After months of pregnancy, your baby has suddenly moved from the protected environment of the uterus into a completely new world. Their temperature, breathing, heart rate, blood sugar and feeding behaviours all need to adapt.
At the same time, your body is undergoing its own enormous transition. There is something extraordinary about the first moments after birth.
One of the simplest ways we at Maxima Women’s Health can support both mother and baby during this period is also one of the most instinctive: placing the newborn directly onto the mother’s bare chest for skin-to-skin contact.
Often called the “golden hour”, the first hour after birth is not a magical deadline or a test that you can fail. Rather, it is a valuable window during which uninterrupted skin-to-skin contact can support the newborn’s transition, encourage early breastfeeding and create an important opportunity for mother and baby to meet one another.
Importantly, these benefits are not limited to a particular type of birth.
What Actually Happens During Skin-To-Skin?
Skin-to-skin contact means placing a newborn, usually wearing only a nappy or no clothing, directly against the mother’s bare chest. The baby is dried, positioned safely and covered with a warm blanket while their face remains visible and their breathing can be monitored.
When mother and baby are both clinically stable, this contact can begin immediately after birth and continue without unnecessary interruption.
WHO recommends early and uninterrupted skin-to-skin contact and support for breastfeeding within the first hour after delivery (WHO, 2023). The UNICEF Baby-friendly Hospital Initiative similarly recommends immediate skin-to-skin contact for at least 60 minutes, regardless of whether the baby was born vaginally or by caesarean section (WHO & UNICEF, 2018).
This matters because a newborn is not simply waiting to be “cleaned, weighed and dressed”. Their body is actively adapting to life outside the womb.
During this transition, the baby may still be covered in amniotic fluid and vernix, the creamy protective substance on the skin. These fluids are not simply something to remove immediately: vernix helps protect the newborn’s skin, while the familiar smells and sensations of birth may support early orientation and connection with the parent.
The second the baby is placed on your body, your chest and arms provide immediate warmth. Your voice and smell provide familiar sensory cues. Your touch provides physical reassurance. Your baby begins to use their natural feeding behaviours.
The Clinical Benefits Of The First Hour
The benefits of skin-to-skin contact extend beyond emotional connection.
A 2025 Cochrane review of 69 studies involving 7,290 mother–infant pairs found that immediate or early skin-to-skin contact probably increases exclusive breastfeeding and helps newborns adapt to life outside the womb by supporting temperature stability and blood glucose levels. The review also found possible benefits for newborn breathing and heart-rate stabilisation, although the evidence for these outcomes was less certain (Moore et al., 2025).
This makes sense physiologically because a newborn has limited ability to regulate their own temperature. Close contact with a mother’s body can help provide warmth during this transition. Skin-to-skin contact has also been associated with improved blood glucose levels, which is particularly relevant for babies who are vulnerable to low blood sugar.
A 2023 systematic review and meta-analysis examining skin-to-skin contact and neonatal hypoglycaemia found evidence supporting its role in maintaining newborn glucose levels, although the quality and design of studies varied (Cong et al., 2023).
These are not reasons to view skin-to-skin as a replacement for newborn monitoring or medical treatment. Rather, it is a simple intervention that can work alongside appropriate clinical care.
Your Baby Knows More Than You Might Think
Following birth, many healthy newborns go through a series of instinctive behaviours while lying skin-to-skin. They may initially be quiet and relaxed before gradually becoming more alert.
You may see your baby:
- Move their arms and legs
- Make small sucking or mouthing movements
- Open their eyes
- Move their head from side to side
- Root towards the breast
- Gradually move closer to the breast
- Attach and begin breastfeeding
This is sometimes referred to as the “breast crawl”. The important point is that breastfeeding does not necessarily need to begin with someone immediately placing the baby onto the breast.
Early skin-to-skin contact helps create an environment in which breastfeeding can begin naturally. WHO recommends supporting mothers to initiate breastfeeding as soon as possible after birth, ideally within the first hour (WHO, 2023).
When circumstances allow, healthcare professionals can give mother and baby time while providing gentle support when needed. The distinction is important, support does not mean pressure.
Then There Is Breastfeeding
Some babies attach quickly. Others need more time. Some mothers need help with positioning or attachment. Some babies may need additional clinical care before breastfeeding can begin.
The goal at this stage is not to produce a perfect first feed. The goal is to create the best possible conditions for feeding to begin safely.
The first milk your baby receives from you is called colostrum. It is produced in small quantities, but those small amounts are highly concentrated and contain nutrients, immune components and other protective substances.
A systematic review and meta-analysis of randomised controlled trials also found that immediate mother-infant skin-to-skin contact was associated with higher rates of exclusive breastfeeding (Safari et al., 2018).
This is where the word “supported” becomes particularly important. Breastfeeding is natural, but that does not mean it is always instinctively easy.
A mother may need help understanding positioning, attachment, hand expression or how to recognise feeding cues. Pain, exhaustion, medication, birth complications, prematurity, previous breast surgery and many other factors can affect the early feeding experience.
Good maternity care should therefore provide practical support without judgement.
There Is An Emotional Side, Too
Birth can be exhilarating, overwhelming, frightening, exhausting or unexpectedly emotional — sometimes all at once.
Skin-to-skin contact gives mother and baby a quiet opportunity to slow down after the intensity of birth.
Research examining the relationship between skin-to-skin contact and stress suggests that physical contact can influence physiological stress regulation, including pathways involving cortisol, oxytocin and the autonomic nervous system (Mäkelä et al., 2018).
More recent research is encouraging but appropriately cautious. A 2025 systematic review and meta-analysis of nine randomised trials involving 1,201 parents found that skin-to-skin contact may reduce short-term parental anxiety, although the certainty of evidence was low or very low and longer-term effects remain uncertain (Mendoza-Aucaruri et al., 2025).
So we should not promise that skin-to-skin prevents postpartum depression, anxiety or traumatic birth experiences. Instead, we can recognise it for what it is: one small, supportive part of early postnatal care.
Sometimes, that first quiet period of holding your baby can be emotionally significant.
What If The Golden Hour Doesn’t Happen?
Birth does not always follow the plan.
A baby may need resuscitation, monitoring or admission to a neonatal unit. A mother may experience heavy bleeding, complications, anaesthesia or another medical emergency. Sometimes mother and baby simply cannot be together immediately.
In these situations, clinical safety always comes first.
UNICEF and WHO specifically recognise that mothers or babies who are medically unstable may need to delay breastfeeding or skin-to-skin contact. They should still be supported to begin skin-to-skin and breastfeeding as soon as they are medically able (WHO & UNICEF, 2018).
For premature or low-birth-weight babies, skin-to-skin can become part of a ‘Kangaroo Mother Care’ protocol, which involves prolonged and often repeated skin-to-skin contact once the baby is stable enough. South Africa’s national maternal and newborn guidance also recognises skin-to-skin contact as an important component of ‘Kangaroo Mother Care’ (National Department of Health, South Africa, 2022).
There will be thousands of opportunities to hold them, feed them, comfort them and learn from one another. Your first hour does not define your entire relationship with your baby.
Missing the first hour does not mean you have missed your chance to bond with your baby or breastfeed successfully.
From The Consulting Room
Make the golden hour part of the conversation. If you are preparing for birth, talk to your healthcare team about skin-to-skin before you go into labour.
You can ask:
- Is immediate skin-to-skin routinely offered at this facility?
- Can skin-to-skin happen after a caesarean birth if my baby and I are stable?
- Can routine observations be performed while my baby remains on my chest?
- Who will support me with the first breastfeed?
- What happens if my baby needs additional medical care?
- If I cannot do skin-to-skin immediately, can my partner provide skin-to-skin when appropriate?
- What breastfeeding support is available after I leave the hospital?
These questions are not about controlling every moment of your birth.
They are about understanding your options and knowing what supportive, evidence-informed care can look like.
The Maxima Takeaway
The first hour after birth can offer important clinical and emotional benefits, but it is not a test of whether you had the “right” birth. Knowing your options can help you approach birth with greater confidence, flexibility and peace of mind.
When mother and baby are clinically stable, uninterrupted skin-to-skin contact can support newborn adaptation, temperature and glucose regulation, early breastfeeding and connection.
When circumstances mean that the first hour looks completely different? That is okay too. Good maternity care adapts to the mother and baby’s needs. The golden hour is an opportunity — not a deadline.
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