A comprehensive review published in the World Journal of Pediatrics suggests that immediate skin-to-skin contact, known as kangaroo mother care (KMC), can substantially reduce mortality and improve health outcomes for premature and low-birth-weight infants when initiated shortly after birth. The analysis, which synthesized data from five randomized controlled trials across multiple countries, found that immediate KMC (iKMC) was associated with a 28-day neonatal mortality reduction, decreased hypothermia, fewer suspected sepsis cases, higher rates of exclusive breastfeeding, and better weight gain compared to delayed KMC.
Preterm birth and low birth weight remain leading causes of neonatal death and long-term developmental issues. Kangaroo mother care, which combines skin-to-skin contact, breastfeeding support, and early discharge, has been recognized as a low-cost intervention. Earlier guidelines recommended starting KMC after clinical stabilization, but emerging evidence supports initiating care immediately after birth. However, implementation varies widely due to differences in hospital protocols, staffing, and facilities. The review, conducted by researchers from Universitas Indonesia and affiliated hospitals and published online in the World Journal of Pediatrics, aimed to clarify the benefits and challenges of iKMC.
The authors searched databases including Medline, Scopus, and Google Scholar up to June 2024, identifying five randomized controlled trials comparing immediate versus delayed KMC in both low- and high-resource settings such as Ghana, India, Malawi, Nigeria, Tanzania, Madagascar, Norway, Gambia, and Uganda. The World Health Organization iKMC trial reported lower 28-day mortality in the immediate-care group, and other trials showed similar trends. Immediate KMC also reduced hypothermia, a critical risk for infants struggling to regulate temperature. Early skin-to-skin contact may promote protective maternal microbiota transfer, reduce hospital-acquired infections, and encourage earlier breastfeeding, boosting neonatal immunity. Additionally, the review noted potential maternal benefits, including greater satisfaction and improved postpartum recovery, as well as economic advantages by reducing reliance on intensive care.
The researchers argue that iKMC should be considered a core component of neonatal care for eligible preterm and low-birth-weight infants rather than an optional add-on. The intervention combines warmth, feeding support, bonding, infection protection, and family involvement in a single low-cost approach. However, safe implementation requires trained staff, suitable facilities, and support for mothers. Scaling iKMC may necessitate mother–neonatal intensive care units, shared obstetric and neonatal protocols, family education, privacy measures, and support for alternative caregivers. The review also highlights gaps, including unclear long-term neurodevelopmental outcomes, limited evidence from high-resource settings, and the need for more research on extremely low-birth-weight infants. Despite these challenges, iKMC offers a rare opportunity in global healthcare: a low-cost intervention that can save lives while easing pressure on overburdened neonatal systems.
