A comprehensive review published in the World Journal of Pediatrics has found that immediate kangaroo mother care (iKMC), initiated as soon as possible after birth and ideally within the first 24 hours, may significantly improve survival and health outcomes for premature and low-birth-weight infants. The review, which analyzed data from five randomized controlled trials across multiple countries, suggests that this simple, low-cost intervention could play a critical role in neonatal care worldwide.
Preterm birth and low birth weight remain leading causes of neonatal death and long-term developmental challenges. Kangaroo mother care, which combines skin-to-skin contact, exclusive breastfeeding, early discharge, and follow-up support, was first introduced as an alternative to incubator care. Earlier guidelines recommended delaying KMC until clinical stabilization, but newer evidence has shifted focus toward starting care immediately after birth. The review compared iKMC with delayed KMC and found that iKMC was associated with lower 28-day neonatal mortality, reduced hypothermia, fewer suspected sepsis cases, improved exclusive breastfeeding rates, and better weight-related growth outcomes.
The researchers, from the Faculty of Medicine, Universitas Indonesia; Dr. Cipto Mangunkusumo National General Hospital; and Universitas Indonesia Hospital, synthesized evidence from studies conducted in both low- and high-resource settings, including 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, while other trials showed similar favorable trends. iKMC also reduced hypothermia, a critical risk for infants who struggle to regulate body temperature. Early skin-to-skin contact may support protective maternal microbiota transfer, reduce hospital-acquired exposure, and encourage earlier breastfeeding, all of which can strengthen neonatal immunity.
Beyond infant outcomes, the review notes potential maternal benefits, including greater satisfaction and improved postpartum recovery markers. Economic analyses suggest that iKMC can lower provider and household costs by reducing reliance on more resource-intensive care. The authors argue that iKMC should be treated not as an optional add-on but as a core part of neonatal care for eligible preterm and low-birth-weight infants. The approach combines warmth, feeding support, bonding, infection protection, and family participation in one low-cost intervention.
However, successful implementation requires safe monitoring, trained staff, suitable facilities, and practical support for mothers and caregivers. To scale iKMC safely, health systems may need mother–neonatal intensive care units, shared protocols between obstetric and neonatal departments, family-centered education, privacy solutions, and support for fathers or relatives as alternative caregivers. The review also identifies key gaps: long-term neurodevelopmental outcomes after iKMC remain unclear, evidence from high-resource settings is still limited, and implementation for extremely low-birth-weight infants requires more study.
The review, published online on November 14, 2025, in World Journal of Pediatrics (DOI: 10.1007/s12519-025-00993-5), provides a strong case for integrating iKMC into routine neonatal care. If implemented effectively, iKMC could offer a rare combination in global healthcare: a low-cost intervention capable of saving lives while reducing pressure on overstretched neonatal systems.
