HUG Teaching: When to Swaddle and When to Put Skin-to-Skin?

My name is Pam. I am a midwife, mother, grandmother, and new Certified HUG Teacher! I live on the Northern Beaches of Sydney in Australia, and work in a local maternity unit. I mainly work with new mothers and their babies from birth to day 7.

Early feeding cue -
bringing hand to mouth
Jan asked me to write a blog about "Early feeding and HUG Techniques and Strategies." The question is: Should you put an unsettled, new baby skin-to-skin, or swaddle the baby to support her and help her settle? A brand new baby needs unlimited access to the breast to facilitate healthy growth in many ways. Newborn babies have a remarkable ability to do “their job” at surviving and getting “mum’s milk in.”

Why more breastfeeding?

Babies know they need extra colostrum to clear the bowel of Meconium, which in turn facilitates the liver to get rid of extra Bilirubin, and therefore reduce the chance of neonatal jaundice. Frequent early feeding also allows many more alveolar receptor cells of the breast to appear. This gives the hormone Prolactin, on day 3-4, more target cells to adhere to. (This influences the milk production for the entire breastfeeding duration for this baby!) Plus the frequent feeding will encourage the milk to “come in” sooner.

Skin-to-Skin first few days increases bonding and
promotes milk supply.
Babies also have a very small stomach (the only size of a small marble) and a fast gastric emptying rate, which makes them hungry all the time! I am constantly telling tired, worried mums that a baby who is unsettled in the first few days is exhibiting NORMAL infant behaviour.

Swaddling should never be used instead of feeding. However, it may be useful for supporting a “cranky” baby. This extra support can help mum calm the baby before she puts the baby to the breast. After breastfeeding his baby may then settle to sleep completely.

Babies are also swaddled and “tucked in” to their little cots right next to mum (when they are asleep). This allows the mother to rest herself, while being in close contact with her baby, helping to recognize feeding cues, and having 24/7 access.

I talk to new mums VERY BRIEFLY about baby’s deep and light sleep cycles, and only BRIEFLY touch on the HUG "Zones and SOSs."  I will discuss all the HUG strategies with her when I visit her at home on days 5, 6 and 7.

CLICK HERE to read a story of Pam using The HUG with a new family.