Study Shows 'Kangaroo Care' for Preemies Has Profound Benefits Even 20 Years Later

Keeping tiny, preterm babies warm and fed through skin-to-skin contact and breastfeeding—called kangaroo mother care—offers significant long-term benefits to infants, researchers say.

In kangaroo mother care (KMC), a parent or caregiver replaces a hospital incubator for a premature infant and also becomes the baby’s main source of food and stimulation, giving constant skin-to-skin contact. KMC includes the following elements:

  1. kangaroo position (ie, continuous skin-to-skin contact between mother and infant), which provides appropriate thermal regulation, among other benefits
  2. exclusive breastfeeding when possible; and
  3. timely (early) discharge with close follow-up.

Originally developed in Colombia as an outpatient alternative to neonatal care units, kangaroo care replaces the practice of separating infants from their mothers and placing them in incubators while they gain weight.

Dr. Nathalie Charpak, a researcher in Bogota, said she and her team reviewed records of 228 babies to see whether kangaroo care was beneficial, comparing the babies with a control group of 213 infants who did not receive kangaroo care. The children were followed up into young adulthood.

“What we found was first the benefit on mortality, it’s clear,” Charpak said in an interview with CBC News. “Yes, really it’s a protector for mortality.”

“In the group of the lowest education of the mother, we found less [aggressiveness], less hyperactivity and less antisocial conduct behaviour in the kangaroo group.”

“We showed that when the father is carrying the baby in kangaroo mother care during the neonatal period, he was more present at one year,” she said. “He is more present at one year you have less separated family at 20 years after. It’s sympathetic.”

The study published in the journal Pediatrics found:

The effects of KMC at 1 year on IQ and home environment were still present 20 years later in the most fragile individuals, and KMC parents were more protective and nurturing, reflected by reduced school absenteeism and reduced hyperactivity, aggressiveness, externalization, and socio-deviant conduct of young adults. Neuroimaging showed larger volume of the left caudate nucleus in the KMC group.

These outstanding results led researchers to conclude that because kangaroo mother care had “significant, long-lasting social and behavioral protective effects, it should be “extended to the 18 million infants born each year who are candidates for the method.”

Dr. Paige Church, who is with the neonatal intensive care team (NICU) at Toronto’s Sunnybrook Hospital said the study confirms what she has long believed about the benefits of kangaroo care for infants and families.

“I think it’s profound. I mean to be held by a human is what we all crave,” Church told CBC News. “It makes sense to me that the power of a mother or a father’s touch has profound effects that will last into adulthood.”

She said kangaroo care empowers parents and the benefits “cascade throughout life” by changing the parents and how the baby experiences the environment.

“The babies are calmer here. They’re more regulated here. There are less desaturations where they have less instability, so that’s protective to their brains,” Church said.

In a companion piece published with the study Dr. Lydia Furman of the pediatrics department at Case Western Reserve University School of Medicine in Cleveland described the revolution in KMC over the last 20 years.

“In comparison with the usual cautious practice of incubator nursing with severely restricted parental access and discharge only when a weight of 1700 g was attained, KMC involved strapping the baby upright to the mother’s chest in skin-to-skin contact, frequent [exclusive or nearly exclusive] breast feeding, formula supplements if weight gain did not exceed 20 g/day, and early discharge,” she wrote. “What now seems a usual intervention was at the time a revolution in newborn care.”

“Despite technical obstacles, provider concern, and infant fragility, SSC is being practiced cautiously in NICUs in high-income countries, even with ventilator-dependent infants, because it can promote parental attachment, decrease stress, and increase breast milk volumes,” she said. Furman added that “KMC clearly makes the world a better place for babies and families.”