The Power of Early Experience: Neonatal Skin-To-Skin Care Mitigates SES-Related Disparities in Developmental Outcomes

Abstract

Infants from lower-socioeconomic (SES) backgrounds are at increased risk for compromised developmental outcomes compared to infants from higher-SES backgrounds. Features of caregiver-child interactions have been proposed as mechanisms through which SES-related factors are associated with child outcomes. This study assessed whether rates of tactile interactions between neonates and family members (skin-to-skin caregiving) served as a mechanism, that is, statistically mediated, SES-related developmental disparities in infants born preterm (n = 95). Infants from lower-SES backgrounds experienced less skin-to-skin care and scored lower on developmental assessments than infants from higher-SES backgrounds. Infants who experienced more skin-to-skin care had better outcomes than infants who experienced less skin-to-skin care. Critically, the direct association between SES and outcomes was significantly reduced after controlling for skin-to-skin care rates. Thus, SES-related disparities were linked to caregiving experiences as early as the neonatal period. Parallel analyses on non-skin-to-skin tactile care (swaddled holding, touch, and massage) revealed no associations, highlighting the specificity of skin-to-skin caregiving. These findings make substantial contributions to developmental theory and offer concrete and scalable recommendations for intervention.