The very first moments with the newborn

Contents

The very first moments with the newborn

Skin to skin

For one to two hours after childbirth, the newborn experiences a period of calm awakening and alert conducive to exchanges, learning and their memorization (1). This state of attention is partly explained by the release of catecholamines in the body of the newborn, a hormone that helps him to adapt physiologically to his new environment. For her part, the mother secretes a quantity of oxytocin, “love hormone” or “attachment hormone”, which contributes to this state of “primary maternal concern” described by the pediatrician Winnicott (2). The two hours following birth are therefore a privileged moment for the first meeting between mother and baby.

If the delivery has gone well, the newborn is presented to the mother from birth, ideally “skin to skin”: he is placed naked, back covered after drying, on his mother’s belly. This skin-to-skin contact (CPP) from the first minutes of life and prolonged (90 to 120 minutes) allows a smooth transition between the in utero world and air life, and promotes the physiological adaptation of the newborn via different mechanisms. :

  • effective maintenance of body temperature (3);
  • a better carbohydrate balance (4);
  • better cardio-respiratory adaptation (5);
  • better microbial adaptation (6);
  • a marked decrease in crying (7).

The skin to skin would also promote the establishment of the mother-child bond, in particular via the secretion of the hormone oxytocin. “This practice of intimate contact during the first hours after birth can facilitate attachment behavior and interactions between mother and baby through sensory stimuli such as touch, warmth and smell. », Indicates the WHO (8).

The “proto-gaze” or “founding gaze”

In photos of newborns in the delivery room, what is often striking is this deep gaze of the newborn just a few minutes of life. For specialists, this look is unique, particular. Dr Marc Pilliot was one of the first, in 1996, to take an interest in this “protoregard” (from the Greek protos, first). “If we leave the child on his mother, the gaze of the first half hour will play a fundamental and founding role. »(9), explains the pediatrician. This look has a “parenting” role: it will promote the mother-child attachment but also the father-child. “The effect (of this protoregard) on the parents is very powerful and it affects them, causing in them a real upheaval which modifies them all at once, thus having a parenting effect that should not be neglected”, explains another precursor of maternology, Dr Jean-Marie Delassus (10). The first moments of the baby’s life, everything must therefore be done, in the delivery room, to favor this look and this unique exchange.

Early latching

The two hours in the delivery room are the ideal time for an early breastfeeding for mothers who wish to breastfeed, but also for those who wish to offer their baby a single “welcome breastfeed”. This feeding is a privileged moment of exchange with the baby and from a nutritional point of view, it allows him to benefit from colostrum, a thick and yellowish liquid very rich in proteins and various protective factors.

WHO recommends that “mothers begin to breastfeed their infants within an hour of birth. Immediately after birth, newborns should be placed skin-to-skin with their mothers for at least an hour, and mothers should be encouraged to identify when their infant is ready to latch on, offering help if needed. . “(11).

A baby knows how to suck from birth, as long as it is given the optimum conditions. “Different studies have shown that in the absence of sedation, infants carried on their mother’s breast immediately after birth, adopt a characteristic behavior before the first feeding, of which only the timing varies. The first movements, carried out after 12 to € 44 minutes, were followed by a correct latch on the breast accompanied by a spontaneous suckling, after 27 to € 71 minutes. After birth, the sucking reflex would be optimal after 45 minutes, then decreasing, stopping for two hours at two and a half hours, ”says the WHO. On the hormonal level, the digging of the breast by the baby causes a discharge of prolactin (lactation hormone) and oxytocin, which facilitates the start of milk secretion and its ejection. In addition, during these two hours after birth, the baby is “in an intense state of action and memorization. If the milk is flowing, if he has been able to take it at his own pace, he will record this first feeding as a positive experience, which he will want to reproduce later ”, explains Dr Marc Pilliot (12).

This first feeding is ideally done skin to skin in order to promote the initiation of breastfeeding but also its continuation. Indeed, “current data indicates that skin-to-skin contact between mother and newborn soon after birth helps initiate breastfeeding, increases the likelihood of exclusive breastfeeding for one to four months, and lengthens the total duration of breastfeeding ”, indicates the WHO (13).

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