Skin-to-skin care

A fundamental part of the care for babies in the neonatal ward is skin-to-skin care with their parents as early as possible.

The baby enjoys being close to you and it feels safe being in an environment that sounds familiar. It recognizes its mother's heartbeat, smell and taste, as well as its parents' voices, from its time in the womb. Holding the baby close to you can mean that it sleeps for longer and sleeps more calmly. When the baby has skin-to-skin contact with its parents, it is calm and contented, and its pulse becomes more stable. Your body gives the baby warmth and the sensation of closeness. It helps the baby maintain a higher and more even temperature. Which can make it easier for the baby to gain weight and promotes a more stable blood sugar. The baby's digestive system also works better when it is with you in an upright position, preferably at feeding time.

You will get to know your baby better if you are in close proximity to one another for much of the day. You learn to interpret the baby's behaviour and understand what the baby wants when it moves or makes a certain sound. You are always the best person for your baby and if it is possible for the baby to have skin-to-skin contact around the clock, perhaps there would be no need for an incubator or heated cot. Its parents' arms are the best place in terms of care for a baby, however there may be medical or other reasons that make it impossible for you to have skin-to-skin contact with your baby for the time being.

The baby's position

The baby is usually positioned with its chest against your chest, its arms and legs slightly bent towards the side of its body (like a frog) and its face turned to one side. The baby's head may need support so that its neck and trunk are kept straight in a neutral position to ensure an open airway. Small babies cannot support themselves very well. The staff will regularly check your baby's position and help correct it if needed.

The skin contact between you and your baby should encompass as large an area of skin as possible, as your skin will be the baby's source of heat. You should hold the baby high up on your chest so that you are able to kiss the baby's head. Sometimes, the equipment or medical conditions can make this more difficult and then the baby's position can be adjusted as needed.

The part of the baby's body that is not in contact with your body needs to be covered with a hat and blanket to prevent the baby from losing body heat. You can hold and support your baby with warm, still hands. Ask the staff to help you find a restful position.

The baby's sleeping

The baby is usually positioned with its chest against your chest, its arms and legs slightly bent towards the side of its body (like a frog) and its face turned to one side. The baby's head may need support so that its neck and trunk are kept straight in a neutral position to ensure an open airway. Small babies cannot support themselves very well. The staff will regularly check your baby's position and help correct it if needed.

The skin contact between you and your baby should encompass as large an area of skin as possible, as your skin will be the baby's source of heat. You should hold the baby high up on your chest so that you are able to kiss the baby's head. Sometimes, the equipment or medical conditions can make this more difficult and then the baby's position can be adjusted as needed.

The part of the baby's body that is not in contact with your body needs to be covered with a hat and blanket to prevent the baby from losing body heat. You can hold and support your baby with warm, still hands. Ask the staff to help you find a restful position.

The parents’ well-being, sleep and hygiene

As a parent, it is important that you take care of yourself, eat and drink regularly and get sufficient rest. You may want to eat and drink when you are holding your baby skin to skin, but not hot food or drinks, this is dangerous for the baby as it could cause burn injuries. In addition to careful hand hygiene, you need to shower every day and avoid using strong fragrances.

Ask the staff for help to find strategies that work for your family to get as much skin-to-skin time as possible. As parents, you are the most important people for your baby, however there may be a relative or close friend who would like to support you while your baby is being cared for at the hospital and who may have the privilege of having skin-to-skin contact with your baby.

You can fall asleep with your baby skin to skin. You will then need to wear a kangaroo carrier that supports the baby as it rests against your body and the baby must be connected to a respiratory monitor. If you lie down and rest with your baby skin to skin, the baby needs to be placed at an angle of about 15 degrees. This can be achieved by raising the head of the bed or putting extra pillows under you.

Baby carriers

Baby carriers make it easy for you to keep your baby comfortable for longer periods of time. Kangaroo carriers and wrap carriers are available to borrow from the ward and can be a nice support to have even when you are not asleep. When the baby is no longer attached to equipment that is connected to the wall, baby carriers allow you to move more freely around the ward with your baby skin-to-skin.

Phototherapy skin to skin

It is possible for you to have skin-to-skin contact with your baby during phototherapy You can sit/recline in an armchair or on a bed. You need to be awake during light therapy as the baby is not completely secured in a baby carrier.

The blue light from the light therapy lamp is not harmful for your eyes, but may seem unpleasant, so sunglasses can be useful.

Care procedures and examinations

Most care procedures can be performed on your baby when it is your arms, such as tube feeding, inserting a feeding tube, taking blood samples, ultrasound, intravenous injections and changing nappies. Constant communication takes places between you and the staff to plan your baby's care.

For how long can the baby be cared for skin-to-skin?

The time your baby spends in your arms is only limited by how long you want to hold your baby and how long you are able. You are not indulging the baby by caring for it skin to skin. The proximity engenders a safe and stable environment for the baby, which is a good basis for its continued development. When you go home from the hospital, you can continue to carry your baby close to you.

Author: Camilla Westberg, RN