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, can significantly improve survival and health outcomes for premature and low-birth-weight infants. The study, conducted by researchers from the Faculty of Medicine, Universitas Indonesia; Dr. Cipto Mangunkusumo National General Hospital; and Universitas Indonesia Hospital, was published online on November 14, 2025 (DOI: 10.1007/s12519-025-00993-5).
Preterm birth and low birth weight remain major contributors to neonatal death and long-term developmental challenges worldwide. Kangaroo mother care, which combines skin-to-skin contact, exclusive breastfeeding, early discharge, and follow-up support, has been recognized as a low-cost intervention. However, earlier guidelines recommended starting KMC only after clinical stabilization. This review shifts the focus toward immediate initiation, showing that iKMC is associated with lower 28-day neonatal mortality, reduced hypothermia, fewer suspected sepsis cases, improved exclusive breastfeeding, and better weight-related growth outcomes compared with delayed KMC.
The authors searched Medline (PubMed), Scopus, EuropePMC, and Google Scholar up to June 2024 and included five randomized controlled trials from 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, with other trials showing similar favorable trends. iKMC also reduced hypothermia, a critical risk for preterm 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, strengthening neonatal immunity. Potential maternal benefits include greater satisfaction and improved postpartum recovery markers. Economic analyses suggest iKMC can lower provider and household costs by reducing reliance on more resource-intensive care.
The authors emphasize that iKMC should be treated as a core part of neonatal care for eligible preterm and low-birth-weight infants, not an optional add-on. The approach combines warmth, feeding support, bonding, infection protection, and family participation in one low-cost intervention. However, success depends on 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 (mother–NICUs), 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. 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.
