You may have heard about the Golden Hour during a breastfeeding class, or from a friend. What is this magical time? What does it mean? What happens if you miss it? Is it actually magic? The technical definition is “a set of evidence-based practices that contribute to the physiologic stabilization of the mother–newborn dyad after birth”.
There are things you can do and advocate for in the first 60 minutes after you bring your baby earthside that can make some magic for your feeding relationship. In reality, babies are born primed and ready to take their cues from their environment and their birthing parent. They’re born waiting, watching, listening, smelling, and tasting. If you send them the right messages, they’ll all respond the same way. We’ll go over a “best case scenario”, and then some modifications and provisions for what happens when things don’t go according to plan.
The benefits of the Golden Hour are many! Better outcomes for lactation. Thermoregulation for the baby. Decreased stress level in the dyad. Improved bonding. Ideally these are all things you can discuss with your provider before your birth so everyone is on the same page going into the birth. If you have a doula, they can help advocate for these things as well.
Vaginal Birth
Delayed cord clamping
Your baby’s umbilical cord is still actively pumping blood into your baby, even after your baby is born. By delaying clamping the cord until it stops pumping blood, you allow ALL of your baby’s blood to enter their body. This has been associated with better outcomes for term and preterm babies alike, and helps boost their iron stores for months to come.
Skin to skin
Rather than being wrapped in a blanket or a towel, keep your baby skin to skin on your abdomen. Baby can be covered with a warm blanket or towel to keep warm, but otherwise should be allowed to stay in constant contact with your skin after birth. This will set the stage for a successful breast crawl.
Assessments on the birthing parent’s abdomen
All urgent assessments can be performed while your baby is skin to skin.
Delaying all non-urgent tasks
Weights, baths, eye ointments, newborn screen, hearing screen, Vitamin K, Hepatitis B, cardiac screen. So many things to check off the nurse’s list before you go home. Make sure your birth team knows that you plan to delay all of these non-urgent things until after you and your baby have completed the Golden Hour.
Breast crawl/self-initiated latch
If left alone and not bothered, a healthy baby mammal will always make its way to the milk. That means your baby too. After resting on your abdomen, your baby will start to wiggle, scoot, and kick their way up to your chest. You can gently support your baby’s bottom, but resist the urge to “help” or “place” your baby where you want them to go. As they make this journey, their brains are making countless connections that will benefit them later on, and help your feeding relationship go well. Once at the chest, your baby will reach out their arms toward your nipple, then bring their hands to their lips. The little bumps on your areola are actually glands that have a specific smell to guide your baby to the right place. After tasting, your baby will start to scoot toward the nipple and bob their head around, licking, smelling, and tasting your skin. Eventually, they’ll self-attach to the nipple and begin the first feeding.
First feeding uninterrupted
It’s crucial that no one interrupts or bothers your baby while they’re attempting this first feeding. Sometimes people want to “help” by shoving a baby’s face toward a breast, or pinching a nipple into a baby’s mouth. This is the opposite of helpful and will interrupt all the connections you want your baby to make during the Golden Hour. This is your time to gently hold your baby, stroke their face, study this person you just brought into the world. Don’t focus on the clock, or switching breasts, or anything. Just let this feeding happen until your baby releases the nipple on their own.
Belly Birth (Cesarean Section)
Skin to skin
This is more likely with a planned cesarean section, although it can always be requested. In emergency situations, separation may happen. Even with a planned cesarean, baby can be weighed and have vitals taken before your surgery is done. By the time you get back into the recovery room, your baby could be 30 minutes old. Skin to skin as soon as possible has benefits for both.
Breast crawl
This usually does not happen after a cesarean, whether scheduled or in an emergency situation. Medication given during this procedure is safe for the baby, although it often leaves infants feeling more tired and often disorganized after birth. This will wear off, but it can impact their ability to perform the breast crawl. This can be stimulated at another time, when both the birthing parent and infant are up for it.
First Feeding uninterrupted
Research has shown that expressing milk within the first hour post delivery is associated with improved outcomes in lactation. Due to this, your health care team may encourage you to nurse within the first hour or two, but this can be difficult after a cesarean. You’re required to lay flat for at least a couple of hours post delivery, and possibly longer for emergency situations, relying on others to even place your baby on your chest for skin to skin. Luckily, hand expression to express milk can be done in the absence of nursing directly at the breast/chest.
We mentioned “in a perfect world”, right? In a perfect world, it’s best to keep the environment warm, dimly lit, quiet, and calm. No people rushing in and out, no visitors, no shouting, no bright lights, cold breezes, or chaos. We also know that in reality, the unexpected happens. If your baby is in distress, it’s always better to put their health and safety before a birth plan if it comes down to it. If you miss your “Golden Hour”, a skilled Lactation Consultant can actually work with you at home to recreate it! We use some of these techniques often in specific circumstances where there are feeding challenges. We can assess what connections your baby might have missed, and come up with a plan to make those connections days, weeks, or sometimes even months after birth. Talk about your postpartum plan with your provider. Look into having a doula at your birth who can help advocate for you. Reach out to a Lactation Consultant if you feel like you and your baby need help getting back on track.
