By Cynthia Epps, MS, IBCLC
In the June 2022 National Geographic cover story “The Power of Touch” author Cynthia Gorney states that “all human beings require the physical presence of others, the comforting touch of others, in order to stay healthy.” As per the magazine’s model, the text is woven around many photos by Lynn Johnson. But one photo is quietly extraordinary; “Snuggle Up” highlights newborn twins wrapped in “kangaroo care” against their aunt Neerja Kumari, while their mother is recovering.
What’s extraordinary about this photo is that this is 2022. Kangaroo Care was first presented to me in my training by Dr. Nils Berstrom from South Africa in the early 2000’s. With the medicalization of birth in the US, placing the newborn against the mother’s chest post birth was – at that time – considered very challenging to long-standing hospital birthing protocols. Didn’t the newborn need to be whisked away and “tested” first? Checked to see if they were breathing properly? Temperature check to see that they weren’t too cold? Aspirate mucous to clear the respiratory airway? Count fingers and toes?
Dr. Berstrom told the conference of nurses and lactation consultants a compelling story. While working at a major hospital in Cape Town in the early 2000’s, he was so concerned over the high mortality rate of premature newborns that he went into the outback – the bush, as it is known among native South Africans -- and observed newborns routinely “tied” to their mothers’ chests post birth – premature or full term. He also learned the mortality rate of these newborns was well below the mortality rates documented at his hospital. So began his research to find out why. Within just two years of placing newborns on their mothers’ chests immediately post birth, and documenting the many physiological benefits to both infant and mother, the hospital’s neonatal death rate was dramatically lowered. Thus, Dr. Bergstrom embarked on his journey of bringing the wisdom of “Kangaroo Care” to the Western birthing world.
What he demonstrated through his many studies is human babies require the comforting touch of their mothers, fathers, or caregivers immediately post birth to stabilize their physiological systems and reset to extrauterine life in the outer world. This was, at that time, considered hearsay among our clinicians, and in defiance of hospital protocols – which were to separate the baby from the mother, place them on a warming table and run the various mandated APGAR tests to assure survival. If the baby’s temperature was deemed “too low”, the infant was routinely placed in an incubator in the hospital nursery.
As a newly minted Board-Certified Lactation Consultant, I immediately brought Dr. Bergstrom’s research into my practice. After all, the mission of my work was, and still is, “For the Babies.” Kangaroo Care has evolved over the ensuing years to be recognized by the American Academy of Pediatrics (2005), UNICEF (2005), and many of my colleagues, including Dr. Kathleen Kendall-Tackett, PhD. IBCLC (2010) (uppitysciencechick.com). It was also defined on the International Childbirth Education Association’s website (2015) under “Skin-to-Skin Contact” as “frequent skin-to-skin care in the first hours and days after the birth of a baby.”
Before I delivered my daughter in the 1980’s, I had the great benefit of having stumbled across Drs. Klaus and Kendall’s groundbreaking work “Bonding.” This was a concept utterly unfamiliar to most women at that time in our birthing culture. But it made sense to me. I had not yet entered the lactation field, but holding my baby after birth seemed so normal. I was singularly confused as to what else to expect post-delivery? I knew nothing about the hospital protocols in place for newborns at that time. So, I insisted that my newborn be placed upon my heart, curled my arms around her and refused to move her off my chest. Inevitably, the nurses took her to the “warming table” to run their “tests” – they must record stats for all newborns as part of their job – but minutes later I insisted on placing her against my heart again. Shortly thereafter, with the approval of my very-forward thinking obstetrician, I called my immediate family into the delivery room with my husband beside me – two grandmothers, one great-grandmother, and two grandfathers – for a ritual “holding”, that is, to introduce my daughter to each one by passing her from person to person. It was a seminal moment in my life, watching each member of my beloved family greet my daughter. She was quiet and wide-eyed, tracking each face, each smile, looking their eyes and listening to their sounds of joy. But the most amazing revelation came from my daughter’s great-grandmother. She gasped when she took her into her arms, and held her close. Spontaneous tears fell from her eyes as she exclaimed “I never held such a new baby!”
This was a woman who had birthed five daughters in the early 20thCentury. Five heavily medicated births, five separations into hospital nurseries for a week so she could “recover”, and five formula fed, babies.
These stories abound. They are just the tip of the iceberg of our historical narrative of birthing and feeding, as it was medicalized during the past century. At that time, precious few mothers ever had a chance to touch, hold and nurture their newborn babies. And now, in the mid-1980’s, I too was caught in this confusion by simply wanting to hold my newborn post-delivery. At that moment, in my vulnerable state, hospital protocols made me feel “unsafe” for my baby.
Today, we, as women, should not have to defend our instinctual choices about the birth and feeding of our babies. Yet, the lack of parental education, cultural barriers, and prejudices against non-technical support, still fuel many outdated hospital birthing policies that block mothers from taking newborns into their arms after birth.
When I saw Lynn Johnson’s extraordinary photos, I felt immediate chills of affirmation. I was catapulted back to the birth of my daughter. Yes, my instinctual response was correct. We now know that “skin-to-skin” works on many physiological levels – it regulates the baby’s temperature with the mother’s body temperature; stabilizes the baby’s cardio-respiratory systems, raises the newborn’s blood glucose levels, lowers stress hormones in both mother and infant, and triggers a healthy immune response in the microbiome of the newborn infant.
And, oh yes. Dr. Berstrom’s marvelous “Kangaroo Care”, also facilitates the infant’s natural instinct for self-attachment for breastfeeding. When placed on the mother post birth, within 90 minutes the human newborn will initiate their inborn rooting response and slowly crawl toward the mother’s breast. Once there, they will self-attach. Holding our babies against our hearts demonstrates the deeper wisdom mothers have long known – the baby belongs with you immediately after birth, rather than waiting hours or days for the baby to be deemed clinically stable.
Trust your body, trust your instincts, and trust the process. Keep feeding!