Early skin-to-skin contact for mothers and their healthy newborn infants

  • Review
  • Intervention


  • GC Anderson,

  • E Moore,

  • J Hepworth,

  • N Bergman

Dr Gene Anderson, Edward J and Louise Mellen Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio, 44106-4904, USA. gca@po.cwru.edu.



Early skin-to-skin contact involves placing the naked baby prone on the mother's bare chest at birth or soon afterwards (< 24 hour). This could represent a 'sensitive period' for priming mothers and infants to develop a synchronous, reciprocal, interaction pattern, provided they are together and in intimate contact. Routine separation shortly after hospital birth is a uniquely Western cultural phenomenon that may be associated with harmful effects including discouragement of successful breastfeeding.


To assess the effects of early skin-to-skin contact on breastfeeding, behavior, and physiology in mothers and their healthy newborn infants.

Search strategy

The Cochrane Pregnancy and Childbirth Group and Neonatal Group trials registers (December 2002), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2002), MEDLINE (1976 to 2002).

Selection criteria

Randomized and quasi-randomized clinical trials comparing early skin-to-skin contact with usual hospital care.

Data collection and analysis

Two reviewers independently assessed trial quality and extracted data. We contacted study authors for additional information. We collected adverse effects information from the trials.

Main results

Seventeen studies, involving 806 participants (mothers and babies), were included, but data from more than two trials were available for only four outcome measures. We found statistically significant and positive effects of early skin-to-skin contact on breastfeeding at one to three months postbirth [8 trials; 329 participants] (odds ratio (OR) 2.15, 95% confidence interval (CI) 1.10 to 4.22), and breastfeeding duration [6 trials; 266 participants] (weighted mean difference (WMD) 41.99, 95% CI 13.97 to 70.00). There was some evidence of improved summary scores for maternal affectionate love/touch during observed breastfeeding within the first few days postbirth [3 trials; 119 participants] (standardised mean difference (SMD) 0.73, 95% CI 0.36 to 1.11) and maternal attachment behaviour [5 trials; 211 participants] (SMD 0.76, 95% CI 0.47 to 1.04) with early skin-to-skin contact.

Authors' conclusions

Limitations included the methodological quality of the studies, variations in the implementation of the intervention and outcome variability. Early skin-to-skin contact appears to have some clinical benefit especially regarding breastfeeding outcomes and infant crying and has no apparent short or long-term negative effects.

Further investigation is recommended. To facilitate meta-analysis of the data, future research in this area should involve outcome measures consistent with those used in the studies included here. Published reports should also clearly indicate if the intervention was skin-to-skin contact and include means, standard deviations and exact probability values.

Plain language summary

Plain language summary

Skin-to-skin contact between mother and baby at birth helps breastfeeding succeed

In many cultures, babies are generally cradled naked on their mother's bare chest at birth. In some societies, babies are separated or dressed before being given to their mothers. The review showed that babies are more likely to be breastfed, and for longer if they have early skin-to-skin contact. Babies are also possibly more likely to have a good early relationship with their mothers but this was difficult to measure.