December 2015
Today, I would like to highlight the famous work of Ann-Marie Widstrom. Her study of the nine instinctual behaviors of newborns immediately after birth is not only renown but fascinating. First published in 2010 in Acta Paediatrica (100, pp 79-85), it can now be easily downloaded from a variety of internet locations, complete with photographs.
Widstrom's work filmed newborn infants who were put immediately skin-to-skin with their mothers, and found the following steps:
1. The birth cry: consisting of intense crying just after birth.
2. Relaxation phase: with the infant resting/recovering and no activity of mouth, head, arms, legs, or body.
3. Awakening phase: where infant begins to show signs of activity. Small thrusts of head: up, down, from side-to-side, along with small movements of limbs and shoulders.
4. Active phase: with more determined movement of limbs and head, rooting activity, "pushing" of limbs without shifting body.
5. Crawling phase: with "pushing" that results in shifting of the body.
6. Resting phase: where infant rests, with some activity such as mouth movements and sucking on hands.
7. Familiarization: infant has reached areola/nipple with mouth positioned to brush and lick areola/nipple.
8. Suckling phase: where infant has taken nipple in mouth and begins suckling.
9. Sleeping phase: with baby closing its eyes.
This phase progression has been noted across culture and country, race and age. The discussion portion of the original paper, too long to copy here, is exciting to read! The full range of phases took at least one hour and occasionally longer. Widstrom states, "...the baby should stay skin-to-skin with its mother in the first hours after birth, and it is clear that delivery ward routines should be designed so as to not disturb the infant's self-regulation process, first suckling and maternal-infant attachment behaviors," (2010).
This paper was one of several upon which Step 4 of the Ten Steps of Baby Friendly was founded. It should be required reading for all hospital staff working with mothers and infants.
Kathy
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