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Little pink and blue striped stocking caps have become tradition for our babies. We assume they keep our babies warm, but have you ever questioned if they’re really effective (hint: they’re not)? In fact, those little caps could do more harm than good – here’s why.

Baby Smell and Bonding

Newborn babies have a wonderful, almost intoxicating smell. If you’ve had a baby, you know what I’m talking about. If you’re expecting your first, you’ll soon know that joy :) This smell isn’t just to make you sigh happily, however. It has an important biological function and it makes a strong case for taking the hat off your newborn.

Mothers and babies are wired by nature to recognize each other’s smell. Your baby can recognize you on scent alone, and you can recognize your newborn on scent alone. These smells cause the two of you to bond strongly, right away. Nuzzling into your baby’s head feels natural because it’s essential to bonding and breastfeeding. Opt to be skin-to-skin with your baby, with no hat between you. You want to smell your baby, not fabric.

A Safe Third Stage

The smell of your new baby’s head isn’t just important for bonding, it’s important for your safety and baby’s well-being. The olfactory system expects certain cues right after your baby is born – these cues are supplied by the smell of your baby’s head as you snuggle with him or her after birth (it’s an even stronger cue than breastfeeding).

This trigger to your olfactory system (and limbic system) cues a massive rush of oxytocin, the “mothering hormone.” Oxytocin causes your uterus to contract, which shears the placenta from the wall of the uterus and forces an instant constriction of the blood vessels that were running to the placenta. This means a safe, effective third stage of labor for you (Odent, 2013).

This oxytocin high is also important for your mental well-being and for your baby. Your high levels of oxytocin increase your baby’s levels of oxytocin (in fact, they increase the oxytocin levels of everyone in the room!), which causes a stronger bond. It’s what’s responsible for the euphoria felt after natural childbirth – nature’s built-in safety and reward system. It’s triggered by snuggling and smelling your baby with no hat in the way.

Keeping Baby Cozy

Studies done decades ago proved conclusively that stocking caps do not help keep baby heads warm (Coles, 1979; McCall, 2010). They’re just ineffective. In fact, studies also show that the belief “we lose most of our heat through our heads” is also false (Pretorius, 2006). Hats on newborns may actually cause their heads to overheat. So how do we keep our newborn babies warm? Nature has the answer, and NICU units around the world already use it: you keep your baby warm.

That’s right, your body keeps your baby’s body at the correct temperature. It was designed to. In fact, you not only keep your baby’s temperature regulated, you also regulate your baby’s breathing pattern, heart rate, and even blood sugar levels (Ludington-Hoe, 2006). All of that magic happens when your baby is skin-to-skin with you and your body adjusts your temperature to keep your baby at the perfect temperature. NICU units call it “kangaroo care” – it works with preemies and full-term babies.

Keep your newborn skin-to-skin on your chest. A blanket can go over both of you to keep you cozy, and no hat needs to come between you and that powerful, precious baby smell.

Sources

Odent, Michel. “Preventing Postpartum Haemorrhage.” Midwifery Today. Spring 2013: 18-19.

E C Coles, H B Valman Br Med J. 1979 September 22; 2(6192): 734–735.

McCall EM, Alderdice F, Halliday HL, Jenkins JG, Vohra S. Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD004210. DOI: 10.1002/14651858.CD004210.pub4

Thea Pretorius, Gerald K. Bristow, Alan M. Steinman, and Gordon G. Giesbrecht
Thermal effects of whole head submersion in cold water on nonshivering humans
J Appl Physiol August 2006 101:669-675; published ahead of print April 13, 2006, doi:10.1152/japplphysiol.01241.2005

Ludington-Hoe SM, Lewis T, Morgan K, Cong X, Anderson L, Reese S.
J Obstet Gynecol Neonatal Nurs. 2006 Mar-Apr;35(2):223-31.


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27 Comments

  1. I LOVE the focus on scent! I’m a big fan of this blog and all of the informative articles. We’re trying to conceive, and my favorite are the birth stories here :) . But a close second would be the discussions on homeopathics. I got to looking at the importance of scent when I was working in a Pediatric ICU and saw some studies on how infants are impacted by scent. I made a blanket and mom can apply her scent on it- for nap time or for any time when mom isn’t there. Scent is SO cool!

    Reply

  2. Yes, skin-to-skin, a baby may not need a hat to maintain proper body temperature. But baby can’t be skin-to-skin against mama all the time, and at those times perhaps a hat may be necessary. Sometimes a hat is just a hat, and not a plot to divide mama and baby or interfere with bonding. If a mom is spending time with her newborn skin-to-skin (as any breastfeeding mama would be), I’m not convinced a baby hat is going to make or break the relationship. Let’s focus on the biggies, please? And trust that mamas know when there babies need (or don’t need) extra clothing for warmth.

    Reply

  3. Thanks your input Melanie. I also used to minimize things like a hat on the baby and how that might affect bonding, thinking about only the “big wins” like avoiding medication, etc. It wasn’t until I really started digging into things that I realized how important this complex interplay is for both mom and baby, and how even the simple things like putting a hat and swaddle blanket on baby, having the room full of chatty admirers, etc. can interfere. When you think about how smell is an important cue for the 3rd stage of labor, and how we regularly hear about how postpartum hemorrhage “almost killed me” from mothers, it doesn’t seem so insignificant.

    Also, I’ve breastfed all of my babies and breastfeeding does not necessarily mean skin-to-skin. It’s possible to breastfeed and have almost no skin contact except for the baby’s lips! It’s no wonder breastfeeding is hard to establish when what’s normal isn’t happening or is even minimized as insignificant.

    I believe that it’s a mother’s choice to put a hat on, swaddle her baby, or dress her baby how she wants (for the record, I swaddle my babies and love cute baby hats) – but you’re not the one shoving a hat on your newborn’s head right after birth. Would you even think to do that in an undisturbed birth?

    I’m not out to overwhelm any mother, but it IS important to inform mothers about what happens during ALL stages of birthing. Just as simple things like ringing phones and extra people in the room can totally interrupt a mother in early labor, simple things like hats and midwife hands and excess chatter can interrupt the third stage of labor and they can get in the way of bonding.

    I believe in giving the mother all the information and letting HER decide what is big and what is small :)

    Reply

    • I really enjoy reading all of these articles and fully believe everyone is entitled to their own opinion. I would just like to share a short version of my birth story. I arrived at the hospital just in time to give birth (my husband almost missed it). Myah was born, the nurses placed her on my chest (on top of my gown) cleaned her up and the doctor told me it was time to birth the placenta all at the same time, just as this was happening I was getting a shot of oxytocin in the thigh. I had about one push and out came the placenta fully intact. I did not have any stitches or anything so it was pretty simple clean up, weigh the baby and my they let my husband out to go get family. Within 5 minutes of my daughter being born our entire family was in the delivery room. (Porbably 15 people). I was frozen and my babies temp was a little low. So they wrapped each of us in a warmed blanket and my babe with a hat. Anyways to get to my point. Myah is now two and a half and we are more bonded then I ever could have hoped for. She is surpassing all of the milestones for her age, she is a healthy, smart & loving little girl who had a hat and didnt get full on skin to skin contact that much. I for sure loved her, held her, snuggled her, read to her, sang to her, rocked her and all those wonderful things. She was bottle feed from the start. Anyways in the end all I wanted to say was not all things apply to everyone. The biggest thing about becoming a Mom is learning from your own experiences. I enjoy reading your posts and am not saying I disagree with this one just that somethings arent always accurate for everyone.

      Reply

  4. A very informative and well researched article. Anyone maligning the information presented has most obviously not read the research or science behind the assertions here. To blatantly refer to these interferences in physiologic third stage as small in impact, shows a complete lack of knowledge and education. If you aren’t convinced of the importance of No Hatting, No Chatting, No Patting you need to get up to speed with the science. Its available for everyone.

    Reply

  5. Been preaching this for years….there is even more….all your readers should take my NO HATTING CHATTING OR PATTING online course! aamioptions@gmail.com for more info
    It is amazing to me how much resistance there is to NOT doing something to baby. Hats do not keep newborns warm…..mammas do!

    Reply

  6. [...] Little pink and blue striped stocking caps have become tradition for our babies. We assume they keep our babies warm, but have you ever questioned if they’re really effective (hint: they’re not)? In fact, those little caps could do more harm than good – here’s why. http://modernalternativepregnancy.com/2013/09/06/take-it-off-why-you-should-drop-your-newborns-hat/#… [...]

    Reply

  7. Thank you so much for this! I’ve been working through this idea since first reading.

    Reply

  8. I am 100% for bonding and skin to skin…I am an IBCLC & work in a Baby Friendly Hospital as a L&D nurse. I have not read the studies that you refer to….and I totally get how evolution as prepared our bodies to procreate successfully. I do wonder, however…. the studies that were conducted decades ago…were they done in institutions that had air conditioning vents and climate controlled rooms. the Labor room is a much colder place than it used to be simply due to technology around that helps to control a laboring woman’s comfort…and most of them like it cold…having a baby is hard work. I’d like to see a modern study on newborn heat loss through the head…..Just curious.

    Reply

  9. I like this, and followed it when holding my baby. I guess I just see that there are times when a hat wouldnt hurt, like car rides or walking outside in winter. When momma can’t be holding the baby skin to skin. Arguements about how/why we shouldnt do those things aside, I mean most women birth in a hospital and this time of year, where I live, I think a hat would be wise to get to the car. But when your just chillin on the couch I dont see the need for it.

    Reply

  10. I’m a Midwife who had all 4 of my babies at home. The ones born in winter or cold weather wore hats. The hats began to smell like my babies after the first day. I also practiced Attachment Parenting and nuzzled & sniffed my babies heads often. There is so much to worry about in this world and this should not be one of them. Whether your baby has a hat on or not, nuzzle & sniff them often, sleep with and breastfeed them and all will be fine!

    Reply

  11. Does a waterbirth diminish the smell of the newborn? Would it dilute the smell of the amniotic fluid on the baby itself?

    Reply

  12. “…It wasn’t until I really started digging into things that I realized how important this complex interplay is for both mom and baby, and how even the simple things like putting a hat and swaddle blanket on baby, having the room full of chatty admirers, etc. can interfere…”

    well, as a mom of a nicu baby from another country that does not encourage kangaroo cuddling…i don’t believe that swaddling blankets, hats, or a room full of chatty admirers has hindered my relationships with either of my children.

    my first was born into a room like that (loud and chaotic) and she was nursed for 18 months and we are great friends today (she’s 7)…my son had no opportunity for that because he was whisked away into the nicu and i barely got to touch him 5 minutes a day…and i am still gladly his “MOMMA!” as he hollers with great smiles 100 times a day (now he’s 1).

    so, as interesting as this article was, i would say that i have two children, one that wore hats and was swaddled and was born into loud, lovely, family chaos; my second was whisked away, incubated, and barely touched === and both know i’m their momma. never a doubt in their minds. and my bond has never been weak because of either situation.

    so, the hat, to me, is purely an accessory…and quite a cute one at that :)

    Reply

  13. I love the smell of my little boy’s hair! He’s 5 now, and I still grab him up to smell his head!

    Reply

  14. When my second son was born by vbac I was able to cuddle him much earlier than my first. We didn’t bathe him fully until he was about a week old and his smell was just intoxicating! I never understood the ‘baby smell’ until then! I had him on my chest skin to skin almost constantly for his first two days of life with just a blanket over us. I don’t think our families were too happy I was constantly nursing and cuddling and not passing around a swaddled pacified baby but every time someone would hold him he’d scream until he came back to me. All of that helped me to finally successfully breastfeed and have a much stronger bond with him!

    Reply

  15. I was wondering why when I posted to Facebook a picture of a baby getting it’s tongue clipped appeared? Thanks so much for the article I loved it.!

    Reply

  16. Hmmm, as a mother who had a baby in a NICU for two months this article is only partially right. Yes the NICU does skin to skin, but that is how they have you hold your baby when you are going to hold them, and most of the time they still put a hat on them. For a lot of preemies they actual limit the amount of time they allow you to hold them. All the rest of the time my daughter was actually in a temperature/humidity controlled incubator and even then they often had a hat on her. When she finally graduated from that she spent any time she wasn’t in my arms in a bassinet swaddled up nice and tight with a hat on. I’m not huge on putting hats on my kids when they come home but I leave the hat on at the hospital and have never noticed it as a hindrance to bounding with any of my kids. Even with a hat on they smell delicious!

    Reply

  17. [...] This is a really interesting article suggesting that we should not be putting a cap on our babies right away.  We should  keep them skin to skin with the mother and  baby covered together. I’ve always known that it was a great way to promote breast feeding and helped to regulate the babies breathing and heart rate.  But the smell of your babies head aids in starting the process of your uteruos contractions as well!  our bodies are miraculous things. Check it out! [...]

    Reply

  18. There are some great points here! I think I had the little cap on my baby’s head in the hospital but he never kept it on so I didn’t bother once we got home – unless we were going outside in the cold, then he had his hat on along with coat, etc. I’m assuming outdoor and proper dress is not what is being talked about here. I am in the process of making 70 preemie crochet hats for the NICU here in town, which is a big undertaking for me. I’m thinking when they can’t be in their mama’s arms, they can at least have a nice hat on.

    Blessings,
    Nicole

    Reply

  19. this was the result of one study; as a NICU nurse I have personally witnessed babies getting cold that dont have their heads covered while in kangaroo care. I have the most experience with preterm infants. Our facility uses plastic lined caps for very low birth weight babies and caps without the plastic. Definitely made a difference keeping the temps stable. Please everyone use your best judgement. Putting a cap on their head will not decrease bonding. This is one opinion and I’m sure there are many.Further research is needed before you stop putting caps on babies heads! Hypothermia can cause an infant who is already compromised to spiral downward into a deadly sequence of events.

    Reply

  20. So — a baby will overheat by wearing a hat, but won’t overheat when pushed up against a hot mama who is covered by blankets? The mama has a greater ability to make heat than the baby, which means all that excess heat will be trapped under the blanket and cook the baby — if it is possible for the tiny baby (much less inner mass) — to cook itself with a hat. Logic fail. Another fail, that a mother can’t smell her baby even though the baby is wearing a permeable cloth hat. I smelled my babies no matter what they were wearing. Experience fail. Bonding doesn’t happen if you can’t snuggle with baby right away? Major experience fail, right there — got a friend who bonded beautifully with the baby she adopted from China at over a year old. No, what’s the _real_ reason for this very strange superstition?

    Reply

  21. Use your judgement. If your home is chilly, then keep a hat on the newborn. Definitely, when the babe is going to be taken out of the house.

    100 years ago, even adults wore sleep caps, because their homes were on the chilly side. A few years ago, I was trying to go to sleep in a chilly bedroom and I couldn’t seem to be quite comfortable. I reached up to smooth my hair and was surprised at how cold my hair was. I got out of bed and found a knitted cap to wear. After a minute in the bed, with the cap on my head, I started feeling a wonderful sense of coziness and comfort. And, my head felt toasty warm! I fell asleep a lot faster than usual that night. So, for the past three years, I have used a sleep cap every night during the chilly months. I mentioned this to a few family members and they have tried it and love it! Now, I mention it to anyone, especially bald men. My hubby has slept with something around his head all his life and now that he is bald, he needs it more than ever.

    I think taking that comfort away from a newborn is a mistake. You don’t have to take away a cozy cap in order for them to bond with you. You can tell when they are too warm; they will fuss and the face will be red. My newborns were taken home to a draft free, warm home. They didn’t need the caps while indoors after a month, but wore them everytime they left the house. Too much wind on delicate ears can cause earaches to flare.

    Reply

  22. I agree with the nurse above… As a neonatal pediatric specialist in respiratory medicine, I have witnessed the decisive benefit of capping our little newborns versus abandoning this practice. While the scent based benefits of the original anecdote are possible, I have yet to hear of a failed bonding experience based on the fact that the baby was wearing a hat. In addition, it’s entirely contradictory to state that wearing a hat does not aid a baby in retaining heat, and then claim in the same breath that wearing one might cause them to overheat.

    Reply

  23. As a Labor and Delivery nurse I can agree that skin-to-skin is best for both baby and mom, especially transitioning right after delivery. I understand the oint of the caps, but I have personally witnessed newborns becoming cold. There are several factors that play into this, mom may be too exhausted to hold the infant or she may be cold herself. I tend to play each scenario case by case. It can become dangerous to make very broad statements. In my experience I believe most of my patients want a safe and natural delivery with a healthy newborn to take home and love. A cold baby can become hypogylcemic and really sick. As this trend is becoming more apparent in the patients I see I do my best to keep the mom covered and the room wam, but a proud momma loves to show of her baby which means uncovering baby, and baby will loose heat. I am going to pass this article on so we are better prepared for these patients. Thank you.

    Reply

  24. I think most commenters are missing the point entirely. I don’t believe this article was suggesting that hats on newborns tossed out completely, babies that wear hats do not bond well with mothers, or even that hats never provide protection against heat loss.

    The article specifically referred to the “Little pink and blue striped stocking caps” hospitals use for newborns and how those particular hats don’t seem to provide any real shield from heat loss. And that *most* babies do just fine when wrapped up with mom. With that said, there are some possible benefits hats-off. I don’t think this article is trying to prove hats-off will improve bonding, but why not take the hats off when they’re not needed and soak up just a little more of that wonderful, intoxicating baby smell!

    Camille

    Reply

  25. OK, folks…
    She never said that putting a hat on a baby will totally destroy the bonding process. She never said that a baby should never ever wear a hat. The discussion here is about best practice immediately after birth. Best practice in a normal birth is generally to keep your cotton picking hands off.
    I have seen a mother DENIED contact with their term, healthy baby because the baby was “a little cool”.
    Would someone please reiterate the FACT that being skin to skin with mother HELPS REGULATE THE BABY’S PULSE, BREATHING AND TEMPERATURE. I would like to scream it in some of the hospitals around here!
    And 97.5 degrees is not too cool for a baby. 97? Put something warm over the baby AS HE IS HELD BY THE MOTHER.

    Reply

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