Immediate Skin-to-Skin Contact Post-Birth: An Essential Standard of Care

A recent review finds that immediate skin-to-skin contact — placing the naked newborn on the mother’s chest within the first hour — improves early breastfeeding and short-term physiologic stability.

The review pooled randomized trials across settings and concludes that uninterrupted contact in the first hour increases breastfeeding initiation, supports thermoregulation, and stabilizes cardiorespiratory measures.

The findings sharpen the rationale behind WHO and other authorities' recommendations by showing consistent effects across trials. Reduced neonatal stress and improved physiologic regulation translate into higher rates of exclusive breastfeeding at one month and more optimal early neonatal blood-glucose and temperature control, reinforcing that skin-to-skin is a low-cost, low-risk intervention that supports bonding and reduces unnecessary separation.

Methodologically, the update synthesizes randomized trials rather than observational reports, increasing confidence in short-term outcomes but stopping short of large-scale long-term endpoints. The pooled evidence reports consistent benefits for breastfeeding initiation and early physiologic measures across diverse settings; where trials differed, benefits remained directionally similar. These trial-level data strengthen the ethical and clinical baseline for neonatal management by reducing equipoise for trials that withhold immediate contact.

Operationally, universal immediate skin-to-skin contact implies deliberate changes to delivery-room workflow and unit processes. Delivery pathways need configuration to maintain uninterrupted contact after both vaginal births and uncomplicated cesarean deliveries, including adjustments to the timing of routine procedures. Staff training and clear protocols help teams prioritize early contact while monitoring maternal and neonatal needs. Unit-level documentation and quality metrics should capture provision and reasons for separation so teams can audit practice; concise prebriefs and warming strategies reduce variability.