Continuity of care and nurturing during the first night at home in newborn care

The intrauterine life offers the newborn a highly structured environment, characterized by constant sensory stimuli, thermal variations, and continuous vestibular and auditory inputs. These elements guide the development of the neurovegetative, cardiovascular, and respiratory systems. During gestation, the fetus integrates these signals into complex neural circuits, developing autonomous adaptations that prepare it for extrauterine life.
The fetal brain processes information coming from the heartbeat and the maternal respiratory rhythm, as well as from metabolic and hormonal fluctuations (glucose, oxytocin, cortisol, prolactin), helping to build a basis for efficient physiological regulation.

After birth, in the first hours and nights at home, the continuity of physical contact, of thermoregulation and of respiratory synchronization with the mother promotes the cardiovascular, respiratory, and metabolic stability of the newborn, maintaining consistency with the intrauterine experience. Skin-to-skin contact also stimulates oxytocin secretion, strengthening the emotional bond and promoting a state of mutual relaxation.

The exogestation: continuation of development after birth

The first weeks of life represent the period of exogestation, a term introduced by Michael King to describe the continuation of fetal development in the extrauterine environment. In this phase, the newborn exhibits needs and behaviors consistent with intrauterine life: seeking warmth, the need for frequent feeding, and synchronization with maternal physiological rhythms.
Neurological maturation is still incomplete, and autonomous systems require continuous and consistent input to stabilize. Proximity and parental care therefore function as an extension of the uterine environment, supporting physiological development, metabolic balance, and behavioral regulation.

Mother-newborn unit and physiological regulation

In the first weeks of life, the newborn does not perceive a clear separation from the caregiver but experiences a condition of continuity with the mother, supported by neurophysiological and behavioral evidence. Maternal multisensory stimuli — tactile, auditory, olfactory — are integrated as part of a single regulatory system. This condition is particularly intense in the first 8–12 weeks, but it continues to influence the sense of security and emotional development in the following months.

From a physiological point of view, such proximity:

• supports cardiovascular and respiratory stability
• promotes metabolic and hormonal homeostasis
• contributes to stress regulation
• supports the organization of activity and rest rhythms

For the mother, the relationship with the newborn activates neuroendocrine processes that increase oxytocin and reduce cortisol, promoting the emotional bond, sensitivity to the baby’s signals, and confidence in her own parenting skills.

Continuous contact, together with the father’s presence, ensures sensory consistency and physiological stability. Paternal involvement significantly contributes both to the newborn’s well-being and the mother’s emotional support, strengthening the balance of the entire family system.

The theories of Donald Winnicott and John Bowlby offer an interpretation consistent with these processes: the concept of holding and that of attachment describe how relational continuity and the predictability of parental responses favor the development of security and autonomy.

The first night at home: continuity, security, and relationship

The guidelines of the World Health Organization recommend early and prolonged skin-to-skin contact, as well as the mother and newborn staying in the same room (rooming-in), day and night, unless there are clinical contraindications.

Proximity favors:

• sensory continuity
• on-demand breastfeeding
• thermal and cardiac stability
• strengthening of the emotional bond

Also room-sharing supports these processes, maintaining an environment consistent with the intrauterine one.

During the first night at home, the joint presence of mother and father favors the newborn’s adaptation to the extrauterine environment. The mother responds to the baby’s signals, while the father contributes to practical and emotional support, creating a context of security and stability.

In this phase, the newborn benefits from relational and sensory continuity, which supports physiological balance, behavioral adaptation, and the building of the emotional bond.