This study was done to evaluate effects of maternal-infant skin-to-skin contact during the first 2 hours postbirth compared to standard care (holding the infant swaddled in blankets) on breastfeeding outcomes through 1 month follow-up. Healthy primiparous mother-infant dyads were randomly assigned by computerized minimization to skin-to-skin contact (n = 10) or standard care (n = 10). The Infant Breastfeeding Assessment Tool was used to measure success of first breastfeeding and time to effective breastfeeding (time of the first of three consecutive scores of 10–12). Intervention dyads experienced a mean of 1.66 hours of skin-to-skin contact. These infants, compared to swaddled infants, had higher mean sucking competency during the first breastfeeding (8.7 ± 2.1 vs 6.3 ± 2.6; P < .02) and achieved effective breastfeeding sooner (935 ± 721 minutes vs 1737 ± 1001; P < .04). No significant differences were found in number of breastfeeding problems encountered during follow-up (30.9 ± 5.51 vs 32.7 ± 5.84; P < .25) or in breastfeeding exclusivity (1.50 ± 1.1 vs 2.10 ± 2.2; P < .45). Sucking competency was also related to maternal nipple protractility (r = .48; P < .03). Very early skin-to-skin contact enhanced breastfeeding success during the early postpartum period. No significant differences were found at 1 month.