ArticleMaternal & child nutrition2020
The nine stages of skin-to-skin: practical guidelines and insights from four countries.
Article in Maternal & child nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Immediate or early skin-to-skin contact for mothers and their healthy newborn infants.The Cochrane database of systematic reviews · 2025Pooled it
- Efficacy of Breast Crawling on Breastfeeding Outcomes, Knowledge, Attitudes, and Anxiety Status After Term Vaginal Birth: A Randomized Controlled Trial.Maternal & child nutrition · 2025Trial
- Initiated Breastfeeding and Physiological Patterns in Newborn Infants When Reunited With Mother After Separation Due to Elective Cesarean Birth.Birth (Berkeley, Calif.) · 2025Trial
- "I Am Going to Take It Up": Implementing Skin-to-Skin Contact in Uganda.Maternal & child nutrition · 2025Article
- The effects of unintended pregnancy on maternal bonding impairment among Japanese mothers: a longitudinal study from pregnancy to one month postpartum.BMC pregnancy and childbirth · 2025Article
- The impact of implementing and sustaining the international guidelines for skin-to-skin contact in the first hour after birth in Uganda.Scientific reports · 2024Article
- Implementing a colostrum-kit reduces the time to first colostrum for neonates admitted to the NICU - a retrospective observational study.International breastfeeding journal · 2024Observational
- Association between combined use of epidural analgesia and oxytocin administration during labor and offspring outcomes: a narrative review and proposal.Nagoya journal of medical science · 2024Review
- Les soins peau-à-peau chez les nourrissons à terme et prématurés.Paediatrics & child health · 2024Review
- Skin-to-skin care (SSC) for term and preterm infants.Paediatrics & child health · 2024Review
- Article
- The thermal consequences of primate birth hour and its evolutionary implications.Biology letters · 2022Article
- The nine stages of skin-to-skin: practical guidelines and insights from four countries.Maternal & child nutrition · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Incorporating systematic evidence with clinical expertise is a key element in the quest to improve quality of care and patient outcomes. The evidence supporting skin-to-skin contact in the first hour after birth is robust and includes significantly improved outcomes for both mother and infant. This paper compares available iterative data about newborn behaviour in the first hour after birth to further describe the observable behaviour pattern and to provide clinical insight for further research. Although the evidence for positive outcomes through skin-to-skin contact are robust, there is a dearth of research specifically focused on clinical practice. The methodology considers the four available data sets that used Widström's 9 stages, which consists of studies from Japan, Sweden, Italy and the United States, examining the parameters of each stage across settings from around the world. This research provides an expanded understanding of the timing of the newborn's progression through Widström's 9 observable stages. We found that newborns in all four data sets began with a birth cry and continued through the remaining stages of relaxation, awakening, activity, rest, crawling, familiarization, suckling and sleeping during the first hours after birth and consolidated the data into a Sign of the Stages chart to assist in further research. The evidence supports making a safe space and time for this important newborn behaviour. Clinical practices should encourage and protect this sensitive period.
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