The golden hour

The golden hour is the period immediately following birth — approximately the first hour — in which newborns are encouraged to remain in uninterrupted skin-to-skin contact with their mother or birth parent. During this time, UNICEF UK's Baby Friendly Initiative notes, babies follow "a unique process" driven by instinct: "if left uninterrupted will result in them having a first breastfeed." La Leche League GB similarly advises avoiding interruptions until after the first breastfeed: "Weighing and washing need to wait — this is much more important."

What happens during the golden hour?

In the first hour after birth, a full-term baby placed skin-to-skin on the mother's chest will typically display a sequence of instinctive behaviours — rooting, finding the nipple, and self-attaching to the breast. UNICEF UK's Baby Friendly Initiative observes that "if they are enabled to familiarise themselves with their mother's breast and achieve self-attachment, it is very likely that they will recall this at subsequent feeds, resulting in fewer breastfeeding problems." Skin-to-skin during this period also supports temperature regulation, breathing stabilisation, and the release of hormones that aid bonding and milk production.

How long should skin-to-skin continue after birth?

UNICEF UK's Baby Friendly Initiative recommends contact continues "at least until after the first feed and for as long as they wish." NHS guidance describes keeping mother and baby together in skin-to-skin until "after their first feed or for a minimum of at least an hour." For babies born by caesarean section, La Leche League GB advises insisting on skin-to-skin contact "as soon as he is born" and beginning skin-to-skin at the earliest possible opportunity.

What is the evidence for the golden hour?

UNICEF UK's research on skin-to-skin contact finds that uninterrupted contact after birth supports early breastfeeding initiation and reduces the risk of neonatal hypoglycaemia. The WHO, in its Early Essential Newborn Care guidelines, includes "beginning immediate skin-to-skin contact for no less than 90 minutes" as one of the core steps following birth. A 2022 WHO-coordinated trial found that immediate skin-to-skin care (kangaroo mother care) for preterm babies reduced 28-day mortality by a further 25% compared with delayed initiation.