The first hours after birth are a developmentally crucial time for a baby. There are well-documented short-and-long-term physical and psychological advantages when a baby is held skin to skin during this time. Knowing these steps can help you recognize. Any time the baby is removed from skin-to-skin contact with the mother it restarts the whole process and the baby will start again from the first stage. 

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:  Awakening

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 three minutes after birth. The newborn in the awakening stage may exhibit head movements, opening the eyes, showing mouth activity and moving the 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 eight minutes after birth.

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 thirty-five minutes after birth.

Stage 7:  Familiarization

The seventh stage is called familiarization. During this stage, the newborn becomes acquainted with the mother’s breast. This stage usually begins around forty-five minutes after birth and could last for twenty minutes or more.

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 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 one to two hours after birth.


It’s important to not interrupt the nine stages (unless medically necessary) to avoid issues with breastfeeding. Our practice at WMMC is to respect this crucial hour as we encourage immediate skin-to-skin contact.


Who Can Help

The internet, friends and family, and mother’s groups can all be great sources of breastfeeding tips and support. However, the most reliable source for up-to-date breastfeeding and pumping information is an international board-certified lactation consultant (IBCLC). Any time a mother has a question about whether or not to pump, how to pump, or whether or not she needs to pump and dump, she should contact a breastfeeding professional. In our area, there are many trustworthy breastfeeding resources:

WMMC Lactation Consultants: Ruthie Porter, RN, BSN, IBCLC, Monday – Friday 9 am – 3 pm (660)-262-7519
• Johnson County WIC Lactation Consultants: Tammie Crabtree, IBCLC & Tricia Fleming, IBCLC, Monday – Friday 7:30 am – 6 pm. (660) 747-2012


Source: Dr. Raylene Phillips

Other Recent Posts by WMMC:

10 Fun Facts You Didn’t Know About Breastfeeding

Breast Feeding Myths DeBunked

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About Western Missouri Medical Center

Western Missouri Medical Center (WMMC) is a fully accredited acute care county medical center located in Warrensburg, MO. WMMC prides itself in emergency care, obstetrics, orthopedic and general surgery, family healthcare, internal medicine, outpatient clinics, ambulatory care, rehabilitation services, and more. Inpatient services include medical, surgical, intensive, obstetrical, orthopedic, pediatric, and skilled nursing care, as well as a wide range of therapeutic and diagnostic outpatient services. This institution is an equal opportunity provider and employer. Learn more at