Booby Traps Series: “I used to ‘forget’ to cut the cord.” Why hospitals should delay newborn procedures until after the first feeding.

This is the 20th post in a series on Booby Traps made possible by the generous support of Motherlove Herbal Company.

Keeping mothers and babies together as much as possible right after birth has long been recognized as important for breastfeeding.  But for years the standard practice has been to remove the baby from the mother’s arms in order to perform a variety of newborn procedures, including weighing and measuring, eye prophylaxis, bathing, and needle sticks.

This tradition of yanking the baby away can be so strong that a nurse midwife once told me she resorted to a kind of guerrilla move to keep moms and babies together:  “When I delivered at hospitals where I knew they liked to separate the mom and baby right after the birth,” she said, “I’d just ‘forget’ to cut the cord for as long as I could.”

Sadly, mothers’ reported experiences bear this out.  In the 2006 Listening to Mothers survey, 66% of mothers reported not having their babies in their arms in the first hour.

When it comes to the timing of newborn procedures, delay is a good thing.  According to Linda Smith in The Impact of Birthing Practices on Breastfeeding, the evidence supporting continuous contact between moms and babies after birth is “overwhelmingly strong.”  This uninterrupted contact allows the natural, programmed behaviors of the infant – including instinctual breastfeeding behaviors – to unfold.  Research has shown that during this sensitive period, separation of the baby from the mother disrupt babies’ instinct to crawl and attach to the breast.   Bathing is particularly disruptive to breastfeeding, since some of breastfeeding at this stage is based on smell.  Linda Smith concludes, “Separating the baby for any reason other than resuscitation is unjustified and harmful.”

It’s not just breastfeeding advocates who believe that delay is best.  The 2005 the American Academy of Pediatrics statement, “Breastfeeding and the Use of Human Milk,” instructs providers to:

Dry the infant, assign Apgar scores, and perform the initial physical assessment while the infant is with the mother. The mother is an optimal heat source for the infant. Delay weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding is completed. Infants affected by maternal medications may require assistance for effective latch-on. Except under unusual circumstances, the newborn infant should remain with the mother throughout the recovery period. [my emphasis added]

What can you do if you’re expecting a baby and are concerned that your baby might be taken away for these newborn procedures?

One thing you can do is include this statement in your birth plan:  “I would like all newborn procedures, including weighing, measuring, bathing, needle-sticks, and eye prophylaxis,* delayed until after the first feeding.  After the feeding, I would like these procedures done with the baby lying on me or being held by me.”

If you think you’ll need some justification for this change in procedure at your hospital, you could cite the AAP policy above.  And if you really need to push for this, you can give your providers a copy of the AAP’s model hospital breastfeeding policy, which states the same thing.

For the one in three babies who are born by cesarean section, this kind of delay may not be feasible, but I’m holding out hope that one day all healthy babies born by cesarean will have the chance at some skin-to-skin time and even the opportunity to feed immediately after birth.  It is certainly worth discussing your desires with your providers and requesting that you get skin-to-skin contact with your baby as early and as much as you are physically capable of having.

Did you have newborn procedures delayed until after the first feeding?  Did you have to fight for this?

*Modify based on the procedures you’re planning to have done.

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21 Comments | Last revised on 10/06/2011

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