The Golden Hour of Breastfeeding

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One of the first things that comes up once a baby is born is how and when to get them to start breastfeeding.  The first hour of the baby's life has been nicknamed The Golden Hour and is an absolutely beautiful process that a newborn naturally goes through in order to initiate breastfeeding.  This blog post will discuss the Golden Hour and some of its benefits.

Birthing Individual versus Breastfeeding Individual

I just wanted to note very briefly that I have chosen to use the terms birthing individual and breastfeeding individual in this post rather than mother.  Sometimes they all refer to the same individual and that individual does identify as a mother.  Sometimes, the birthing and breastfeeding individuals are different people as in the case of adoption.  Adoptive parents, lesbian partners, and trans parents can all be either the breastfeeding or the birthing individual depending on the situation.  Breastfeeding Outside the Box is a great podcast that discusses all of these scenarios.

Stages of The Golden Hour

  1. The Birth Cry: as the baby’s lungs expand and it takes its first breath it often cries.  It’s important to note that the baby does not always cry.  
  2. Relaxation: Baby exhibits no mouth movements and the hands are relaxed.
  3. Awakening: About three minutes after birth the baby shows small thrusts of movement in the head and shoulders and may open their eyes.
  4. Activity: About eight minutes after birth the baby begins to make increased mouthing and sucking movements as rooting becomes more obvious.  During this time the baby could keep eyes open, look at breast, salivate, move hand to their mouth and breast, protrude tongue, look at breastfeeding individual, massage breast with a hand, rub cheek against and / or lift their torso from breastfeeding individual’s chest.
  5. Rest: Periods of rest may occur throughout the first hour or so after birth
  6. Crawling: About 35 minutes after birth baby can leap, slide or crawl to the breast
  7. Familiarization: Beginning about 45 minutes after birth and lasting about 20 minutes or more baby becomes familiar with breast by licking, touching and massaging.  This may involve touching the breast, putting baby’s hand in their mouth, licking the breast, looking at the breastfeeding individual, making sounds to get attention, putting their mouth on or licking the nipple, moving their hand to the breast, protruding their tongue, looking at other people in the room or massaging the breast
  8. Suckling: About an hour after birth the baby takes the nipple, self latches and suckles.
  9. Sleep: Babies and sometimes the breastfeeding individual and / or birthing individual usually fall into a restful sleep at about 1.5 to 2 hours after birth.

Benefit to the Golden Hour: Immediate Skin-To-Skin

Being placed skin-to-skin immediately activates neuroprotective mechanisms, enables early neurobehavioral self-regulation, enhances cardio-respiratory stability, and enhances thermal regulation.  Several authors summarized a variety of Cochrane articles that found that immediate skin-to-skin increased overall breastfeeding duration, success of breastfeeding as compared to a with a swaddled baby, cardio-respiratory stability, thermal stability and blood glucose in the infant 75-90 minutes after the birth as well as reducing crying.  It also showed no short or long-term negative effects.  Another study showed that skin-to-skin contact beginning within the first 5 minutes after birth and contact lasting between 60 and 120 minutes after birth is “beneficial for stability of cardiopulmonary dynamics and the reduction of infant stress during the early period post birth”.  One final study showed that disrupting or delaying this skin-to-skin contact may suppress a newborn’s innate protective behaviors, lead to behavioral disorganization, make self-attachment and breastfeeding more difficult, disturb maternal-infant bonding, reduce the mother’s affective response to her baby, and have a negative effect on maternal behavior.

Benefits to the Golden Hour: Postpartum Hemorrhage

Breastfeeding immediately after delivery encourages oxytocin production and increases uterine productivity therefore in areas where oxytocics (like pitocin) are not available, this may reduce the incidence of postpartum hemorrhage but more studies need to be done on this.  

Benefits to the Golden Hour: Successful Breastfeeding

In order to successfully breastfeed, there are a few things that baby needs.  All of these are achieved when we let baby go through the natural process that occurs during the Golden Hour.

1.  Baby needs to be calm first, soothe them if they aren’t and try to react to baby’s early breastfeeding cues so you don’t have to wait till they’re extremely upset to try to feed.  

2.  Baby needs good support either from gravity or by being held from behind their back and shoulders with their front to yours.  Their shoulders should be close to you, which helps keep them stable while they search with their head.  Babies who don’t feel stable tend to move their arms around, making latching difficult.

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3.  Babies’ lower jaw needs room to move, just like yours.  Be sure to keep your fingers away from where your baby’s chin and lower jaw need to be.

4.  Babies need a big mouthful since most of the milk is in the ducts, not the nipple.  If baby doesn’t get a big mouthful it will hurt.  When it feels good it’s a good latch.

5.  Babies need a big fat sandwich.  It’s ok to hold your breast so it’s flattened a bit for your baby just keep your fingers out of their way.

6.  Babies need to choose their own timing so don’t latch them on when their mouth is wide.  They need to be ready to latch on themselves.

7.  Babies need to reach forward with their lower jaw.  Tipping their head back makes it easier for them to get a bigger bite and easier for them to swallow.

8.  Babies need to breathe.  Babies get plenty of air when their heads are tilted back which lifts their noses free of the breast.  Make sure their back and shoulders are in close enough to you so their nose isn’t buried.

Resources I used while writing this article: