Starting skin-to-skin contact right after birth—even before stabilization—slashes premature infant mortality by 25%, according to a major study published in Nature.
The kangaroo mother care method places premature babies in continuous skin-to-skin contact on their mother's chest. This approach supports the health and well-being of both full-term and preterm infants. Previously, the World Health Organization (WHO) advised delaying skin-to-skin contact until infants under 2 kg were stabilized, which could take days. But is waiting optimal?
"Offering skin-to-skin contact immediately after birth to very small, unstable babies has faced strong resistance, yet about 75% of deaths occur before stabilization," notes Nils Bergman, PhD, from Sweden's Karolinska Institutet.
Funded by the Bill & Melinda Gates Foundation and led by WHO, Bergman and colleagues examined immediate kangaroo care for infants weighing 1-1.8 kg at birth. The trial focused on middle-income countries, collecting data from teaching hospitals in Ghana, India, Malawi, Nigeria, and Tanzania, where pre-study mortality for these infants ranged from 20-30%.
Prior to the study, staff received training in basic neonatal care and kangaroo methods from University of Stavanger experts in Norway, plus equipment for oxygen monitoring and assisted ventilation.
In this randomized trial of 3,211 premature infants, one group received immediate skin-to-skin contact with mothers, while the control group waited for stabilization in separate units, reuniting only for feeds.
Kangaroo group infants averaged 17 hours of daily skin-to-skin contact in the first 72 hours, versus 1.5 hours for controls.
Results: 28-day mortality was 12% in the kangaroo group versus 15.7% in controls—a 25% reduction. Kangaroo infants also maintained better body temperature and had fewer sepsis cases.
"The key takeaway: Low-birth-weight newborns need immediate skin-to-skin contact, then care as a mother-infant dyad in dedicated units," says co-author Björn Westrup, MD, PhD. "This low-resource model yields profound health benefits."
Researchers project it could save 150,000 newborns annually worldwide. WHO is now updating its kangaroo care guidelines.
