Uninterrupted Mother-Son Tie Part I
One of the most important missions during a natural delivery consists in to make sure the close contact between the mother and her newborn.
Just immediately after the birth, even before the moment when we cut the umbilical cord, begins their mutual relationship which will be decisive to them during all the life.
Is absolutely necessary to create the conditions and give peace to the mother. The silence is crucial, not much light and to provide the initial contact.
The baby is placed softly just he birth, still humid on the naked mother´s belly. Immediately begins their visual and physical contact between them.
Both, believe me, talk! The newborn babbles and converses with her mother.
They touch and caress each other. We invite the mother and her couple to dry the baby, maintaining him or her always in direct contact with her belly, skin to skin. This contact assures the transfer by irradiation of the high mother´s temperature to the baby, saving him stress and energy so important for his initial adaptation.
After a couple of minutes, when the umbilical cord stops their beats, we proceed to cut it. This procedure is absolutely imperceptible to both of them: the baby and her mother.
Once we cut the umbilical cord is easier to the mother to approach the baby and place him (her) on her chest, which in women is endowed with a very high temperature and the newborn can easily hear the mother´s heart beats, which will bring him security and peace for all his life.
Mother´s heart beats strong and quickly due to her recently ended big effort.
We encourage the mother to speak with her baby, to dry him and to approach him to her breasts.
The newborn do not need to suck up yet. He sucks a bit and enjoys. He feels her mother´s odor which is for him so familiar, as well as he (she) listen her mother´s and father´s voice so well-known to him (her).
All these events should happen in silence. We should keep the deepest respect to them in these so decisive minutes.
While all these moments are happening, we make a courteous and watchful look, observing the baby´s adaptation process to the extra uterine life. We are located in some distance of them.
With these quiet moments, some minutes later arrive the moment of the placental birthing. The placenta appears softly.
We show the placenta always to the parents. This act give her the possibility to better understand and to visualize the internal ambient in which was her baby before the birth.
We ask her some minutes and make carefully and meticulous baby´s examination.
This procedure do make the Pediatrician or we, maintaining always the newborn in skin to skin contact with her belly. We take advantage of this moment to clean, to cut and fix the clamp of the remainder umbilical cord. After a few days the clamp and the remainder cord will fall.
We ask the mother her permission to weigh the baby, taking care of her continuous glance to him.
We make a carefully placental inspection being sure of her complete integrity as well as the well uterine retraction.
Occasionally we must suture some lacerations and normally we make it with local anesthesia in some minutes with the baby preferably in mother´s hands.
Al these events normally take some 20-30 minutes.
After we clean the mother gently we propose her to rest in this intimate ambient, preferably with mild light in her room together with her child. During these first two hours we must be sure about the suitable womb retraction and the beginning of the breast feeding.
This can be the appropriate moment in which the rest of the family congratulate the mother and meet the child.
This is the real task we think about in each birth. We can say that always results marvelous!
Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar
Johana, Emerson y Aldair
Uninterrupted Mother-Son tie. Part II
In the first section of this narration, we commented about the crucial importance, for the mother and her child, of the uninterrupted link between them during the first hours after the child´s birth.
Who accompany the mothers and their children should be very carefully and respectfully in such relationship that begins between them immediately after the birth, trying to do nothing to interfere or interrupt this tie so crucial for both of them.
We only support with a thoughtful and alert look, from some distance and through it we can easily identify any change or deviation of the natural or normal process, such that merit some minimal correction.
The arrive of the rest of the family to congratulate the mother and know the child should be gradual, short, joyful, trying to not distract them from such so important link between the mother and her child.
In home deliveries the task for us is easy: The mother and her newborn are in their home! For both we repeat: Is their home, their ambient. For both is familiar.
All flows easily. Both will be this day and the next days in the parent´s bedroom. There and very near will be the bassinet. It will be near them their bathroom.
The newborn will have his clothes. The mother will can dress his child with the clothes such she, with love and patience, selected for this moment. The bassinet will have surely an embroidery blanket for one of the grandmothers!
All this and much more, give us the possibility to obtain an intimate ambient, so essential for them and for their mutual understanding.
The human being is a mammal. For the mammals the direct contact with the baby´s body, skin to skin, is indispensable and determinant for their development. It would be babies with different character and personality: Some of them would like to be virtually all day “pasted” to the mother, others not so. The most important is to adapt to their needs.
The first breast feedings days are not easy. They require patience and calm and the most important a lot of intimacy between the mother and her baby.
Another very different reality occurs when the birthing it produced in a Panamanian Hospital: State or Private Hospital!
For us Obstetricians and Pediatricians the task is much more complicated. We must say: almost titanic!
1- Some minutes after the birth the newborn is detached from her mother and transferred in a transportable incubator! in another floor of the building. The nurses promise the mother “to carry” the baby to her room that is located in other floor three, four hours later!
2- When they give the baby to the mother, the hospital personal “allow” the mother be with her baby maximal two-three hours with the idea to carry the newborn once again to the Rooming In , “to watch over” him until the next turn!
3- During all this time a lot of members of the hospital´s team, like nurses, assistants come in to the mother´s room frequently, during the days of her permanence in the hospital, during the day and at night, measuring her body temperature, pulse, etc.
In the Rooming In, they assure the mother that the baby don´t receive any artificial milk. They explain that occasional they give them some “serum” (water with sugar). The result is absolutely discouraging: The baby arrives to the mother´s room asleep, without hunger. She try to breast feed him and nothing: “he do not want”, “he do not like my milk”. I “ do not produce milk”: These are the unanimous mother´s protests!
The baby became nervous, because she is stressfully.
4- When at the end of their permanence in the hospital and they return to their home, the hospital give away them some artificial tins milk if the baby need because the mother milk production is not enough!
In our country there are only three States Hospital with the UNICEF´s designation: “Children Friends Hospital”. That means: In these hospitals is prohibited the use of feeding bottle for infants and exclusively breast feeding.
Only to give one example: In Sweden, one of the best healthcare lands of the world, all the Maternity Care Hospitals have the United Nations recognition through the UNICEF of “Children Friends Hospitals”.
We believe and are anyway confident that in our country the things are changing. The woman and their families are asking for.
Although still timidly, in some Hospitals of Panama City there are some changes and they are discussing how to make them.
In our mother´s honor and their children invite them to continue in this direction!
Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar