Postpartum Maternal Oxytocin Release by Newborns: Effects of Infant Hand Massage and Sucking
Stockholm University, Tukholma, Stockholm, Sweden Birth
(Impact Factor: 1.26).
04/2001; 28(1):13-9. DOI: 10.1046/j.1523-536x.2001.00013.x
Newborns placed skin-to-skin with their mothers show an inborn sequence of behavior similar to that seen in other mammals. The purpose of this study was to make a detailed exploration of hand movements and sucking behavior in healthy term newborns who were placed skin-to-skin on their mothers' chests, and to study maternal oxytocin release in relation to these behaviors.
Ten vaginally delivered infants whose mothers had not been exposed to maternal analgesia were video-recorded from birth until the first breastfeeding. Video protocols were developed based on observations of the videotapes. Each infant's hand, finger, mouth, and tongue movements, positions of the hand and body, and sucking behavior were assessed every 30 seconds. Maternal blood samples were collected every 15 minutes, and oxytocin levels were analyzed by radioimmunoassay. A statistical test for establishing the relationship between maternal oxytocin levels and infants' hand movements or sucking behavior was developed.
Infants used their hands to explore and stimulate their mother's breast in preparation for the first breastfeeding. A coordinated pattern of infant hand and sucking movements was also identified. When the infants were sucking, the massagelike hand movements stopped and started again when the infants made a sucking pause. Periods of increased massagelike hand movements or sucking of the mother's breast were followed by an increase in maternal oxytocin levels (p < 0.005).
The findings indicate that the newborns use their hands as well as their mouths to stimulate maternal oxytocin release after birth, which may have significance for uterine contraction, milk ejection, and mother-infant interaction.
Available from: Kathleen Fahy
- "The physiological reason is that women have similar reproductive physiology as other female mammals where, in undisturbed birth, uterine atony and therefore PPH is rare (Abrams and Rutherford, 2011). Left undisturbed, the newborn mammal remains in close contact with its mother (Nisbett and Glander, 1996; Fahy, 2008; Henry et al., 2009); immediately searches for the breast and suckles, causing oxytocin levels to peak in both the mother and newborn (Nissan et al., 1995; Matthiesen et al., 2001). For women, skin to skin contact and breast feeding (pronurturance) occur naturally when labour is peaceful and undisturbed – in that situation both the woman and baby are under the influence of the parasympathetic nervous and hormonal system; appropriately termed the state of 'calm and connect' (Uvnas-Moberg, 2013). "
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ABSTRACT: Objective: to examine the effect of skin-to-skin contact and breast feeding within 30 minutes of birth, on the rate of primary postpartum haemorrhage (PPH) in a sample of women who were at mixed-risk of PPH. Design: retrospective cohort study. Setting: two obstetric units plus a freestanding birth centre in New South Wales (NSW) Australia. Participants: after excluding women (n ¼3671) who did not have opportunity for skin to skin and breast feeding, I analysed birth records (n ¼ 7548) for the calendar years 2009 and 2010. Records were accessed via the electronic data base ObstetriX. Intervention: skin to skin contact and breast feeding within 30 minutes of birth. Measures: outcome measure was PPH i.e. blood loss of 500 ml or more estimated at birth. Data was analysed using descriptive statistics and logistic regression (unadjusted and adjusted). Findings: after adjustment for covariates, women who did not have skin to skin and breast feeding were almost twice as likely to have a PPH compared to women who had both skin to skin contact and breast feeding (aOR 0.55, 95% CI 0.41–0.72, p o0.001). This apparently protective effect of skin to skin and breast feeding on PPH held true in sub-analyses for both women at 'lower' (OR 0.22, 95% CI 0.17–0.30, po 0.001) and 'higher' risk (OR 0.37 95% CI 0.24–0.57), p o0.001. Key conclusions and implication for practice: this study suggests that skin to skin contact and breastfeeding immediately after birth may be effective in reducing PPH rates for women at any level of risk of PPH. The greatest effect was for women at lower risk of PPH. The explanation is that pronurturance promotes endogenous oxytocin release. Childbearing women should be educated and supported to have pronurturance during third and fourth stages of labour.
Available from: Sofia Zwedberg
- "The benefits of skin-to-skin contact for the mother include an increase in the level of oxytocin in response to the massage-like movements that the infant makes on the breast during presuckling . These movements may prepare the mother to provide milk, and are also a means for attachment with the newborn infant (Matthiesen et al., 2001). It has been suggested that increased levels of oxytocin may strengthen the mother's instinct to protect and care for her infant (Moore et al., 2012). "
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To explore midwives’ experiences and perceptions of skin-to-skin contact between mothers and their healthy full-term infants immediately and during the first day after caesarean section.
Qualitative interviews with semi-structured questions.
Setting and participants
Eight midwives at three different hospitals in Stockholm participated in the study. All participants provided care for mothers and their newborn infants after caesarean birth.
Transcribed material was analysed and interpreted using qualitative content analysis. The analysis yielded the theme ‘fighting an uphill battle’.
Skin-to-skin contact was considered to be important, and something that midwives strove to implement as a natural element of postnatal care. However, in daily practice, midwives experienced many obstacles to such care, such as lack of knowledge among parents and other professionals about the benefits of skin-to-skin contact, the mother's condition after the caesarean section, and other organisational difficulties (e.g. collaboration with other professionals, lack of time). Introducing more skin-to-skin care was a challenge for the midwives, who sometimes felt both dismissed and disappointed when they tried to communicate the benefits of this type of care.
Skin-to-skin contact is not prioritised because many health-care practitioners are unaware of its positive effects, and their care reflects this lack of knowledge. There is a need for education among all health-care practitioners involved in caesarean procedures. Another difficulty is that many parents are unaware of the benefits of skin-to-skin contact. Maternity outpatient clinics need to inform parents about the benefits of such care, so mothers will understand the importance of skin-to-skin contact.
- "In most mammals, the stimulation of the teats by her pups elicits a modification in the activity of oxytocin magnocellular neurons , resulting in a pulsatile release of oxytocin in the neurohypophysis that leads to periodic milk ejections (Poulain and Wakerley, 1982). In humans, nipple stimulation also increases oxytocin levels in breastfeeding mothers (Dawood et al., 1981; Amico and Finley, 1986; Uvnäs-Moberg et al., 1990; Uvnäs-Moberg, 1996; Matthiesen et al., 2001; White-Traut et al., 2009). In parallel to the release of oxytocin in the neurohypophysis, there is also an increased intracerebral release of oxytocin during lactation, together with an increased expression of oxytocin receptors, in specific brain regions (Kendrick et al., 1988; Moos et al., 1989; Neumann et al., 1993a,b; Bealer and Crowley, 2001; Veenema and Neumann, 2008). "
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ABSTRACT: This review focuses on the neuroendocrine mechanisms in the mother and the newborn that are involved in the generation and consolidation of mother-child attachment. The role that different hormones and neurotransmitters play on the regulation of these mechanisms during parturition, the immediate postpartum period and lactation is discussed. Interferences in the initiation of mother-child attachment may have potential long-term effects for the behavior and affection of the newborn. Therefore, the possible consequences of alterations in the physiological neuroendocrine mechanisms of attachment, caused by elective Cesarean section, intrapartum hormonal manipulations, preterm delivery, mother-infant postpartum separation and bottle-feeding instead of breastfeeding are also discussed.
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