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The first hours after birth are a developmentally distinct time for a baby and there are well documented short and long term physical and psychological advantages when a baby is held skin to skin during this time. When a baby is in skin to skin contact after birth there are nine observable newborn stages, happening in a specific order, that are innate and instinctive for the baby. Within each of these stages, there are a variety of actions the baby may demonstrate. The baby may do one, some, or all of these actions.

Stage 1: The Birth Cry

The first stage is the birth cry. This distinctive cry occurs immediately after birth as the baby’s lungs expand.

Stage 2: Relaxation

The second stage is the relaxation stage. During the relaxation stage, the newborn exhibits no mouth movements and the hands are relaxed. This stage usually begins when the birth cry has stopped. The baby is skin to skin with the mother and covered with a warm, dry towel or blanket.

Stage 3: A wakening

The third stage is the awakening stage. During this stage the newborn exhibits small thrusts of movement in the head and shoulders. This stage usually begins about 3 minutes after birth. The newborn in the awakening stage may exhibit head movements, open his eyes, show some mouth activity and might move his shoulders.

Stage 4: Activity

The fourth stage is the activity stage. During this stage, the newborn begins to make increased mouthing and sucking movements as the rooting reflex becomes more obvious. This stage usually begins about 8 minutes after birth.
During the activity stage, the newborn could:
• keep eyes open,
• look at the breast, j
• salivate to the point of dampening the mother’s skin,
• root by moving his or her mouth from side to side over the skin by

rubbing the cheek against the mother’s chest,
• move his or her hand to the mouth,
• move his or her hand to the mother’s breast and back to the mouth,
• protrude the tongue,
• look at his or her mother (although some babies wait to do this until a

If you are on medications or anything that might impair your strength or ability to Slay awake when holding the baby. be sure someone else can help you care for the baby and hold the baby skin \0 skin .

later stage instead),
• massage the breast with one or both hands,
• exhibit high rooting (rooting that includes lifting part of the baby’s torso from the mother’s chest).

Stage 5: Rest

At any point, the baby may rest. The baby may have periods of resting between periods of activity throughout the first hour or so after birth.

Stage 6: Crawling

The sixth stage is the crawling stage. The baby approaches the breast during this stage with short periods of action that result in reaching the breast and nipple. This stage usually begins about 35 minutes after birth.

The crawling stage does not need to involve “crawling.” It could be accomplished through leaping, through sliding (sometimes in conjunction with rooting and questing), or through crawling (sometimes in conjunction with pushing and rooting).

Stage 7: Familiarization

The seventh stage is called familiarization. During this stage, the newborn becomes acquainted with the mother by licking the nipple and touching and massaging her breast. This stage usually begins around 45 minutes after birth and could last for 20 minutes or more.

During the familiarization stage, the baby may touch the mother’s breast, may mouth on his or her own hand, lick the mother’s breast, look at the mother, make soliciting sounds to get the mother’s attention, mouth the nipple, lick the nipple, move his or her hand from his or her mouth to the mother’s breast, protrude the tongue, look at other people in the room, or massage his or her mother’s breast.

Stage 8: Suckling

The eighth stage is suckling. During this stage, the newborn takes the nipple, self attaches and suckles. This early experience of learning to breastfeed usually begins about an hour after birth. If the mother has had analgesia! anesthesia during labor, it may take more time with skin to skin for the baby to complete the stages and begin suckling.

Stage 9: Sleep

The final stage is sleep. The baby and sometimes the mother fall into a restful sleep. Babies usually fall asleep
about IY2to 2 hours after birth.