REGULAR ARTICLE Cortisol and blood pressure levels decreased in fathers during the first hour of skin-to-skin contact with their premature babies Natalia Varela (natalia.varela@uexternado.edu.co) 1,2 ,R ejean Tessier 2,3 , George Tarabulsy 2,4 , Tamarha Pierce 2 1.Department of Social Sciences, Facultad de Ciencias Sociales, Universidad Externado de Colombia, Bogota, Colombia 2.Department of Psychology, Universit e Laval, Qu ebec City, QC, Canada 3.University Hospital Research Centre, Universit e Laval, Qu ebec City, QC, Canada 4.Centre universitaire de recherche sur les jeunes et les familles, Universit e Laval, Qu ebec City, QC, Canada Keywords Cortisol, Father, Physiological stress, Premature baby, Skin-to-skin contact Correspondence N Varela, PhD, Facultad de Ciencias Sociales, Universidad Externado de Colombia, Calle 12 # 1-17 Este, Bogota, Colombia. Tel: +571 3420288 | Email: natalia.varela@uexternado.edu.co Received 5 September 2016; revised 21 November 2017; accepted 5 December 2017. DOI:10.1111/apa.14184 ABSTRACT Aim: Premature birth is an extremely stressful experience. In 2013 to 2014, we explored the physiological stress responses of fathers during their first skin-to-skin contact (SSC) with their new baby. Methods: We recruited 49 fathers whose partners had given birth to a premature baby of up to 33 weeks and three days. The study, in the neonatal intensive care unit (NICU) of a Quebec hospital, measured the physiological stress responses of the fathers before and after they first experienced SSC with their new baby. Cortisol levels and blood pressure were measured, and a generalised estimating equation was used for the data analysis. Results: The fathers’ cortisol levels decreased from 10.55 nmol/L, with a 95% confidence interval (95% CI) of 9.61–11.59 at the beginning of the experiment to 8.26 nmol/L (95% CI: 7.51–9.07) after 75 minutes. Meanwhile, their systolic blood pressure decreased from 135.16 mmHg (95% CI: 130–140) to 125.25 mmHg (95% CI: 121–129). Conclusion: Fathers who held their baby in SSC for the first time showed a significant reduction in physiological stress responses. Our findings support hospital practices that enable fathers to experience their first intimate contact with their newborn infant in the NICU. INTRODUCTION The incubator is the main care environment for premature infants in developed countries. However, this traditional model of care physically separates the infant from their parents, depriving them of close contact with one another, sometimes for long periods of time (1–3). This forced separation has been shown to be an extremely stressful experience for both the premature babies and their parents (4), and stress can affect parenting and influence the parent–child relationship (5,6). Owing to these issues, it became clear that there was a need for an alternative method of care. Kangaroo mother care (KMC), which was originally developed in Colombia in the 1970s to provide care in areas where incubators were unavailable or unreliable, has been reported to decrease mortality rates (7) and promote the proper development of the premature child, family integra- tion and parental involvement (7,8). KMC has proven to be an effective alternative to ensuring the survival of preterm and, or, low birthweight infants and provide them with a better quality of life (7). This method has three components: direct skin-to-skin contact (SSC) between the caregivers and baby, exclusive breastfeeding and interdisciplinary monitoring during the first years of the child’s life. Its benefits have been confirmed in the literature (7,8). In the light of these studies, a number of developed countries have introduced SSC into their hospital care for premature infants. In Quebec City, the Universit e Laval Hospital Centre has been using this method since 2011. It has been shown that the fathers of premature babies experience parenthood differently from the fathers of term babies (9), with lower involvement and significantly higher Abbreviations NICU, Neonatal intensive care unit; SSC, Skin-to-skin contact. Key notes  We explored the physiological stress responses experi- enced by 49 new fathers by measuring their cortisol levels and blood pressure before and after their first skin-to-skin contact with their premature baby  This Canadian neonatal intensive care unit (NICU) study showed a significant reduction in the fathers’ physio- logical stress responses.  The findings support hospital practices that enable fathers to experience their first intimate contact with their newborn infant in the NICU. 628 ©2017 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd 2018 107, pp. 628–632 Acta Pædiatrica ISSN 0803-5253