A Baby’s 9 Instinctive Stages

There has been quite a gap since I last posted a blog. My husband and I found out about six weeks ago that we will be moving to Houston because of changes in his job responsibilities. My son, daughter-in-law, and two-year old grandson live there so we are delighted. But finding a new place to live, getting the house we’ve lived in for 20 years ready to sell, and getting ready to present at the recent Lamaze-ICEA MegaConference in Milwaukee left no time for blogging. But now we have a contract on a townhouse in Houston, our house is on the market, and the MegaConference is but a wonderful memory.

One of the topics that I discussed during my MegaConference presentation was a baby’s nine instinctive stages while skin-to-skin during the first hours after birth. Ann-Marie Widstrom, a Swedish researcher on skin-to-skin contact between mother and baby, described the nine stages that occur in the first hour or two after birth when a baby is placed immediately skin-to-skin with his mother. She (and many other breastfeeding experts) believe that if a baby is put skin-to-skin on the mother’s chest immediately after birth, without a delay for routine procedures, and left there undisturbed as he or she goes through the nine developmental stages at his or her pace, that the likelihood of breastfeeding success is greatly enhanced. I have a dear friend, Jeannette Crenshaw, who is doing her doctoral project on the impact of immediate, uninterrupted skin-to-skin contact on rates of exclusive breast milk feeding at hospital discharge. (Note: Exclusive breast milk feeding at hospital discharge is one of the new Joint Commission perinatal quality measures that went into effect on April 1st, 2010.)

At the hospital where Jeannette is conducting her project, DVDs illustrating the nine instinctive stages were shown to childbirth education classes, physicians, and nurses. Babies were placed immediately on the mother’s chest after most vaginal and cesarean births. As the mothers and babies were filmed, Jeannette was delighted to hear parents, physicians, and nurses identifying the nine instinctive stages that the babies went through. Staff were surprised to see that cesarean moms who had uninterrupted contact experienced fewer shakes and fewer episodes of hypothermia. She has not yet processed her data, but she is looking forward to exploring the influence of uninterrupted skin-to-skin contact on the rates of exclusive breast milk feeding at hospital discharge.

Here is something that childbirth educators can do to make a real difference! We know how important breastfeeding is to both a baby’s and to a mother’s health and well-being. We also know from the Listening to Mothers’ postpartum survey, New Mothers Speak Out, that too many mothers, especially cesarean mothers, who plan to exclusively breastfeed their babies are not doing so at the time of hospital discharge. If we teach our students about the nine instinctive stages and advocate at our hospitals for immediate, uninterrupted skin-to-skin care until the first feeding is accomplished, we can increase the number of mothers exclusively breastfeeding their babies.

You can read about Ann-Marie Widstrom’s research on the nine instinctive stages in an online article published September 14, 2010 in Acta Paediatrica. In this interesting article, Dr. Widstrom emphasizes the critical importance of not forcing the infant to the breast and of allowing the infant to proceed through the nine stages at his or her own pace. You can order a handout about the nine stages; a DVD, Breastfeeding: Baby’s Choice, for parents about the nine stages; and/or a DVD for staff, Skin to Skin in the First Hour after Birth – Practical Advice for Staff after Vaginal and Cesarean Births, from Health Education Associates, Inc. at www.healthed.cc/. Do what you can to help to increase your hospital’s rate of mothers exclusively breastfeeding at hospital discharge and to promote, protect, and support breastfeeding.

Anybody looking for a house in Plano, Texas?

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