Objective: To determine whether kangaroo care (skin-to-skin contact) between mother and baby in the operating theatre can affect breastfeeding outcomes following an elective caesarean section. Method: A randomised controlled trial recruited 366 women (182 in study group, 187 in control) having an elective caesarean section at term (≥37 completed weeks of pregnancy) who chose to breastfeed their baby at birth. Babies in the study group had immediate skin-to-skin contact in the operating theatre. The control group had standard care (skin-to-skin following the operation). Results: There was a 5% increase in breastfeeding rates at 48 hours (88% vs 83%) and 7% at 6 weeks (53% vs 46%); however, these differences were not statistically significant (P = 0.25 and 0.44). There was a significant correlation between the length of time for which skin-to-skin was performed and continuing to breastfeed at 48 hours (P = 0.04). Conclusion: Skin-to-skin contact in the operating theatre following an elective caesarean section is a simple intervention associated with a trend towards an increase in breastfeeding rates at 48 hours and 6 weeks. There is a correlation between length of time for which skin-to-skin is performed during the first 24 hours and the continuation of breastfeeding at 48 hours (P = 0.04).