A growing body of research underscores that the first hour after birth is far more than a gentle moment; it is a critical biological window for both the newborn and the mother. A joint study conducted by Karolinska Institutet, Stockholm, and the Healthy Children Project Inc., Massachusetts, published in the National Library of Medicine, found that placing a healthy, full-term infant skin-to-skin with the mother immediately after a non-instrumental vaginal birth triggers instinctive behaviours that regulate the baby’s temperature, breathing, and blood sugar, while also deepening maternal bonding and promoting breastfeeding initiation.
The paper highlighted that the first hour after birth is a sensitive and irreplaceable period, one that should be protected by evidence-based routines of staff. While scientific evidence strongly supports uninterrupted skin-to-skin contact, many clinical settings worldwide still lag in implementation. The researchers integrated clinical observations with earlier research to bridge this gap, emphasising that understanding a newborn’s natural instincts during skin-to-skin time can guide safer, more responsive postnatal care.
The Nine Stages of Newborn Instinct
The newborn’s behaviour during this golden hour follows a remarkably consistent pattern, known as the Nine Instinctive Stages of Skin-to-Skin Contact. These include:
1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Resting
6. Crawling
7. Familiarisation
8. Suckling, and finally,
9. Sleep.
Each stage unfolds naturally as the baby adjusts to life outside the womb, guided by innate reflexes. Occasional pauses or resting periods are normal; they reflect the baby’s need to self-regulate before progressing further. This sequence, observed across diverse cultures and birth settings, underscores that the first hour is not merely symbolic; it is biologically designed for adaptation and connection.
Skin-to-Skin: The Newborn’s First Stabiliser
As Dr Hemant Sharma, Senior Consultant, Neonatology, Amrita Hospital, Faridabad, explains, skin-to-skin contact acts as nature’s incubator for the newborn:
“Skin-to-skin contact right after birth is like placing the baby in nature’s own incubator. When a mother holds her newborn close, the baby’s stress melts away, glucose levels stabilise, breathing becomes rhythmical, and the heart rate steadies. It’s a beautiful, science-backed expression of love and healing in action,” says Dr Hemant Sharma, whose experience in the field of neonatology makes him a formidable force.
Beyond emotional warmth, this early physical closeness plays a measurable physiological role, regulating the baby’s body temperature, oxygen levels, and energy balance while reducing crying and cortisol (stress hormone) levels.
The Protective Power of Vernix
The conversation around postnatal care is also evolving to include delaying the first bath and allowing the vernix caseosa, the creamy, wax-like coating covering the newborn’s skin, to stay longer. Dr Hemant Sharma elaborates.
“Vernix is the baby’s first protective armour, rich in antimicrobial and moisturising properties. Allowing it to stay on the skin for some time strengthens immunity, nourishes the skin, and supports a smoother transition to life outside the womb,” says Dr Hemant Sharma.
This protective layer not only guards against infections but also helps maintain the skin barrier and supports the baby’s microbiome, forming a natural shield during the first few hours and days.
Gentle Birth Practices and the Mother–Infant Connection
Immediate skin-to-skin is influenced by how deliveries are managed. Dr Deepthi Sharma, Head of Obstetrics and Gynaecology at Amrita Hospital, stresses that mindful, less invasive birthing practices can make all the difference.
“Whether it’s a vaginal or a caesarean birth, gentle delivery practices that prioritise delayed cord clamping, minimal separation, and immediate skin-to-skin make a world of difference. This precious contact not only calms the baby and stabilises vital signs but also helps initiate breastfeeding early, creating a seamless emotional and biological connection between mother and child,” says Dr Deepthi Sharma.
These early interactions lay the groundwork for breastfeeding success and emotional bonding, both of which have lifelong health implications for mother and child.
When Skin-to-Skin Must Wait
However, there are rare circumstances when immediate contact may not be feasible. Dr Deepthi Sharma adds, “In rare situations when the mother or baby needs urgent medical attention, immediate skin-to-skin may be delayed for safety. However, once both are stable, kangaroo care can begin, and it often accelerates recovery, warmth, and early breastfeeding success, irrespective of the mode of delivery.”
Protecting the Golden Hour
The research by Widström and colleagues reinforces what clinical experts like Drs. Hemant and Deepthi Sharma advocate, that the first hour after birth must be protected as a sacred, evidence-backed time for both mother and child. Recognising and supporting the newborn’s instinctive progression during this period allows clinicians and caregivers to bridge science and compassion, giving every baby the best possible start in life.
(Kirti Pandey is a senior independent journalist)
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