Research on skin-to-skin contact

Below is a selection of studies exploring the impact of skin-to-skin contact on infant and maternal health. Find out more about how skin-to-skin works.

Mother-infant contact after birth can reduce postpartum post-traumatic stress symptoms through a reduction in birth-related fear and guilt

This longitudinal study from Israel aimed to further research on the negative effects of posttraumatic stress symptoms following childbirth (PTSS-FC) by examining the protective factors for PTSS-FC. Guilt and fear during birth mediated the association between mode of birth (instrumental or cesarean versus vaginal) and PTSS-FC. Skin-to-skin contact was related to reduced feelings of guilt and fear during birth, especially for women who had a cesarean section. Results emphasise the importance of the implementation of skin-to-skin contact following childbirth, and especially following a cesarean section as recommended by the Baby Friendly Health Initiative.

Immediate skin-to-skin contact may have beneficial effects on the cardiorespiratory stabilisation in very preterm infants

Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates

This study examines the interactive effects of maternal depression and breastfeeding on mother and infant affectionate touch, as well as infant temperament and cortical maturation patterns across early development. A total of 113 mothers and their infants aged between 1 and 3 months were assessed to determine levels of maternal depressive symptoms, feeding, and temperament. Tonic EEG patterns (asymmetry and left and right activity) were collected, with data analysis showing that EEG activity and mother-infant affectionate touch differed as a function of mood and feeding method. Notably, only infants of depressed mothers that bottle-fed showed right frontal EEG asymmetry and attenuated change in the left frontal region across 3 months. Breastfeeding positively impacted affectionate touch behaviors and was associated with increased left and decreased right frontal EEG activation even for depressed groups, suggesting that breastfeeding and the infant’s positive temperament influence mother-infant affectionate touch patterns and result in neuroprotective outcomes for infants, even those exposed to maternal depression within early development.

Hardin, JS. et al. 2021. Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates. Neuropsychobiology 2021;80:158–175. https://doi.org/10.1159/000511604

Immediate “Kangaroo Mother Care” and Survival of Infants with Low Birth Weight

Findings from a new study coordinated by the World Health Organization (WHO) demonstrate that initiation of kangaroo mother care (KMC) alongside skin-to-skin contact and exclusive breastfeeding dramatically improves survival outcomes for preterm or low-weight babies when started immediately after birth. Outcomes suggest that early initiation of KMC could save up to 150,000 more lives each year.

The WHO is currently in the process of reviewing its 2015 recommendations on initiating KMC upon stabilisation of the infant in light of the new evidence that has become available. You can read more on this study on the Baby Friendly blog.

Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants

Approximately 1 in 5 women in low- and middle-income countries experience postpartum depression, and the risk is higher among mothers of low-birth-weight (LBW) infants. Kangaroo mother care (KMC) is effective in improving survival among LBW infants, but the benefits of KMC for mothers are not well described. This randomised clinical trial explores whether the practice of community-initiated kangaroo mother care (ciKMC), an intervention encompassing skin-to-skin-contact and exclusive breastfeeding, during the neonatal period reduces the risk of moderate-to-severe postpartum depressive symptoms among mothers of low-birth-weight (LBW) infants. The trial included 1950 mothers of stable LBW infants from low-income areas in India, with findings suggesting that ciKMC practice may substantially reduce the risk of moderate-to-severe maternal postpartum depressive symptoms. This evidence supports KMC as an intervention to be incorporated in essential newborn care programs in low- and middle-income settings.

Bireshwar, S., et al. 2021. JAMA Netw Open. 2021;4(4):e216040. doi:10.1001/jamanetworkopen.2021.6040

Synchronous caregiving from birth to adulthood tunes humans’ social brain

This birth-to-adulthood study tested the effects of maternal–newborn contact and synchronous caregiving on the social processing brain in human adults. Authors observed mother-child social synchrony of preterm and full-term neonates who received or lacked initial maternal bodily contact for two decades, with findings demonstrating the long-term effects of maternal care giving in humans, similar to their role in other mammals and particularly in tuning core regions implicated in salience detection, simulation, and interoception that sustain empathy and human attachment.

Yanviv. A. et al. 2021. Synchronous caregiving from birth to adulthood tunes humans’ social brain. Proceedings of the National Academy of Sciences Apr 2021, 118 (14) e2012900118; DOI: 10.1073/pnas.201290018

Positive Effects of Kangaroo Mother Care on Long-Term Breastfeeding Rates, Growth and Neurodevelopment in Preterm Infants

This study investigates the impact of kangaroo mother care (KMC) on breastfeeding and health outcomes in preterm infants and concludes that KMC effects are significant in promoting a higher proportion of mothers’ milk used during hospitalisation, less feeding intolerance at discharge, higher rates of exclusive breastfeeding at 6 months, improved growth and neurodevelopment.

Wang Y, Zhao T, Zhang Y, Li S, Cong X. Positive Effects of Kangaroo Mother Care on Long-Term Breastfeeding Rates, Growth, and Neurodevelopment in Preterm Infants. Breastfeed Med. 2021 Feb 2. doi: 10.1089/bfm.2020.0358. Epub ahead of print. PMID: 33533688.

The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies

This review of studies found that preterm and low birthweight infants receiving a kangaroo mother care intervention initiated breastfeeding 2 days 14 h 24 min earlier than infants who received the “conventional” care of the radiant warmer/incubator method.

Mekonnen, A, Yehualashet, S and Bayleyegn, D, (2019). The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and low birthweight infants: a meta-analysis of published studies. International Breastfeeding Journal, doi.org/10.1186/s13006-019-0206-0

Effects of paternal skin-to-skin contact in newborns and fathers after cesarean delivery

This study of neonates born via elective cesarean delivery and their fathers investigated the effects of paternal skin-to-skin contact (SSC) on newborns and fathers after cesarean delivery. Newborns who received SSC shortly after delivery had a more stable heart rate and forehead temperature, less duration of crying, and started feeding behavior earlier. The duration of breastfeeding after SSC in the treatment group was longer as well, with statistical significance, than the control group. In addition, fathers in the treatment group had lower scores of anxiety and depression and better role attainment than those in the control group, with statistical significance.

Xiaoli Huang, Liling Chen, & Li Zhang, (2019). Effects of paternal skin-to-skin contact in newborns and fathers after cesarean delivery. Journal of Perinatal & Neonatal Nursing 2019, 33 (1): 68-73

Hospital breastfeeding support and exclusive breastfeeding by maternal prepregnancy BMI

This US study explored the impact of the Ten Steps to Successful Breastfeeding on supporting breastfeeding amongst mothers with obesity, who have disproportionately lower rates of exclusive breastfeeding than mothers who are not obese. Researchers found that holding babies in skin-to-skin contact for the first time and being encouraged to feed on demand were more strongly associated with exclusive breastfeeding among mothers with obesity than other mothers. Additionally, mothers with obesity reported holding babies skin‐to‐skin significantly less often than other mothers. They concluded that interventions aimed at helping mothers with obesity to hold their babies skin‐to‐skin in the first hour and teaching them to breastfeed on demand have the potential to decrease the breastfeeding disparities in this population.

Kair, L, Nickel, N, Jones, K, et al, (2019). Hospital breastfeeding support and exclusive breastfeeding by maternal pre‐pregnancy BMI. Maternal & Child Nutrition, doi.org/10.1111/mcn.12783

Older research 

  • Who owns the baby? A video ethnography of skin-to-skin contact after a caesarean section

Stevens, J, Schmied, V, et al (2018). Who owns the baby? A video ethnography of skin-to-skin contact after a caesarean section. Women and Birth, doi.org/10.1016/j.wombi.2018.02.005

  • Mapping, measuring, and analyzing the process of skin-to-skin contact and early breastfeeding in the first hour after birth

Cadwell, K, Brimdyr, K, et al (2018). Mapping, measuring, and analyzing the process of skin-to-skin contact and early breastfeeding in the first hour after birth. Breastfeeding Medicine, doi.org/10.1089/bfm.2018.0048

  • An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth

Brimdyr, K, Cadwell, K, et al, (2017). An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth. Maternal & Child Nutrition, doi.org/10.1111/mcn.12571

  • An analysis of the effects of intrapartum factors, neonatal characteristics, and skin-to-skin contact on early breastfeeding initiation

Lau, Y, et al (2017), An analysis of the effects of intrapartum factors, neonatal characteristics, and skin-to-skin contact on early breastfeeding initiation, Maternal & Child Nutrition, DOI: 10.1111/mcn.12492

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

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003519.pub4/full

  • Kangaroo mother care for preterm infants

Charpak, N (2016), Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care. Pediatrics 139(1):e20162063

  • Healthy Birth Practice #6: Keep Mother and Baby Together – It’s Best for Mother, Baby, and Breastfeeding

Crenshaw, JT, (2014). Healthy Birth Practice #6: Keep Mother and Baby Together- It’s Best for Mother, Baby, and Breastfeeding, Journal of Perinatal Education, doi: 10.1891/1058-1243.23.4.211

Related research and further reading