Mental health challenges are common among parents after the birth of a very preterm infant. Feelings of anxiety and depression can emerge in both mothers and fathers, especially during the early days in the neonatal intensive care unit (NICU). One important approach to supporting parent-infant bonding is skin-to-skin contact (SSC), where the newborn is placed directly on a parent’s chest. A recent randomized clinical trial from Sweden and Norway explored whether immediate SSC at birth could help improve parental mental health. The study involved 91 very preterm infants (born between 28 and 33 weeks) and their parents. The findings showed that early SSC significantly reduced depression symptoms in mothers shortly after birth and eased both anxiety and depression symptoms in fathers up to the infant’s term-equivalent age.

When an infant is born very preterm, parents are suddenly thrust into an unexpected and emotionally intense situation. The experience of separation from their child immediately after birth, especially in the clinical setting of a NICU, can lead to significant psychological stress. These early days are a sensitive period not only for bonding but also for setting the stage for parental mental well-being.

This study looked at whether holding a very preterm infant skin-to-skin right after birth, rather than placing them in an incubator, could make a difference for parents. Families were randomly assigned to either begin SSC immediately at birth or to receive standard incubator care with delayed SSC. Mental health was then assessed during the first year of the infant’s life.

Early Holding, Early Healing

The most striking findings were observed in the first days and weeks after birth. Mothers who began SSC immediately had significantly lower signs of depression one week after birth compared to those who received standard care. Among fathers, anxiety symptoms were lower in the SSC group both one week after birth and at the infant’s term-equivalent age. At this later timepoint, fathers in the SSC group also showed fewer symptoms of depression. Notably, none of the fathers in the SSC group exceeded the threshold for clinical depression or anxiety at term age.

These results suggest that SSC – especially when started right after birth – may provide emotional support for parents during a particularly vulnerable time. Fathers, who often play a secondary role in early NICU care, seemed to benefit notably when engaged in immediate SSC.

From Birth Onward: A Path to Stronger Mental Health

SSC initiated at birth also appeared to encourage more contact in the following week. Parents in the SSC group spent more time in SSC overall, particularly fathers. While this increase did not directly explain the mental health benefits, the timing of early SSC may hold a unique value for fostering emotional stability. Being physically close to their newborns might help parents feel more competent and connected during a difficult time.

Incorporating SSC as a routine part of care immediately after very preterm birth could offer meaningful emotional support to parents. Medical staff can play a critical role by facilitating this closeness even during necessary medical interventions.

Supporting parents right from the beginning matters – not just for emotional bonding but for their own mental health. These findings highlight how something as simple and natural as holding one’s child can make a profound difference.

Paper available at: Skin-to-skin contact at birth for very preterm infants and symptoms of depression and anxiety in parents during the first year – A secondary outcome of a randomized clinical trial - ScienceDirect

Full list of authors: Lilliesköld, S.; Lode-Kolz, K.; Westrup, B.; Bergman, N.; Sorjonen, K.; Ådén, U.; Mörelius, E.; Rettedal, S.; Jonas, W.

DOI: https://doi.org/10.1016/j.jad.2025.04.160