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Q & A: Kangaroo Mother Care

We have a policy [in our hospital NICU] that says we cannot put a baby skin-to-skin (kangaroo mother care) if the baby is born before 28 weeks gestation. Is there any research to support or refute this?
– Erika K., Texas

Hi, Erika! As you are aware, there are dozens of well-controlled trials that show the benefits of kangaroo mother care. The sheer number of studies that show such benefits is astounding. What’s even more remarkable is that to date, no study has shown adverse effects of kangaroo mother care (KMC).

If I were to pick articles that might become seminal pieces, I would pick two whose first author is one of my favorites, Kirsten Nyvquist. (See this and this.) These were apparently written with an eye toward establishing guidelines for KMC. Neither supports the idea of a 28-week barrier, although the authors recognize that some medical conditions may come in the way of KMC, particularly prior to 27 weeks.  They nevertheless call on physicians to evaluate each mother-baby dyad case-by-case and hold that KMC is the best practice for all babies after birth. Furthermore, a study by Bohnhorst and colleagues included infants born as early as 24 weeks gestation.

In short, I cannot find any evidence-based reason for your NICU to prohibit all infants born before 28 weeks of gestation from experiencing kangaroo mother care. Although KMC might be inappropriate for a few, it would seem that a case-by-case evaluation would be more appropriate.

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