In recognition of World Breastfeeding Week, Springer Publishing Company wants to emphasize the importance of closeness and skin-to-skin contact (SSC) between mothers and their infants. In the early days of life, mothers are encouraged to prioritize breastfeeding as a means of achieving this intimacy with their babies.

The following content is adapted from How to Become Mother-Friendly: Policies & Procedures for Hospitals, Birth Centers, and Home Birth Services by Barbara Hotelling and Helen Gordon. 

A mother-friendly hospital, birth center, or home birth service encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.

Keeping mothers and babies together enhances attachment, increases breastfeeding initiation and duration, and decreases infant stress. Use of skin-to-skin contact (SSC), often called kangaroo care (KC), in the neonatal intensive care unit (NICU) environment, is beneficial for sick and premature newborns. Touching, holding, and caring for healthy infants enhance feelings of attachment between mothers and babies.

Benefits of closeness and SSC between mothers and babies:

• Minimizing separation during the hospital stay increases breastfeeding initiation and duration in mothers with healthy infants.

• Unimpeded early SSC increases breastfeeding initiation and duration in mothers with healthy infants.

• Touching, holding, and caring for sick or premature infants enhances attachment between mothers and babies.

• KC in preterm infants is associated with less immediate pain and less immediate pain reaction.

• Eliminating or minimizing separation for procedures whenever possible reduces distress in sick or premature infants, infants with congenital problems, and mothers.

• KC promotes infant-parent bonding, stabilizes vital signs including respiratory rate, heart rate, and temperature, increases maternal milk supply, and increases parent confidence in caring for the child and in breastfeeding.

• Significant health benefits have been associated with premature infants receiving mother’s milk, including short-term and life-long benefits.

• Breastfeeding is universally accepted as the biologically normal human infant-feeding method.

Guidelines for implementation of mother-child closeness:

1. There will be no separation of mother and infant unless medically necessary.

2. Infants are to be placed skin-to-skin on the mother following birth when the infant’s and mother’s conditions allow. If the mother is unstable, another family member will be encouraged to hold the newborn skin to skin.

3. Once clinically stable, an infant in the NICU is a candidate KC.

4. Eligibility requirements of the clinically stable newborn in the NICU environment will be clearly defined by providers.

5. The NICU team will educate parents about the benefits of KC and will implement KC when the infant is stable and if the family wishes to participate.

6. Educate all members of the health care team on the benefits of maternal–infant bonding and KC in the NICU population.

7. Create clear tools for documentation of KC.

8. Create a private environment in which it is possible for mothers and immediate family members to be comfortably at the baby’s bedside as much as possible.

9. Implement strategies for parents to comfort the newborn during painful procedures, including holding and feeding.

10. If the newborn and mother must be separated due to medical indications and direct breastfeeding is not possible, mothers will be instructed on how to use hand expression or electric breast pump.

11. Mothers will be encouraged to breastfeed on demand as soon as the infant's condition permits, taught proper storage and labeling of human milk, and assisted in learning skilled hand expression and/or obtaining a double set-up electric breast pump prior to going home.

12. Institution will have a policy for storage and use of human milk.

13. When a mother’s milk is not available for her infant, human milk from a donor milk bank will be offered to the family as an alternative feeding method when available. Donor milk banks operate in compliance of federal regulations to ensure safe feeding of all recipients.