Breastfeeding from the first hour of birth: What works and what hurts

Whether delivery takes   place in a hut in a rural village or a hospital in a major city, putting newborns to the breast within the first hour after birth gives them the best chance to survive, thrive and develop to their full potential.

UNICEF and WHO recommend exclusive breastfeeding for the first six months of life, starting within an hour of birth. Continuing to breastfeed exclusively – without any other food – for the first six months promotes sensory and cognitive development, and protects babies against infectious and chronic diseases.

But mothers cannot be expected to do it alone. Early and exclusive breastfeeding needs to be supported by hospitals and birthing healthcare workers, governments and families. When it comes to supporting breastfeeding from the first hour after childbirth, here’s what works, and what hurts:

What works: Skin-to-skin contact immediately after birth
Immediate skin-to-skin contact helps regulate newborns’ body temperature and exposes them to beneficial bacteria from their mother’s skin. These good bacteria protect babies from infectious diseases and help build their immune systems.

Skin-to-skin contact immediately after birth until the end of the first breastfeeding has many other benefits as well. It has been shown to increase the chances that babies are breastfed, to extend the length of breastfeeding, and also to improve rates of exclusive breastfeeding.

What hurts: Supplemental foods or liquids for newborns
Giving newborns liquids or food other than breastmilk in the first days of life is common in many parts of the world, and is often linked to cultural norms, family practices or hospital policies and procedures that are not based on scientific evidence. These practices vary by country and may include throwing away colostrum – a mother’s “first milk” rich in antibodies – or having a doctor or elder family member give the newborn specific liquids or foods, like formula, sugar water or honey. These practices can delay a baby’s first critical contact with his or her mother.

>> Read the report: Early initiation of breastfeeding – the best start for every newborn

A health worker supports a new mother breastfeeding, Mongolia
A health worker looks on as a new mother holds her baby to her chest, Ulaanbaatar, Mongolia.

What works: Delivering in baby-friendly hospitals
A hospital or healththat is ‘baby-friendly’ provides the support women need to breastfeed – specifically by following the Ten Steps to Successful Breastfeeding. These facilities also counsel mothers who cannot or have decided not to breastfeed by teaching them how to use donor milk or feed safely with formula.

In countries like Sri Lanka and Turkmenistan, baby-friendly hospitals have been instrumental to increasing rates of breastfeeding. Almost 90% of women in Turkmenistan, and almost all mothers in Sri Lanka give birth in hospitals certified as baby-friendly, and both of the countries have high rates of early breastfeeding initiation.

What hurts: Caesarean sections without support for breastfeeding
Globally, caesarean sections (C-section) rates have continually risen over the past decade, and in many countries, early initiation of breastfeeding is significantly lower in newborns delivered by C-section.

Mothers who deliver by C-section usually face multiple challenges after childbirth, like managing the effects of anesthesia, recovering from surgery, and finding help to hold the baby safely. But with the right support – training birth attendants, putting breastfeeding policies in maternal wards, and involving fathers in breastfeeding – most newborns

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