New guidelines for ‘kangaroo care’ to save preterm babies’ lives

Every year, an estimated 15 million babies are born prematurely - 1 in 10 of all births globally. More than 20 million babies have a low birthweight and this number is rising. Across the world, prematurity is now the leading cause of death of children under 5. 

While most babies born at or after 28 weeks in wealthier countries go on to survive, in poorer countries survival rates can be as low as 10%. 

In the UK, around 60,000 babies are born prematurely every year, many needing to spend a period in an incubator in a hospital Neonatal Intensive Care Unit (NICU) before being well enough to go home. 

Skin-to-skin contact or kangaroo care is the practice of laying a baby directly on the parent or caregiver’s bare chest wearing just a nappy or no clothing.  

Research shows that kangaroo care is hugely beneficial for babies’ health by improving sleep and growth and helping protect babies against infection and hypothermia. We also know that it’s beneficial for many parents, reducing stress and anxiety through bonding, helping them feel more confident about looking after their baby. 

Parents of premature babies may have more limited opportunity for this skin-to-skin contact if their baby needs medical treatment and additional care.  

Skin-to-skin contact should begin immediately after birth 

Just ahead of this year’s World Prematurity Day on 17 November, WHO announced new international advice for healthcare professionals that skin-to-skin contact with a caregiver should begin immediately after birth without an initial period in an incubator. 

Previous advice and common clinical practice in many countries is for preterm babies to have an initial period of a few days in an incubator before starting kangaroo care. But research published last year showed that starting kangaroo care immediately improves survival rate, reduces infections and hypothermia (low body temperature), and improves feeding.  

If WHO’s guidelines are adopted globally, they say 150,000 lives a year could be saved. 

Our midwife Alanna explains: 

“In the UK kangaroo care is seen as beneficial by midwives and NICU nurses because it’s supported by numerous international research studies in recent years showing the benefits. It's common practice at most NHS Trusts in the UK but unfortunately may not be happening in all of them.  

“If mum or baby experience any complications immediately after birth it can result in skin-to-skin being delayed. This new WHO guidance that skin-to-skin should take place immediately after birth for both term and preterm babies is a welcome step forward.   

"It can be trickier if babies aren’t stable, but nurses will help parents to do it safely when possible and there are ways to modify how it’s done too. We encourage parents to ask their healthcare teams if they don’t feel they’re getting enough skin-to-skin time. 

"Parents should be educated by their health caregivers on the many benefits of skin-to-skin. It’s a very special part of the experience of getting to know your new baby and a calming and relaxing experience for both mother and baby. It helps regulate the baby’s temperature and breathing which preterm babies in particular often require support with.  

“Skin-to-skin contact also stimulates the release of hormones to support the early initiation of breastmilk production, which is especially important for premature babies due to their immature gut systems to help reduce rates of infection." 

Based on feedback from families gathered through more than 200 research studies, WHO’s new guidelines also advocate for better financial and emotional support for the parents or caregivers of preterm babies. The guidelines stress the importance of families being together in intensive care units and support parental leave so parents can care for their infant to the best of their ability without the worry that they will lose their job and income during a lengthy hospital stay. 

Read more about kangaroo care and find out more about our premature birth research.  

Read more from the World Health Organisation