First hour of life for newborns: a timeline

Photo by Mikaela Wapman

Photo by Mikaela Wapman

Laura Sanders of Science News recently published a post on a Timeline of a Baby’s First Hour.

In the post, she stumbles upon a 2011 study from Sweden regarding observations of 28 of “the most mysterious creatures on the planet: brand-spanking-new humans.”

Sanders goes on,

Videos of babies in their first hour of life gave the researchers an unprecedented view of how newborns instinctually behave, when left to their own devices and nestled skin-to-skin on their mothers’ chests. I found the results, published in January 2011 in Acta Paediatrica, just as fascinating as the Drosophila courtship ritual.

Having supported a fair number of births in the hospital, I have witnessed many of the instincts of the newborn to cry, nurse, and sleep. Sometimes, routine tests or complications in birth interrupt the newborn’s instinctive inclinations and the maternal / infant initiation, as the hospital team performs the necessary evaluations, perfunctory tests (birth weight, length, head measurements, immunizations… the list goes on and on).

In uncomplicated, low-intervention births, new mothers are able to rest with their newborns on their chest and relish in the unique, indescribable joy of skin-to-skin. It is during these moments that the researchers from Sweden noted some key milestones in the first hour and 10 minutes of a newborn’s life, presented in median minutes:

Minute 0: Babies wail a robust, angry birth cry that helps wake up the lungs.

Minute 2: After all that wailing, babies spend less than a minute relaxing, holding perfectly still on their mothers’ chests. The authors speculate that this silent, still break might have evolved to keep babies hidden from predators.

Minute 2.5: As they start to wake up, newborns open their eyes for the first time. Babies gradually start moving their heads and mouths.

Minute 8: Babies become even more active, keeping their eyes open for five minutes or longer at a time. During this active phase, newborns seem to grow interested in eating, looking at their mothers’ faces and breasts, making sweet little “hungry” noises and moving their hands toward their mouths.

Minute 18: That was exhausting. Time for another rest.

Minute 36: Recharged newborns really kick it into high gear and begin scooting toward their mothers’ breasts, relying heavily on a sense of smell to navigate.

Minute 62: Babies nurse, most likely getting small amounts of colostrum, a pre-milk substance packed with protein and immune molecules. This early suckling stimulates the breasts to make milk and also helps mom’s uterus contract back to its pre-pregnancy size.

Minute 70: Babies fall asleep for a well-deserved break.

There you have it: the first seventy minutes of a newborn’s life, as described by science. Of course, these minute markers are median numbers drawn from a small number of newborns (n=28), and even the time tables of the babies included in the study varied substantially. Any single baby’s behavior might fall well outside of these time points.

These quantitative observations are helpful with respect to the introduction and recent emphasis that most hospitals are placing on “baby friendly” practices, designed to encourage breastfeeding and also happen to support the bond between mom and baby.

Photo by Mikaela Wapman

Photo by Mikaela Wapman

“Baby friendly” practices, as outlined by Baby-Friendly USA, state that “health care systems should ensure that maternity care practices provide education and counseling on breastfeeding. Hospitals should become more “baby-friendly,” by taking steps like those recommended by the UNICEF/WHO’s Baby-Friendly Hospital Initiative.” Initiatives to improve breastfeeding rates include forgoing formula and pacifiers, allow the mom and baby to stay together (rather than baby in nursery), and provide hospital staff to instruct and support new moms with breastfeeding.

Sanders refers to another observational study:

In the first hour of birth, babies whose chins touched the underside of their mothers’ breasts were more likely to successfully suckle than babies who didn’t do a chin-brush. These sorts of studies, which rely on carefully watching a newborn, are beginning to paint a more complete picture of what newborns might need in the moments after birth. And that understanding might ultimately be useful to the adults who want to ease the introduction of this new little person to the world.

Observations from these studies regarding the instinctive newborn behaviors – without interference from anyone – might help healthcare providers come up with better ways to encourage breastfeeding, and cut down on some of the routine tests that might be best delayed until the third (or fourth, fifth, or sixth) hour of the baby’s life.

You can read the whole article here. Via Science News.

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The Best of Breastfeeding Awareness Week

It’s August, National Immunization Awareness Month, and the first week of August is the World Breastfeeding Week! People all over the world – from Tennessee to Singapore – are taking action to raise awareness and promote the powerful importance of breastfeeding.

Here’s a roundup of some compelling information on the call for Breastfeeding Awareness:

  • Red Wine and Applesauce covers Breastfeeding and Immunizations: Yay for Breastfeeding and Immunizations! Tara Haelle raises awareness of the importance of breastfeeding and immunizations and the benefits of both.
  • Celebrating the Very Ordinary – Chrissy Chittenden of The Huffington Post asks why something so ordinary and natural as breastfeeding has become taboo in the eyes of the public.
  • Looking Beyond 2015: Ellen Piwoz, writing for the Bill and Melinda Gates Foundation, presents the gains and challenges in promoting immediate and continued breastfeeding around the world. She calls for an indicator to increase the rate of exclusive breastfeeding from birth to six months to 60% by the year 2030, urging the goal to be included in the Sustainable Development Goals for the UN General Assembly.
  • Most under two-year Tanzanian children suffer from malnutritionMothers of in Tanzania are reminded that exclusive breastfeeding for their infant from birth to six months is the best nutritional option their babies. Breastfeeding assures 100% food security for Tanzanian mothers, and improving exclusive breastfeeding rates could potentially reduce the mortality rate of children under five years old by up to 13 percent.
  • I fed my newborns formula to keep them alive. Still, I felt guilty about itvia the Washington Post‘s Darlena Cunha – A heartbreaking essay by a woman who fed her newborn premies formula and her experience of shame and judgement from the public.
  • The Millennium Development Goals: What’s Breastfeeding Got to do with it? – 1000 Days considers how promotion of breastfeeding alleviates global poverty and interacts with the UN’s Millennium Development Goals (MDG).
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Image from the Cincinnati Zoo & Botanical Garden

Nursing is something we share with every mammal – it is a normal, natural thing to do.. everywhere! Breastfeeding Awareness Week is a perfect time to demonstrate the importance and benefits of breastfeeding! From the words of Tara Haelle:

Exclusively breastfeeding offers wonderful health benefits and should be encouraged as the default norm. Yet World Breastfeeding Week is actually a good time to also remind folks that as long as a baby is well fed, a mother’s choice should be respected in how she feeds her child, and no mother should be made to feel guilty or ashamed if she is feeding her child some or all formula.