Holding a Premature Baby Skin-to-Skin Right After Birth: What a New Study Found About Long-Term Development

A plain-language look at a Norwegian trial of immediate skin-to-skin contact for very premature babies

A Norwegian study followed 108 very premature babies to see whether two hours of skin-to-skin contact with their mother right after birth would help their thinking, language, and movement skills as toddlers. By age 2 to 3, children who had the early cuddle scored no differently on development tests than those cared for in an incubator — but the skin-to-skin babies were more likely to be breastfeeding at hospital discharge and for months afterward. The researchers concluded that this simple, safe, no-cost practice is worth encouraging, even though it is not, by itself, a way to boost brain development [1].

The Problem This Study Set Out to Solve

Babies born much too early — in this study, between 28 and nearly 32 weeks of pregnancy, instead of the usual 40 — face a harder road than babies born on time. As a group, they are more likely to have delays in learning, talking, and movement, and on average their thinking scores run somewhat below those of children born at full term [2]. For decades, doctors and parents have looked for gentle, affordable ways to protect these fragile brains during the earliest, most sensitive days of life.

One of the most promising ideas is beautifully low-tech: placing the baby directly on the parent's bare chest, skin against skin. This is the heart of "kangaroo mother care," and there is now strong evidence that it helps premature and low-birth-weight babies survive and stay healthier, lowering the risk of death, serious infection, dangerous drops in temperature, and low blood sugar [3],[4]. A landmark international study went further, showing that starting this contact immediately after birth — rather than waiting until the baby was considered stable — saved even more lives. That result led the World Health Organization to recommend skin-to-skin contact "as soon as possible after birth" [5].

The Question That Remained

Saving lives and preventing infections is one thing. But many families naturally wonder about something further down the road: will holding my baby skin-to-skin in those first hours help my child think, learn, and develop better years later? Until recently, no one had run the kind of study needed to answer that fairly.

The strongest earlier hint came from a long-running study in Colombia, which found that children who received kangaroo care had social and behavioral advantages 20 years later [6], and, in a smaller group given brain scans as young adults, differences in the size of certain brain structures [7]. But those children had received prolonged kangaroo care, not a single early session, and the meaning of the brain-scan finding was not fully clear. The question of whether just a couple of hours of immediate contact for very premature babies makes a lasting developmental difference had never been tested in a carefully designed trial — until this one.

How the Study Worked

Researchers at three hospitals in Norway enrolled 108 premature babies between 2014 and 2020. These were babies who were doing relatively well at birth — those who needed a breathing tube or a lot of extra oxygen were not included, so the findings apply to moderately stable premature infants rather than the very sickest [1]. Right after birth, each baby was randomly assigned — essentially by the flip of a coin — to one of two paths. Half went skin-to-skin on their mother's chest in the delivery room for two hours, positioned upright with the head gently turned to keep the airway clear. The other half received the usual care, moved to the neonatal unit in an incubator.

Randomly sorting babies this way is what makes a study trustworthy: it means the two groups were alike in every way except the one being tested, so any later difference can be credited to the skin-to-skin contact itself. The families and staff obviously knew which group each baby was in, but importantly, the specialists who later measured each child's development did not — which keeps those measurements fair and unbiased. When the children were 2 to 3 years old, they took a standard, well-respected developmental test (the Bayley scales), and parents filled out questionnaires about their child's skills.

What They Found

On the main measure — thinking and problem-solving skills at age 2 to 3 — the two groups were essentially identical. The average scores were 99.6 for the skin-to-skin group and 99.4 for the standard-care group, a difference so small it is meaningless, and both averages sat comfortably in the normal range [1]. Language and movement scores were also similar, and the questionnaires showed no meaningful differences. When the researchers counted how many children showed signs of possible developmental delay on any measure, it came out to about half in each group — 51% versus 49%, again with no real difference between them.

There was, however, one clear and encouraging difference. Babies who had the early skin-to-skin contact were more likely to be breastfeeding when they went home (84% versus 67%), and they kept breastfeeding longer: at six months, half of the skin-to-skin group was still exclusively breastfeeding, compared with about one in five of the other group. This matches what many earlier studies have found — that early skin-to-skin contact helps mothers and babies get breastfeeding off to a strong start [8].

What the Results Mean for Families

It would be easy to read "no difference in development" as disappointing news, but that is not the right takeaway. A few things are worth understanding. The study was smaller than planned — the researchers had hoped to enroll 136 babies but stopped at 108 — which means it could have missed a small benefit. Just as importantly, the babies in the "standard care" group were not deprived of closeness; in Norwegian hospitals, parents hold their premature babies skin-to-skin a great deal during the nursery stay. So this study really compared two extra hours in the delivery room against a background of plenty of cuddling that both groups received. Finally, because these were relatively healthy premature babies who mostly developed normally, there was not much room for any single intervention to push scores higher.

In other words, the study tells us that two hours of skin-to-skin right after birth is not, on its own, a magic developmental boost for this group of babies. It does not tell us that early closeness is unimportant. This echoes what researchers have learned from other gentle NICU practices, such as music therapy, which also improved short-term wellbeing without changing 2-year development scores [9]. If early contact does shape the developing brain in lasting ways, it may depend on the total amount of skin-to-skin time built up over weeks — the way the Colombian children received it — rather than one session at birth.

The bottom line for parents is reassuring. Immediate skin-to-skin contact for a stable premature baby has already been shown to be safe, with no harm to the baby's heart rate, breathing, or oxygen levels in the hours after birth [10]. It supports breastfeeding, it supports bonding and closeness, it costs nothing, and it is recommended by the World Health Organization. This study simply adds an honest note: it is a wonderful and worthwhile practice, but families should not feel that their child's future intelligence hinges on those first two hours. What happens over months and years of loving care matters far more.

What Comes Next

Researchers now want to follow children like these for longer — into school age — using tests of thinking, attention, and behavior that may pick up subtle effects a toddler test cannot. They also want larger studies, combining babies from many hospitals, and want to measure the total amount of skin-to-skin time a family gives, not just a single delivery-room session. Until those answers arrive, the guidance for families and caregivers is steady and hopeful: hold your premature baby skin-to-skin as early and as often as your care team supports, for all the comfort, closeness, and breastfeeding benefits it brings — and know that doing so is genuinely good for your baby.

References

  1. Kristoffersen L, Støen R, Bergseng H, et al. Immediate Skin-to-Skin Contact in Very Preterm Neonates and Early Childhood Neurodevelopment: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(4):e255467. doi:10.1001/jamanetworkopen.2025.5467 ↩
  2. Serenius F, Källén K, Blennow M, et al. Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden. JAMA. 2013;309(17):1810-1820. doi:10.1001/jama.2013.3786 ↩
  3. Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016;(8):CD002771. doi:10.1002/14651858.CD002771.pub4 ↩
  4. Boundy EO, Dastjerdi R, Spiegelman D, et al. Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis. Pediatrics. 2016;137(1):e20152238. doi:10.1542/peds.2015-2238 ↩
  5. World Health Organization Immediate KMC Study Group. Immediate "Kangaroo Mother Care" and Survival of Infants with Low Birth Weight. N Engl J Med. 2021;384(21):2028-2038. doi:10.1056/NEJMoa2026486 ↩
  6. Charpak N, Tessier R, Ruiz JG, et al. Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care. Pediatrics. 2017;139(1):e20162063. doi:10.1542/peds.2016-2063 ↩
  7. Charpak N, Tessier R, Ruiz JG, et al. Kangaroo mother care had a protective effect on the volume of brain structures in young adults born preterm. Acta Paediatr. 2022;111(5):1004-1014. doi:10.1111/apa.16265 ↩
  8. Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;(11):CD003519. doi:10.1002/14651858.CD003519.pub4 ↩
  9. Gaden TS, Ghetti C, Kvestad I, et al. Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children: A Secondary Analysis of the LongSTEP Randomized Clinical Trial. JAMA Netw Open. 2024;7(5):e2410721. doi:10.1001/jamanetworkopen.2024.10721 ↩
  10. Kristoffersen L, Bergseng H, Engesland H, et al. Skin-to-skin contact in the delivery room for very preterm infants: a randomised clinical trial. BMJ Paediatr Open. 2023;7(1):e001831. doi:10.1136/bmjpo-2022-001831 ↩