Table 1.

Widström's 9 Stages

Babies progress through nine observable, instinctive stages during the first hour after birth when in immediate, continuous, and uninterrupted skin-to-skin contact with the mother. Stage 8 is suckling, the first experience of breastfeeding.

1. The birth cry is a distinct and specific cry as the baby's lungs expand for the first time.

2. Relaxation is a time immediately after the birth cry ends, when the baby becomes still and has no visible movements.

3. Awakening begins as the baby opens the eyes for the first time, blinks, has small mouth movements, and limited hand and shoulder motions.

4. Activity involves larger body movements, including whole arm motions, specific finger movements, shoulder motion, head lifting, and stable open eyes.

5. Rest could happen at any point during the first hour, interspersed between stages or as a transition between stages.

6. Crawling involves the baby moving purposely toward the breast and nipple. It could be accomplished through sliding, leaping, bobbing, or pushing.

7. Familiarization is a stage at the mother's nipple where the baby licks, tastes, touches, and moves around the nipple and areola area.

8. Suckling involves the baby self-attaching to the nipple and initiating breastfeeding.

9. Sleeping is an involuntary activity of the baby around 1.5 to 2 hours after birth.

Adapted from Widström et al.¹⁹