This study was done to evaluate effects of maternal-infant skin-to-skin contact during the first 2 hours postbirth compared to standard care (holding the infant swaddled in blankets) on breastfeeding outcomes through 1 month follow-up. Healthy primiparous mother-infant dyads were randomly assigned by computerized minimization to skin-to-skin contact (n = 10) or standard care (n = 10). The Infant Breastfeeding Assessment Tool was used to measure success of first breastfeeding and time to effective breastfeeding (time of the first of three consecutive scores of 10-12). Intervention dyads experienced a mean of 1.66 hours of skin-to-skin contact. These infants, compared to swaddled infants, had higher mean sucking competency during the first breastfeeding (8.7 +/- 2.1 vs 6.3 +/- 2.6; P < .02) and achieved effective breastfeeding sooner (935 +/- 721 minutes vs 1737 +/- 1001; P < .04). No significant differences were found in number of breastfeeding problems encountered during follow-up (30.9 +/- 5.51 vs 32.7 +/- 5.84; P < .25) or in breastfeeding exclusivity (1.50 +/- 1.1 vs 2.10 +/- 2.2; P < .45). Sucking competency was also related to maternal nipple protractility (r = .48; P < .03). Very early skin-to-skin contact enhanced breastfeeding success during the early postpartum period. No significant differences were found at 1 month.