A comprehensive review published in the World Journal of Pediatrics provides strong evidence that immediate kangaroo mother care (iKMC), initiated as soon as possible after birth and ideally within the first 24 hours, can dramatically improve outcomes for premature and low-birth-weight infants. The analysis, which synthesized data from five randomized controlled trials across diverse settings including Ghana, India, Malawi, Nigeria, Tanzania, Madagascar, Norway, Gambia, and Uganda, found that iKMC was associated with a significant reduction in 28-day neonatal mortality, fewer cases of hypothermia and suspected sepsis, higher rates of exclusive breastfeeding, and better weight gain compared with delayed kangaroo mother care.
Kangaroo mother care, which combines skin-to-skin contact, exclusive breastfeeding, early discharge, and follow-up support, was originally developed as an alternative to incubator care in resource-limited settings. Earlier guidelines recommended KMC only after clinical stabilization, but emerging evidence has shifted the focus toward immediate initiation. The review, 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, under the DOI 10.1007/s12519-025-00993-5.
The authors noted that iKMC not only improves infant survival but also offers maternal benefits, including greater satisfaction and improved postpartum recovery. Economically, iKMC reduces reliance on resource-intensive neonatal care, lowering costs for both healthcare providers and families. The intervention is powerful because it combines warmth, feeding support, bonding, infection protection, and family participation in one low-cost approach. However, safe implementation requires trained staff, suitable facilities, and practical support for mothers and caregivers.
To scale iKMC effectively, health systems may need to establish mother–neonatal intensive care units (mother–NICUs), create shared protocols between obstetric and neonatal departments, provide family-centered education, ensure privacy, and support 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 limited, and implementation for extremely low-birth-weight infants requires further study. Despite these gaps, the findings make a strong case for treating iKMC as a core component of neonatal care rather than an optional add-on, offering a rare combination of lifesaving potential and cost savings.
