In the week of the hug we talk about the fundamentals of this contact for the physical and emotional health of people. With the Covid pandemic, this practice was discouraged. But nevertheless, In newborns, and even more so in premature babies, skin-to-skin contact with the mother and/or father is irreplaceable and, despite the pandemic, highly recommended.
Skin-to-skin contact (Copap) is an ancient practice that, due to the institutionalization of childbirth care, decreased in the West and was resumed when humanized care at birth began to be promoted. It consists of putting the newborn in contact with its mother’s bare chest and abdomen, immediately after birth, even before cutting the umbilical cord, and keeping it in that position for as long as possible. After that moment, skin-to-skin contact is also encouraged because it provides multiple benefits to newborns in their psycho-physical, neurological and emotional development.
During the last decades, the rate of premature births has been increasing -more than 20 million low birth weight children are born every year in the world, which is equivalent to 17% of all live births-. According to the World Health Organization (WHO), Prematurity is the leading cause of infant mortality up to five years of age. Despite this, 75% of these deaths can be prevented with simple solutions: “skin-to-skin” contact or “kangaroo care” is among the main recommendations.
That practice of hugging and holding the newborn, dressed only in a diaper, against the mother’s breast in the hours, days and weeks after birth is one of the most valuable gifts that someone can give a baby, since reduces infant mortality by 40%, the risk of hypothermia by 70% and infections in early childhood by 65%.
The medical pediatrician Ivana Giachino warns that prematurity represents a public health problem. It gives an account of the figures for births of low birth weight babies -1 kilo in critical situations- and refers that the risk of dying is 40 times greater than that of any child of adequate weight. “It also conditions the appearance of physical, sensorineural, psychomotor sequelae and chronic diseases in adulthood, such as obesity, metabolic syndrome, among others,” he lists. And it expresses that, for this reason, it is necessary to promote actions to improve the quality of life of these children in the long term.
“One of the most important methods is the kangaroo mother method, which refers to skin-to-skin contact,” he mentions. And it is seconded by “exclusive breastfeeding” from the beginning of birth and, thirdly, early hospital admission as the three pillars to guarantee the development of these babies.
The brand for child care Huggies launched these days a campaign to talk about care during the first months of life and emphasizes the importance of the hug. Carolina Tacco, Brand Manager of the company, mentions: “We are committed to keeping babies healthy, loved and safe during those first critical moments in their lives. We know how important the first hug is; we also know that they are the most important memories we have of our childhood. That is why we want to highlight the benefits of this skin-to-skin contact and promote this simple practice that allows many babies to suffer fewer illnesses, surround themselves with positive stimuli, and develop in the best possible conditions.”
the professional nurse Noelia Maugouber, with 13 years dedicated to neonatal care, mentions the difficulty of treating a baby who is separated from his mother because he needs care in neonatal intensive care. On the one hand, he is given the care without which he would not survive, but the cost is doing it in a strange environment away from the embrace of his mother.
The contexts are difficult. She describes and accounts for her daily reality. “The baby may weigh less than a kilo if it is an extreme case; you may have a tube so you can breathe; a venous access route to be able to feed, hydrate, receive medication; maybe you will have a catheter to be able to urinate; perhaps some other intervention if you have needed it, ”he lists. A patient like this, with several interventions, is very difficult to remove from an incubator, the place that is giving him warmth and protection from the outside, since due to his prematurity, that baby is not prepared to receive too many influences from the outside.
“Skin-to-skin contact is essential, it is one of the first interventions that your mother can perform when the baby is stable and can be taken out of the incubator,” says Noelia.
Difficulties arise in two ways. “To be able to make contact with a highly invaded or critically ill baby, it is necessary that his mother is willing to hug and have contact with the baby in those conditions, with those tubes, cables and everything he has when he is hospitalized,” he says. “The first barrier we find is that sometimes the mother does not dare to make her baby upa”.
On the other hand, it happens that health personnel have reservations before taking a baby out of the incubator, because it is critically ill. “That’s why sometimes it takes a while, so as not to take away that stability,” he explains. However, he reports that studies show that there are far more advantages to skin-to-skin contact with the mother than the possible risks of removing him from the incubator.
“Skin-to-skin contact with his mother has been proven to reduce mortality, infections, shorten the length of hospital stay, so we are less likely to have a hospital-acquired illness, to have respiratory tract illnesses. And there is evidence that from that maternal embrace, weight gains easier and better, their brain circumference increases, breastfeeding is established earlier, they develop their psychomotricity in a better way”, he lists. “We can say that skin-to-skin contact has innumerable benefits, much more than the risks involved in removing the baby from the incubator.”
The advantages are also for the mother. “The mother is going through a period of stress, she has her son hospitalized, there is a lot of anxiety. He has to go through an environment that is sometimes frightening because of the situations that are seen. So, a mother needs that contact with her son.”
Even with Covid, those visits are no longer suspended, as at the beginning of the pandemic. There are protocols and the mother must always wear a mask, have her hands well sanitized and be tested. “What is true is that there are fewer kisses from mothers to their children,” says Noelia, who sometimes observes one who surreptitiously lowers her chinstrap, kisses her baby, and covers her mouth again.