I caught up briefly with Suzanne Colson at the Midwifery Today conference last month, and was really interested to hear about her take on a possible explanation for the possible link between maternal breastfeeding position and sudden unexpected postnatal collapse (SUPC) in healthy term babies. I have been quite concerned about the implication that breastfeeding and skin-to-skin contact may be linked with SUPC, for I find it hard to see how such things could be intrinsically dangerous to our babies. So I was really interested to hear Suzanne’s thoughts about the possiblility that the angle of the mother’s body slope may be a key factor in this.
And yes, that’s a lot of possibles for one paragraph, but we need to be clear that these are all theories, and we need more research into all aspects of this.
Suzanne has long argued that certain maternal body positions (namely lying supine and sitting upright, both of which have become cultural norms in many areas) may be less advantageous than a supported semi-reclining position, and she is now asking whether this biological nurturing (laid-back breastfeeding) position may also be protective of neonatal breathing. Happily, she has recently written an article about this, and the nice people at Clinical Lactation have made the pdf of the article available for free here. Suzanne also raises important points about maternal and neonatal competence, which is a subject close to my own heart, and I would thoroughly recommend reading and pondering this article.
Colson S (2014). Does the Mother’s Posture Have a Protective Role to Play During Skin-to-Skin Contact? Clinical Lactation 5(2): 41-50.
Abstract: Skin-to-skin contact during the first hour following birth is the gold standard in breastfeeding. Although consecutive meta-analyses report no adverse effects, a recent review shows an increase in idiopathic sudden unexpected postnatal collapse (SUPC) in healthy term babies identifying three main risk factors: skin-to-skin contact, breastfeeding, and baby lying prone. Concurrently, authoritative visual materials tacitly promote maternal supine postures illustrating the breast crawl, a form of birth skin-to-skin contact. The naked baby lies on top of his or her mother’s body, in close ventral contact with torso parallel to the floor—a position strongly associated with sudden infant death. Biological nurturing (BN) research, the first to examine maternal postural effects on breastfeeding success, suggests that a semireclined maternal position is optimal for breastfeeding initiation. The maternal body slope ensures that the baby lies tilted, a position known to promote oxygenation. The angle of maternal recline, a variable central to BN but hitherto ignored in the skin-to-skin and SUPC literature, is unrelated to dress level. This commentary develops a postural argument to increase understanding of the potential role played by the maternal body slope to reduce the risk of idiopathic SUPC.