Kangaroo Care

What is kangaroo care?

Kangaroo care is a method of holding your baby to your chest. Your baby wears only a diaper and possibly a hat and socks to help stay warm. They rest against your bare chest, allowing for skin-to-skin contact. This type of touch is a special experience that can help you and your baby bond. It also has medical benefits, particularly for babies with a low birth weight or babies born preterm.

You can typically do kangaroo care in the hospital, including in the neonatal intensive care unit (NICU), as well as at home. How long you hold your baby each time can vary depending on your situation and your baby’s medical needs. Your care team can advise you on this. They’ll also let you know if kangaroo care is doable if your baby is connected to IVs or other medical equipment.

“Kangaroo mother care” is another name for kangaroo care. Most research focuses on the benefits of a mother providing such care. But other caregivers can practice kangaroo care, too. These include fathers, other family members and trained volunteers.

What is skin-to-skin contact?

Most people use the terms skin-to-skin contact and kangaroo care to mean the same thing. In the context of delivery, skin-to-skin contact means your baby is placed belly-down, directly on your chest, right after birth. This window of time is often called the “golden hour.” Your care team dries off your baby and puts a hat on their head. They cover your baby’s back with a warm blanket and get them settled on your chest.

The first hours of snuggling like this, skin-to-skin, let you and your baby get to know each other. This practice also has important health benefits for your baby. Plus, many research studies have shown that skin-to-skin contact helps your baby start and continue breastfeeding.

The American Academy of Pediatrics recommends that all breastfeeding babies spend time skin-to-skin right after birth. Keeping your baby skin-to-skin in their first few weeks makes it easier for you to know when to feed them, especially if they’re a little sleepy.

Your care team will try to help you do skin-to-skin after a vaginal delivery or a C-section. If you need surgery or aren’t feeling well enough to do skin-to-skin, your partner or another support person can step in to do it.

Newborns crave skin-to-skin contact. But it might feel overwhelming to you at first. It’s OK to start slowly as you get to know your baby.

How do I do kangaroo care?

Your care team will help you get started in the hospital. Here are some basic tips for doing kangaroo care at home:

• Dress comfortably: Wear something that you can easily open in front because your baby will rest against your bare chest. You’ll also need to remove your bra if you wear one.
• Place your baby on your chest: Your baby should be in an upright position with their head resting to one side against your chest. Your baby will typically wear only a diaper, hat and socks.
• Cover your baby: Once you’re settled skin-to-skin, drape a blanket over your baby’s back to keep them warm and comfortable. You may use a wrap to secure your baby against your chest.
• Relax together: Try to relax as you hold your baby. Breathe normally. This is a great time to let your baby relax or fall asleep. Avoid playing with your baby or rousing their attention. To keep your baby safe, you should stay awake.

The more time you spend skin-to-skin, the better. Choose a time that works best for you and your baby. Convenient times are often early in the morning and after you give your baby a bath.

What to avoid during kangaroo care

To make kangaroo care safe and comfortable for your baby, you should:

• Put away phones or other electronic devices. These can distract your focus away from your baby. Focusing on your baby is important for bonding and also for keeping your baby safe.
• Make sure your skin is clean and healthy. Clean your skin first and don’t apply perfumes or lotions. Don’t do skin-to-skin contact if you have a rash, open cuts or cold sores.
• Avoid smoking. Don’t smoke before or during kangaroo care. Secondhand smoke poses many health risks for your baby.
• Avoid doing kangaroo care if you’re sick. Your baby’s immune system doesn’t fully mature until they’re 2 to 3 months old. Limit your baby’s exposure to germs during this time. Your provider may say it’s OK to snuggle close if you wear a facemask.
• Avoid kangaroo care if you’re sleepy. If you’re very tired, you might fall asleep with your baby while you’re skin-to-skin. This can increase the risk of sudden infant death syndrome (SIDS).

What are the benefits of kangaroo care?

Kangaroo care has many benefits, especially for babies born early or with a low birth weight. It can help:

• Stabilize your baby’s heart rate
• Improve your baby’s breathing pattern and make their breathing more regular
• Support healthy sleep, including more quiet sleep and longer cycles
• Encourage your baby’s growth
• Relieve pain your baby might feel during certain procedures, like a heel prick test
• Lower your baby’s risk of hypothermia, serious infections or death (for babies born in resource-limited nations)

Kangaroo care also helps you:

• Bond with your baby
• Establish breastfeeding and increase your milk supply
• Feel confident in your ability to care for your baby and respond to their needs

What is the history of kangaroo care?

Resting your baby against your chest is a natural practice that’s gone on throughout history. But kangaroo care as a named, clinically defined process began in Bogotá, Colombia, in the late 1970s. Preterm babies there had a high mortality rate at that time.

Two doctors in Bogotá, Edgar Rey, MD, and Hector Martinez, MD, went in search of a solution to help the babies they cared for. They found one through a conversation with a village wet nurse. She explained how she bundled newborns up against her chest. This supported the babies’ health and growth.

Drs. Rey and Martinez tried such skin-to-skin contact with mothers and babies at their hospital. They called this practice “kangaroo mother care.” The term describes how bundling your baby against your chest looks like preterm kangaroos crawling inside their mother’s pouch and latching on to a nipple for feeding. The baby kangaroos stay in the pouch for many months until they’re old enough to search for food on their own.

The doctors’ efforts in Bogotá were very successful. They led to a 70% drop in deaths among preterm babies within the first year.

Meanwhile, in the 1970s, researchers in the U.S. were studying how skin-to-skin contact can help babies and parents. They discovered the minutes and hours immediately after birth are crucial bonding times for parents and their infants.

In the decades that followed, researchers have continued to uncover the benefits of kangaroo care. For example, they learned it helps babies sleep better and breathe more regularly. It also helps support breastfeeding and healthy parent-infant attachment.

Researchers today are looking further into the benefits of kangaroo care and how it can help babies thrive in different settings. In nations with limited access to medical technologies, kangaroo care can be lifesaving. In high-resource nations, kangaroo care can still play a valuable role in supporting a baby’s health and well-being while also helping with the bonding process.