety and the effects that closeness has for a baby, can be passed on through generations, in that way the benefits are not only for the moment but the oxytocin-cycle weaves and threads through generations. 

 

And what about the scent of the skin, does that have any impact? 

The scent also has an impact on the bonding between mother and baby. Often mothers are very attracted to their babies smell, they will kiss and smell their baby's head, some will even lick it. The baby also uses its sense of smell to crawl towards the mothers breast. The areola, which is the circular darker-colored area of skin surrounding your nipple, has glands called Montgomery glands. These glands secretes a scent of amniotic fluid, which attracts the baby to the breast. Probably because this is a smell that the baby is familiar with from swimming in it inside the womb.

 

We would love to hear about your personal experience of the skin-to-skin practice you had with your children! Would you like to share it with us?

 

I was breastfeeding Gaya and now I also breastfeed Kai. That is quite a clear source to skin-to-skin contact. I also co-sleep with Kai, he has a bed next to us, so he starts there, but early in the night he is transferred to ours. Gaya, who is older, has her own room but often comes into our bed as well. Even though co-sleep is not a direct source to skin-to-skin it has similar positive effects.

Kai is a fireball of a baby so baby-massage is not something we have practiced a lot but he does like to have his hands and fingertips stroked and gives me his hands to do that. Its very sweet, then I know the moment for falling asleep is close. Gaya likes to have her forehead stroked and I do small little patterns and circles around her forehead, eyes, cheeks and mouth with my fingertips. It relaxes her as well as me before she falls asleep. Sometimes there is a need to do small touch/pressures down her body, a little reminder of where the body is and an invitation to land in it. Of course, it is not every evening it is this “zen” (: 

 

Thank you so much Katrine for your time and for providing us with so much fascinating information!