The Sacred Hour

Uninterrupted Skin-to-Skin Contact Immediately After Birth

Raylene Phillips MD, IBCLC, FAAP


NAINR. 2013;13(2):67-72. 

In This Article

Early Postpartum Skin-to-Skin Contact is Endorsed By Many Organizations

The benefits of skin-to-skin contact immediately after birth for stable mothers and babies is so well documented, it is recommended by all major organizations responsible for the well-being of newly born infants, including The World Health Organization (WHO), the American Academy of Pediatrics (AAP), the Academy of Breastfeeding Medicine (ABM), and the Neonatal Resuscitation Program (NRP).

The WHO advises that, given the importance of thermoregulation, skin-to-skin contact should be promoted and "kangaroo care" encouraged in the first 24 hours after birth. The AAP recommends that healthy infants be placed and remain in direct skin-to-skin contact with their mothers immediately after delivery until the first feeding is accomplished.[29]

The ABM Protocol #5, Revision 2008 states, "The healthy newborn can be given directly to the mother for skin-to-skin contact until the first feeding is accomplished. The infant may be dried and assigned Apgar scores and the initial physical assessment performed as the infant is with the mother. Such contact provides the infant optimal physiologic stability, warmth, and opportunities for the first feeding. Delaying procedures such as weighing, measuring and administering vitamin K and eye prophylaxis (up to an hour) enhances early parent–infant interaction."[30] (p 2).

The NRP says that skin-to-skin care can be used to provide routine resuscitation for all normal newborns. The changes included in the updated 2011 NRP indicate that even the vigorous meconium-stained newborn need not receive initial steps at the radiant warmer, but may receive routine care (with appropriate monitoring) with the mother. It clarifies that routine care includes staying with the mother in skin-to-skin contact to ensure warmth. It also specifies that suctioning following birth (including bulb suctioning with a bulb syringe) should be reserved for babies who have obvious obstruction to spontaneous breathing or who require positive pressure ventilation.[28]