[Skin to skin contact and breast-feeding after birth: not always without risk!]

Skin-to-skin contact after birth is propagated to facilitate breast-feeding and mother-child bonding. We describe two term infants with sudden unexpected postnatal collapse (SUPC) during skin-to-skin contact. The infants were found with abnormal colour, hypotonia and apnoea, in a prone position on the chest of their mothers, both of whom were primipara with a high BMI. After stimulation, both infants recovered completely. No specific potential cause, other than the position, could be found. These cases illustrate that skin-to-skin contact after birth is not without risk. In available literature, risk factors for SUPC include primiparity and infant orientation such as prone and lateral positions. These positions are also risk factors for sudden infant death syndrome (SIDS). To improve safety, a primipara should be supervised during skin-to-skin contact and not be left alone in the first hours after delivery; the infant should be guaranteed a free airway, especially when the mother has a high BMI.