What is the Science Behind the Golden Hour After Birth?

You've waited 9 months, attended your antenatal care, and followed your Obstetrician's advice. You prepared yourself mentally and physically for the rigorousness of labor and delivery. Finally, your baby arrives, but now what? 

Have you prepared for neonatal life like you prepared for labor and delivery? 

This article will walk you through the first hour of your new baby's life. We will discuss the golden hour, the benefits of skin to skin contact for both mom and baby and what a baby friendly birthing facility looks like. 

What is the golden hour?

The golden hour is the first hour of a newborn's life. This first hour of a baby's life is really important for many reasons. During this time, the newborn is in an alert state. After the stress of labor and delivery, the baby will cry in the minutes after birth and then become quiet and alert once they are placed skin to skin with their mother. 

During this first hour, a healthy newborn should be immediately placed on his or her mother's chest to be dried and assessed. Additionally, most birthing facilities practice delayed cord clamping as it provides numerous benefits for new babies. In the first few minutes of life, newborn infants will be active and alert. 

Immediate skin to skin contact with the mother allows the baby to transition from life inside the womb to life on the outside. As the baby's physiology changes from living in amniotic fluid for 9 months to breathing air, a lot changes inside of their body. Direct contact with their mother's skin allows them to have a more gentle transition into extrauterine life.

This magical time is also important for bonding with a new baby. 

Benefits of Skin to Skin Contact for Babies

Skin-to-skin contact between a newborn baby and their mother has numerous benefits:

• Stabilize heart rate and respiratory rate
• Thermal regulation/ Prevention of hypothermia 
• Decreases metabolic demand 
• Reduces hypoglycemia (low blood sugar)

Moreover, skin-to-skin contact encourages successful breastfeeding. The close proximity between the baby and the parent's chest stimulates the baby's natural instincts to root and latch onto the breast. This not only facilitates the initiation of breastfeeding but also improves breastfeeding outcomes. Early initiation of breastfeeding is important for establishing a good breast milk supply. 

In addition, skin-to-skin contact reduces crying in babies. The physical contact, familiar smell, and soothing voice of the parent provide comfort, reassurance, and a sense of security. This helps to alleviate distress and promote a calm and contented state.

Benefits for Mothers

The benefits of the golden hour are not just for the baby. Mothers also benefit from this magical time of uninterrupted skin-to-skin bonding. Skin to skin contact with her newborn allows a mother's body to release the "feel good" hormone of oxytocin. This hormone also plays a role in uterine contractions as well as breast milk production. 

Oxytocin acts on the mother's uterus to cause it to contract down and return to its pre-pregnancy size more quickly. Mothers who initiate early skin to skin contact with their newborns as well as breastfeed experience less risk of postpartum hemorrhage after a vaginal birth. 

In addition, oxytocin is released from the brain in response to the smell and feel of the newborn against the mother's skin. Oxytocin also acts on the breast to allow the milk to let down into the milk ducts. The more often this happens in the first hours of life, the better a mother's milk supply will be for the duration of breastfeeding. 

Furthermore, the golden hour of skin-to-skin contact fosters a strong emotional bond between the mother and her newborn. This closeness promotes feelings of love, connection, and confidence in the mother's abilities to care for her baby. It also reduces the risk of postpartum depression and anxiety, ensuring a positive start to the mother's postnatal life.

Breastfeeding

The golden hour allows for the short-term outcome of time for bonding, but also allows for the long term outcome of breastfeeding success. Mothers who breastfeed their babies within the first hour of life have a greater chance of meeting their breastfeeding goals. 

Skin-to-skin contact helps babies latch on to the mother's nipples naturally. The warmth and scent of the mother's skin stimulate the baby's instinctive stages of searching, crawling, and latching on to the breast. This instinctive behavior leads to a more effective and efficient breastfeeding experience.

Baby Friendly

The Baby Friendly initiative is a global program launched by the World Health Organization (WHO) and UNICEF to promote and support breastfeeding. It sets standards for maternity facilities to ensure that all mothers and babies have the best possible start to breastfeeding and newborn care. One of the key components of this initiative is promoting skin-to-skin contact immediately after birth and for as long as the mother and baby desire.

10 steps to Successful Breastfeeding set by the Baby Friendly Initiative:

1 Comply fully with the International Code of Marketing of Breast-milk Substitutes; Have a written infant feeding policy; Ongoing monitoring
2. Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding

3. Discuss the importance and management of breastfeeding with pregnant women and their families.
4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.
6. Do not provide breastfed newborns any food or fluids other than breast-milk, unless medically indicated.
7. Enable mothers and their infants to remain together and to practice rooming-in 24 hours a day.
8. Support mothers to recognize and respond to their infants’ cues for feeding.
9. Counsel mothers on the use and risks of feeding bottles, artificial nipples (teats) and pacifiers.
10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.

The Baby Friendly initiative is just one way that birthing facilities can help to promote skin to skin during the golden hour as well as breastfeeding. Even if a facility is not officially a "baby friendly" designated place does not mean that they don't follow the practices. Be sure to take a tour of the facility where you plan to deliver and ask those questions. 

Birthing centers are often run by a certified nurse-midwife and have different policies when it comes to early initiation of skin to skin and breastfeeding. Often, there is more freedom for these activities in early neonatal life at a birthing center vs hospital setting. 

Wherever you deliver, it is important to have a birth plan and/or a breastfeeding plan that states your desires to have a period of skin to skin time immediately after birth. Infant outcomes improve with early breastfeeding and golden-hour bonding. 

Conclusion 

 The golden hour is a magical time for the first minutes of newborn life, and the benefits continue in the hours after birth. Immediate and un-interupted skin to skin contact with mother, delayed umbilical cord clamping, and early initiation of breastfeeding help both a baby and a mother to thrive. These are evidence based practices that have been shown to improve outcomes during the early postpartum period. 

If you are looking for a way to communicate your wishes for early skin to skin and initiation of breastfeeding to your birthing facility, download our free Breastfeeding Plan.

© 127 Pediatrics; November 2023

This article is for informational purposes only and should not be construed as medical advice.

Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house-calls only pediatric practice in Colleyville, TX. She is also the owner and operator of the 127 Pediatrics Online Breastfeeding Medicine and Education Center.