Newborn skin-to-skin contact from birth is recommended by the WHO and UNICEF, and its benefits for breastfeeding are confirmed by a Cochrane review published in October 2025. In April 2026, however, France's Haute Autorité de santé (HAS), the national health authority, published a “patient safety flash” with an explicit title: “gentleness does not rule out vigilance”. It follows an analysis of serious adverse events affecting newborns in 2025. The two messages do not contradict each other: early contact is beneficial, provided positioning and monitoring are right. Here is what these texts say and what parents can take from them.
Newborn skin-to-skin: what the 2025 Cochrane review shows
The Cochrane review led by Elizabeth Moore, updated on 22 October 2025, brought together randomised trials comparing immediate or early skin-to-skin contact with usual hospital care. Thirty-eight trials, involving 3,472 women, provided usable data. The results point the same way on breastfeeding. Mothers who practised skin-to-skin were more likely to be breastfeeding one to four months after birth, and more likely to breastfeed exclusively from discharge up to six months. The certainty of evidence is rated moderate.
On the newborn's physiology, the effects are more modest. Slightly higher blood sugar, a slightly higher temperature but of no clinical significance according to the authors, and a better cardio-respiratory stability score with low-certainty evidence. The authors conclude that the data support immediate skin-to-skin for healthy babies born at or near term, whatever the mode of birth. They add that, since the WHO and UNICEF recommend immediate and uninterrupted contact, randomising mother–baby separation would probably no longer be justifiable.
The review states its own limitations: often small trials, varying definitions of skin-to-skin and standard care, no blinding. The data after a caesarean rest on just two trials. Our article on the caesarean rate in France notes that this applies to around one birth in five.
What does the HAS patient safety flash say?
The document was adopted by the HAS Board on 9 April 2026. It is based on an analysis of serious care-related adverse events reported in newborns in 2025. Two situations are described: a newborn collapsing during skin-to-skin in the delivery room, and a fall or collapse during breastfeeding in the maternity ward room. Two mechanisms recur: positioning that obstructs the upper airways, and parental tiredness, which makes falling asleep with the baby on one's chest more likely.
The HAS addresses its recommendations to care teams. For skin-to-skin in the delivery room: train professionals and systematically inform parents before the birth and again in the delivery room. Added to this are checking that there is no contraindication at the time of birth and a formal monitoring procedure. For breastfeeding on the maternity ward: remind the mother of the need to keep the newborn's airways clear and of the risks of shared sleep. Teams should also regularly assess her level of tiredness and check the safety equipment. In every case, they should make sure parents have understood the instructions.
This flash follows on from the HAS guidance sheet on welcoming the newborn in the delivery room, published in 2018. That sheet already called for close monitoring of the baby in skin-to-skin during the first two hours, every fifteen minutes in the first hour, with a record kept in the file.
A note on sources
The HAS pages and PDF could not be accessed with our tools at the time of writing. The content of the flash was read via the relay published by the Collège de gynécologie du Centre-Val de Loire, dated 10 May 2026. The 2018 guidance sheet was read via a legal analysis by MACSF dated 20 November 2025. The full HAS text is authoritative.
Is newborn collapse during skin-to-skin common?
No. It is a rare event: the MACSF analysis cites a risk of anoxic collapse of around one case per 65,000 births associated with skin-to-skin. When it does occur, however, it is serious, which explains the vigilance being asked for. The circumstances described are similar: the baby's face buried against the chest, nose blocked, the mother exhausted after giving birth, lights dimmed, no staff member in the room. The risk is therefore concentrated in the first hours and, later, during night-time feeds in the room.
What parents can take away in practice
- Ask for skin-to-skin, and keep it up. The benefits are established; nothing in the HAS flash suggests giving it up, including after a caesarean when the team offers it.
- Check the position of the face. The baby's nose and mouth must stay clear, the head turned to the side, the chin lifted and not tucked onto the chest. The face must remain visible to the adult at all times.
- Do not stay alone in the first hours. The other parent or birth partner has a specific role: watch the baby, not the mother, and call for help at the slightest change in colour or muscle tone.
- Say when you are tired. After a long labour or a sleepless night, let the midwife know before feeding lying down. Putting the baby back in the cot as soon as you feel sleep coming on is the most protective thing you can do.
- Know the warning signs. Pallor or bluish lips, a floppy baby, absent or irregular breathing, no response: take the baby out of contact, stimulate them and ring for help immediately.
- Ask your questions before the birth. The HAS calls for systematic information during pregnancy. Antenatal classes and the maternity unit visit are the right time to ask how the team organises skin-to-skin and monitoring.
And after the maternity ward?
Skin-to-skin does not stop in the delivery room. At home, it remains a simple way to soothe a baby, support milk supply and encourage bonding; the first 1000 days count it among the basic gestures. The same rules apply: face clear, adult awake, and back to bed as soon as the parent gets drowsy. The recommendations on safe sleep for infants explain why the sofa and the parents' bed are not places for a baby to sleep. For babies born preterm, prolonged skin-to-skin, known as “kangaroo care”, is part of neonatal care; our article on preterm birth in France gives the context.
On the practical side, packing a front-opening top in your hospital bag makes those first contacts easier, and our resources on breastfeeding in France round off this topic.
In summary
Newborn skin-to-skin is beneficial and recommended; the 2025 Cochrane review confirms this for breastfeeding. The HAS patient safety flash of April 2026 does not call the practice into question. It reminds us that a baby in skin-to-skin needs watching, that their face must stay clear and that an exhausted mother should not be left alone with the baby on her chest. Informed parents, together with the care team, are the first line of this vigilance.
Sources
- Haute Autorité de santé, Flash sécurité patient “Peau à peau et allaitement du nouveau-né à la maternité. La douceur n'exclut pas la vigilance”, Board decision no. 2026.0072/DC/SEVOQSS of 9 April 2026; read via the relay by the Collège de gynécologie du Centre-Val de Loire, 10 May 2026.
- Moore E.R. et al., “Early skin-to-skin contact for mothers and their healthy newborn infants”, Cochrane Database of Systematic Reviews, CD003519, 22 October 2025.
- MACSF, “Un peau à peau aux conséquences dramatiques”, case analysis, Stéphanie Tamburini, 20 November 2025.
- HAS, guidance sheet “Accueil du nouveau-né en salle de naissance”, December 2017, published in 2018, cited by MACSF.
- Santé publique France, “Enquête nationale périnatale, résultats de l'édition 2021”, press release of 6 October 2022.
