Does the Mother’s Posture Have a Protective Role to Play During Skin-to-Skin Contact? Research Observations and Theories

Abstract

Skin-to-skin contact during the first hour following birth is the gold standard in breastfeeding. Although consecutive meta-analyses report no adverse effects, a recent review shows an increase in idiopathic sudden unexpected postnatal collapse (SUPC) in healthy term babies identifying three main risk factors: skin-to-skin contact, breastfeeding, and baby lying prone. Concurrently, authoritative visual materials tacitly promote maternal supine postures illustrating the breast crawl, a form of birth skin-to-skin contact. The naked baby lies on top of his or her mother’s body, in close ventral contact with torso parallel to the floor—a position strongly associated with sudden infant death. Biological nurturing (BN) research, the first to examine maternal postural effects on breastfeeding success, suggests that a semireclined maternal position is optimal for breastfeeding initiation. The maternal body slope ensures that the baby lies tilted, a position known to promote oxygenation. The angle of maternal recline, a variable central to BN but hitherto ignored in the skin-to-skin and SUPC literature, is unrelated to dress level. This commentary develops a postural argument to increase understanding of the potential role played by the maternal body slope to reduce the risk of idiopathic SUPC.