The first hour: what skin-to-skin contact really does for breastfeeding

What happens in the first hour after birth can feel important. But if your first hour looked different from the one you imagined, you have not missed your only chance to connect with your baby or build a feeding relationship.

Skin-to-skin contact means placing a newborn directly against a parent's bare chest, with the baby kept warm and safely positioned. A 2025 Cochrane review looked at what research can tell us about skin-to-skin contact and breastfeeding, and where the evidence still has limits.

What the review looked at

The review included 69 randomized trials with 7,290 parent and baby pairs. It defined immediate skin-to-skin contact as starting less than 10 minutes after birth, and early contact as starting between 10 minutes and 24 hours. The trials compared these approaches with standard hospital contact after vaginal or cesarean birth. Participants were mothers and healthy full-term or late preterm newborns, at least 34 weeks' gestation. Babies admitted to a neonatal intensive care unit were excluded.

What the research found, and what it does not tell us

Across 12 trials with 1,556 pairs, exclusive breastfeeding from discharge to one month was more likely with skin-to-skin contact than with standard contact (risk ratio 1.36, 95% confidence interval 1.19 to 1.56). Across 11 trials with 1,135 pairs, the estimate from six weeks to six months was also higher (risk ratio 1.38, 95% confidence interval 1.09 to 1.74). The authors rated both results moderate certainty. The results differed across trials, so they do not predict what will happen for one family.

The review's summary table gives illustrative group estimates. For discharge to one month, about 548 of 1,000 were exclusively breastfeeding with standard contact, compared with about 745 of 1,000 with skin-to-skin contact (estimated range 652 to 855). From six weeks to six months, the table estimates 593 of 1,000 with standard contact and 818 of 1,000 with skin-to-skin (estimated range 646 to 1,000). These are estimates for groups in the review, not a prediction for an individual family.

For newborns, skin-to-skin contact probably increased underarm temperature by an average of 0.28 °C (95% confidence interval 0.14 to 0.41), measured 30 minutes to 2.5 hours after birth. The authors said this difference was not clinically meaningful. Blood glucose was also probably higher, by an average of 10.49 mg/dL (95% confidence interval 8.39 to 12.59), across three trials.

For parents, skin-to-skin may make little or no difference to the time until placental separation. Its effect on postpartum blood loss is very uncertain. Both findings came from few studies and varied widely.

No included trial met all criteria for high-quality methods and reporting. Parents and staff knew who received skin-to-skin contact, and no trials were conducted in low-income countries. The review does not show that skin-to-skin guarantees breastfeeding or that a different start means feeding will not go well.

A first hour is not a test

Birth can involve a cesarean, extra monitoring, a need for medical care, or time apart. Sometimes a parent or newborn needs support before skin-to-skin is possible. If that happened to you, it does not mean you did anything wrong. Your care team can talk through what contact and feeding support are appropriate for your situation.

Feeding can take different paths, and you deserve support without treating one moment as a measure of how well you are doing.

At Milkwell, we believe feeding support should meet you where you are. If you have questions about feeding your newborn, you can learn about our lactation consultations at milkwelllactation.com/lactation-consultations. A lactation consultant or your clinician can help you explore your specific questions. This article is general education, not individualized medical advice.

Sources

Moore ER, Brimdyr K, Blair A, et al. Immediate or early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews. 2025;10:CD003519. Published October 22, 2025. https://pubmed.ncbi.nlm.nih.gov/41120189/