The first hour after birth: skin-to-skin, the first feed, and what to ask for

What skin-to-skin does

The baby, dried and naked apart from a nappy and cap, lies on the mother's bare chest under a cloth. It stabilises the baby's temperature, breathing and heart rate better than a warmer does, reduces crying and stress, and colonises the baby with the mother's bacteria rather than the ward's.

It also drives feeding. Babies left undisturbed on the chest work their way to the breast and latch themselves — the 'breast crawl' — and skin-to-skin in the first hour is strongly associated with breastfeeding starting well and lasting longer.

For the mother it releases oxytocin, which helps the uterus contract and reduces bleeding. This is a clinical intervention, not a sentimental preference, and Indian national newborn care guidance supports it.

The first feed

The aim is a first breastfeed within the first hour. What the baby gets is colostrum — thick, yellowish, tiny in volume, packed with antibodies. It is the entire intended first food.

This is where the household conversation matters. Honey, ghutti, janam ghutti, sugar water, cow's milk or formula given as a first feed all displace colostrum, introduce infection risk, and undermine the start of breastfeeding. Agree on this with the elders before the delivery, not in the room afterwards.

If the baby does not latch immediately, that is common — keep the skin-to-skin going, ask for help from a nurse or lactation counsellor, and try again. Hand-expressing a few drops of colostrum onto a spoon is a useful backup that keeps everything on track.

What can wait, and what cannot

Can usually wait an hour where the baby is well: weighing, bathing (which should be delayed for several hours — the vernix is protective), vitamin K injection, eye care, and detailed measurements. Ask for them to be done after the first feed, or on your chest.

Cannot wait: drying and assessing the baby, resuscitation if needed, and clamping the cord — though clamping is now delayed by one to three minutes as standard, which improves the baby's iron stores for months.

If the baby needs medical attention, that comes first — and skin-to-skin can start later, including hours later, and still helps. Fathers can do skin-to-skin too when the mother cannot, and it does the same stabilising work.

After a caesarean, ask for skin-to-skin in theatre or in recovery. Many Indian hospitals now offer it, and where they do not, ask that it happen as soon as you are in the ward.

When to see a doctor

Tell staff immediately if, in the first hours, the baby: is breathing fast or with effort, grunts, has blue lips or tongue, is floppy or unusually cold, will not feed at all, or has a weak or high-pitched cry. And during skin-to-skin, keep the baby's face visible and clear — a mother who is drowsy after a long labour or medication should have someone else watching the baby's position.

For the mother, tell staff about heavy bleeding, feeling faint, or severe pain in the hours after delivery — the first hours carry the highest risk of postpartum haemorrhage and are monitored for exactly that reason.

This article is general information, not medical advice, and is no substitute for personal medical advice. For any decision about your or your child's health, please consult your doctor.

Frequently asked questions

Q: The hospital took my baby away immediately and I did not get skin-to-skin. Have I lost the benefit? — No. It is best in the first hour, and it still works later — hours, days, weeks later. Do it as much as possible once you are together, and ask for lactation support if feeding got off to a slow start.

Q: How do I ask for this in a busy government hospital? — Say it clearly and early: on arrival, and again as delivery approaches — 'I would like the baby on my chest and the first feed before the routine checks, if the baby is well.' National guidance supports it, so you are asking for standard practice rather than a favour.

Q: The family wants to hold the baby and take photos immediately. — Ask them to wait an hour. Say it in advance, once, so nobody is offended in the moment — this hour belongs to the mother and baby, and the photographs will be better afterwards anyway.

Q: What if I have had a caesarean and am shaking too much to hold the baby? — Shivering is common and normal after surgery. Ask for the baby to be placed on your chest with a nurse or your partner supporting, or let your partner do skin-to-skin until you are steady. It transfers, and it works.