After decades of accumulating evidence, it is now “no longer ethical” to withhold skin-to-skin contact from healthy newborns in future randomized trials. The benefits are clear, consistent, and meaningful enough that intentionally denying the practice to a control group would violate current ethical standards. Few interventions in perinatal care reach this level of scientific and ethical consensus.
These are the authors’ ethical conclusions of the latest Cochrane Review on immediate or early skin-to-skin contact, which has been updated in 2025 and includes 69 randomized or quasi-randomized trials with 7,290 mother–infant pairs from 24 countries. In evidence-based medicine, few sources carry more weight than these reviews, which rigorously collect, assess, and synthesize all available high-quality studies on a given question, offering what is often considered the most reliable answer that science can currently provide. The Review arrives at a clear conclusion: placing a healthy newborn directly on their mother’s bare chest in the minutes after birth is not merely comforting. It is clinically effective and biologically meaningful, and should be part of standard care.
Studies were examined in which skin-to-skin contact typically began within the first 10 minutes postpartum and continued for at least an hour, compared with “usual care”, where newborns are often taken to be weighed, cleaned, or monitored separately. The results were consistent across settings and continents. Infants who received early skin-to-skin contact were substantially more likely to be exclusively breastfed, both at hospital discharge or one month (36% more likely) and between six weeks and six months (38% more likely). These findings come from moderate-certainty evidence, a level indicating that further research is unlikely to change the direction of the effect.
Physiological benefits were also evident. Babies kept in skin-to-skin contact had higher body temperatures and higher blood glucose levels shortly after birth, both indicators of better early adaptation. They also showed more stable cardiopulmonary parameters, reflected in improved SCRIP scores, a measure that combines heart rate, breathing, and oxygenation. For newborns transitioning from the uterus to the outside world, these differences matter.
The effects on mothers were more variable, in part because maternal well-being is harder to measure consistently across studies. Some trials reported increased confidence or reduced anxiety, while others showed no clear difference. The certainty of evidence for maternal outcomes remains low, largely due to methodological constraints: for example, blinding is impossible in trials where mothers physically hold their babies.
The implications extend beyond the delivery room. In low-resource settings, skin-to-skin contact is a zero-cost intervention with measurable gains. In high-income hospitals, it reinforces a shift toward evidence-based, family-centered care. And for parents, it underscores something both simple and profound: that the earliest moments after birth carry significant biological weight.
A Cochrane Review rarely speaks in absolutes. But here, the message is unequivocal. The evidence supports it, and the ethics demand it: immediate skin-to-skin contact should be part of every healthy birth whenever possible.
Reference
- Moore, E. R., Brimdyr, K., Blair, A., Jonas, W., Lilliesköld, S., Svensson, K., … & Cadwell, K. (2025). Immediate or early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, (10). https://doi.org/10.1002/14651858.CD003519.pub5
PhD in Sociology