Do you know why lactation specialists insist on feeding your baby within one hour after birth? Learn all about the ‘Golden Hour’ and its benefits for both mother and newborn. Read on!
By Dr Aruna Savur
"While breastfeeding may not seem the right choice for every parent, it is the best choice for every baby." - Amy Spangler, Breastfeeding Expert, Baby Gooroo
The first hour after birth, when a mother has uninterrupted skin-to-skin contact with her newborn is referred to as the 'golden hour'. Making mother’s breast milk available to infants during this hour (within one hour of birth) is referred to as ‘early initiation of breastfeeding.’ It ensures that the infant receives the colostrum, or ‘first milk’, which is highly rich in protective nutrients.
Apart from the nutritive value of the first milk, feeding the baby early has other benefits too. Early breastfeeding also increases the likelihood of exclusive breastfeeding for one to four months of life, as well as the overall duration of breastfeeding. Infants placed in early skin-to-skin contact with their mother also appear to interact more with their mothers. It is a physiological need that cements the bond between the mother and the baby.
According to a research article titled 'Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother, Baby, and Breastfeeding' by Jeannette T. Crenshaw published in The Journal of Perinatal Education in 2014, "Keeping mothers and babies together is a safe and healthy birth practice. Evidence supports immediate, uninterrupted skin-to-skin care after vaginal birth and during and after cesarean surgery for all stable mothers and babies, regardless of feeding preference. Unlimited opportunities for skin-to-skin care and breastfeeding promote optimal maternal and child outcomes."
Another factor that makes the golden hour important is that the baby is alert for an hour or so after birth. Both the mother’s and the baby’s adrenaline are very high during this period and it is a good time for the baby to feed. And the first feed sets the tone for all future feedings.
Skin-to-skin contact and the first breastfeed given during this hour after birth forms an integral part of the breastfeeding journey that follows in the time to come.
When the newborn feeds on breast milk in the first hour after birth, the baby is protected by the colostrum or the first milk that is rich in nutrients and antibodies. This snuggling also helps you and the baby get to know each other.
Colostrum is high in fat, proteins and antibodies which deliver the benefits in a concentrated form since it is produced in very small quantities. This provides a boost to the child’s immunity and protection for a lifetime against allergies and infections.
Once the baby is cleaned after birth and clinically checked, the baby should be placed next to the mother. Their skin should touch. They can be covered in a blanket. This promotes bonding and stimulates oxytocin, which encourages maternal behaviour. With the help of the healthcare provider, breastfeeding can be initiated during this precious time.
Sakina Dhilawala, mother of one-year-old Shirin, recollects her golden hour.
"When I was expecting Shirin, I went for couple of lactation classes and seminars. Thanks to these classes, I came to know about the importance of the golden hour. Once I delivered my daughter, I insisted with the doctor and nurses that I wanted skin-to-skin contact with her, and they obliged. I also wanted a delayed cord clamping. It is advisable for expecting moms to go for such classes and be aware."
The first feed helps the baby develop antibodies to fight against diseases. Breast milk forms a shield that helps the baby fight diabetes, obesity, and cancer. Studies also show that early breastfeeding helps infants gain the right amount of weight. Bottle-fed babies are likely to develop obesity or remain underweight.
Further, the first hour of bonding helps optimal cord clamping and the baby benefits from the goodness remaining in the placenta. It also helps regulate the baby’s body temperature and breathing.
The mother also benefits from the golden hour. Giving birth changes the woman’s brain chemistry increasing her desire to nurture. Skin-to-skin contact and nursing the baby, releases hormones that help the mother to connect with her child. This sets the tone for the days to come, making the mother breastfeed the baby longer. It also causes the uterus to contract and stop bleeding, as the first step towards returning to normalcy.
If skin-to-skin contact is not possible at birth, the benefits still remain as and when it happens for the first time. Also, if the mother is unable to give skin-to-skin contact soon after birth, her partner, family member or a loved one, can also provide contact to the baby.
However, there is good evidence that newborns, who are placed skin-to-skin with their mothers immediately after birth, make the transition from fetal to newborn life with greater respiratory, body temperature and glucose stability. Baby's body temperature, heart rate and breathing rate stabilises and becomes normal. This sets breastfeeding in motion and calms both the mother and baby.
Also, it is the first step to bonding. When the baby is made to lie against her mother’s skin, her familiarity with the touch and smell of the mother is established and enhanced. In case the baby falls asleep, then the mother can express the colostrum, which can be fed later.
Mothers who undergo a c-section delivery, sometimes find it difficult to breastfeed their baby. If possible, breastfeeding should start from the recovery room itself. In the operation theatre, after birth, the mother should have the support of the doctor or nurses to help her nurse the baby. Or it can be done immediately after she is shifted to post-operative care.
The mother may be recuperating after the operation, but if possible, she should initiate skin-to-skin contact and hold the baby to her chest. In c-section births, chances are that the baby would be sleeping. As soon as the baby wakes up, initiate the first breastfeed or if that is not possible, colostrum should be expressed to feed the child. Skin-to-skin contact helps the baby breastfeed better because this process enables a baby’s innate breastfeeding reflexes. This process also keeps the baby more alert and oriented.
When the baby is in the mother’s tummy, he can already smell and feel her. This touch and smell capacity remains after birth, and helps the baby in familiarising with the mother. Thus, creating an emotional bond and helping him develop an attachment towards her.
For the mother, breastfeeding helps her recover physically and emotionally. Oxytocin released during contact helps the tissues recover faster from the birthing trauma. It is calming and helps her sleep and digest better, making her less anxious and depressed, thereby protecting against postnatal depression.
This, in turn, puts her in sync with the baby. She can make eye contact, talk soothingly to the baby and caress him. This is the first step in adjusting to motherhood for her. Further, the early release of oxytocin is said to prime the brain for breastfeeding, as well as stimulate the breasts to produce milk.
The ‘Golden Hour’ is recognised as a significant period in hospitals and most doctors and healthcare providers are aware of its importance. However, as an expecting parent, you can also stress on this as the value of the first feed, creates a bond with the mother. Hence, nurses and caregivers would ensure that the baby and mother are separated for the least time necessary to clean the baby and carry out quick check-ups. All other procedures can be delayed, so that the baby and mother get the required bonding time. The first hour is important for the baby to feel the touch of the mother than a nurse or some other caregiver. The father is also usually included in this bonding time and this is known as the 'Sacred Hour'.
The mother should be given help initially to position the baby properly for feeding and taught how to do it. This will help her establish a process, which works for her and the baby to put minimum stress on them and feed better.
So, this is the importance of the precious 'golden hour'. Spread the word!
About the expert:
Written by Dr Aruna Savur, MBBS, DNB on 5 August 2019.
Dr Aruna Savur comes with 14 years of experience in general Pediatric practice. Post fellowship in Neonatal Intensive Care, she worked in a level 3 NICU for two years. She has a special interest in lactation support and counselling. She is a certified lactation counsellor and paedatrician at Motherhood Hospitals, Bangalore.
Also read: Attachment Parenting And Breastfeeding
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