Skin-to-Skin Contact

Skin-to-Skin Contact (SSC): A low-cost intervention with a high return

There aren’t many interventions in maternity care that are as simple, evidence-based, and cost-effective as immediate, uninterrupted skin-to-skin contact (SSC) after birth. It requires no expensive equipment, no specialized training or technology—yet it improves outcomes for both mothers and babies.

While most birth facilities now practice skin-to-skin immediately after delivery, the challenge is encouraging skin-to-skin for as much time as possible during the first hours and days of life.

The Benefits

Skin-to-skin is more than a beautiful bonding experience—it’s a powerful physiologic intervention.

Research consistently demonstrates that early and prolonged skin-to-skin contact:

• Improves breastfeeding initiation and exclusivity

• Increases the likelihood of exclusive breastfeeding at hospital discharge and beyond

• Promotes more effective infant feeding behaviors and latch

• Stabilizes infant temperature

• Improves cardiorespiratory stability

• Reduces infant stress and crying

• Supports maternal oxytocin release, enhancing milk production and uterine involution

• Strengthens maternal confidence and parent-infant attachment

• Reduces NICU admissions for at-risk infants in some populations

Skin-to-Skin and Hypoglycemia

Late preterm infants, infants of mothers with diabetes, large- and small-for-gestational-age infants, and other newborns at risk for hypoglycemia benefit tremendously from remaining skin-to-skin whenever medically feasible.

Studies have shown that maintaining skin-to-skin during the transitional period can:

• Improve glucose homeostasis

• Reduce the need for intravenous dextrose

• Decrease NICU admissions related to hypoglycemia

• Encourage earlier and more effective breastfeeding

• Help infants conserve energy by maintaining normal body temperature

Rather than separating these infants for routine observation and testing, many can safely remain on their mother’s chest while receiving close monitoring and frequent feedings.

One Small Habit Change Can Make a Big Difference

One of the simplest ways to normalize skin-to-skin care is to change our own behaviors. Do we routinely swaddle babies after assessments and then hand baby to mom? Do we tell mom that baby’s temperature is “a little low,” then double swaddle and hand baby to mom? Instead of automatically wrapping the newborn in blankets try handing the baby directly to the mother for skin-to-skin, and then take the opportunity to teach her about the benefits of keeping baby in SSC for at least an hour at a time.

This small change sends a powerful message:

“The normal place for a healthy newborn is on the parent’s chest.”

Blankets can be placed over the baby while skin-to-skin is maintained, allowing warmth, bonding, and breastfeeding to begin naturally. When healthcare professionals consistently role model this practice, parents quickly recognize that SSC is an important part of newborn care.

Teaching Parents

Families often assume skin-to-skin is only important during the “golden hour.” We can help them understand that the benefits continue beyond this time. We can teach them how to safely implement SSC and encourage them to:

• Hold their baby skin-to-skin immediately after birth whenever possible

• Continue frequent skin-to-skin throughout the hospital stay

• Practice skin-to-skin before feedings to encourage feeding cues and improve latch

• Use skin-to-skin when the baby is sleepy or reluctant to feed

• Comfort fussy infants with skin-to-skin rather than immediately reaching for a swaddle or pacifier

• Include partners whenever the mother is unavailable, as partner skin-to-skin also supports infant regulation and bonding

Of course safety is paramount, so include the education that at least one adult is awake and alert and observing the infant while in SSC. If both partners are too drowsy, SSC should be discontinued and baby wrapped and placed securely in bassinet.

Role Modeling Matters

Parents learn more from what they see than from what they hear.

• Place the baby directly on the mother’s chest

• Delay unnecessary interruptions

• Complete assessments while the baby remains skin-to-skin whenever possible

• Encourage skin-to-skin before glucose checks and feedings

• Explain why skin-to-skin is beneficial

When nurses routinely model these behaviors, families begin to see that skin-to-skin is a routine part of the early transition for baby.

Whenever medically appropriate, keep mothers and babies together—not separated.

The most effective skin-to-skin intervention isn’t complicated. It’s simply making sure babies spend as much time as possible on their parent’s chest during the first days of life.

Cochrane Review 2025

One of the most thought-provoking conclusions from a 2025 Cochrane Review on skin-to-skin contact, isn’t about breastfeeding or temperature regulation—it’s about research ethics.

After reviewing nearly three decades of evidence, the authors concluded that there is now sufficient evidence supporting immediate, uninterrupted skin-to-skin contact that future randomized controlled trials assigning healthy newborns to routine separation (”usual care”) may no longer be ethically justifiable.

The question is no longer, “Does skin-to-skin work?” The question is, “Why are healthy mothers and babies being separated?”

As maternity professionals, we have an opportunity—and a responsibility—to make uninterrupted skin-to-skin contact the expected standard of care and to support continued SSC in the early days. With every routine process we should begin with asking ourselves one simple question: Can this be done while the baby remains skin-to-skin? When the answer is yes, that’s exactly where the baby should stay.

Skin-to-skin contact is safe, feasible, inexpensive, and profoundly effective.

SSC supports breastfeeding, improves newborn transition, and strengthens the earliest relationship a baby will ever have. So then next time you are swaddling a baby to hand to parent - consider a slight change in practice - hand the baby over for SSC and encourage this amazing intervention.

References

1. Academy of Breastfeeding Medicine. ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term. Academy of Breastfeeding Medicine. Updated 2024.

2. Chiruvolu A, Miklis KK, Stanzo KC, Petrey B, Groves CG, McCord K, Qin H, Desai S, Tolia VN. Effects of skin-to-skin care on late preterm and term infants at risk for neonatal hypoglycemia. Pediatr Qual Saf. 2017;2(4). doi:10.1097/PQ9.0000000000000030

3. Moore ER, Brimdyr K, Blair A, et al. Immediate or early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2025;(10). doi:10.1002/14651858.CD003519.pub5

4. World Health Organization. Immediate KMC for Preterm or Low Birth Weight Infants. World Health Organization; 2022.

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