No tech needed: Skin-to-skin contact for premature babies saves lives and has long-term benefits

Edith’s two twin boys are strapped to their grandmother’s chest in the maternity unit in the Queen Elizabeth hospital in Blantyre, Malawi. (Credit: indsay Mgbor/Department for International Development)

Continuous skin-to-skin contact and breastfeeding benefit premature children more than incubator care, according to a new study from Colombia. Those gains do not disappear over time.

Children who received skin-to-skin kangaroo care are more likely to go to school, less likely to die and earn more money compared to children who did not. The findings build on the already-strong evidence that exclusive breastfeeding and direct contact between a caregiver and child help babies survive and thrive.

“A premature infant is born somewhere in the world every two seconds,” said Peter Singer, chief executive officer of Grand Challenges Canada and study funder, in a statement. “This study shows that kangaroo mother care gives premature and low birth weight babies a better chance of thriving. Kangaroo mother care saves brains and makes premature and low birth weight babies healthier and wealthier.”

Researchers followed up on the progress of children included in a randomized controlled trial conducted in Colombia from 1993 to 1996. The original study followed the babies for a year to observe the short-term benefits of kangaroo care. A follow-up 20 years later looked at 264 children from the original study who weighed less than four pounds at birth.

They found that all the benefits to kangaroo care observed after a year remained two decades later. The mortality rate for babies in the incubator group was more than twice that of the kangaroo group. There were major emotional benefits, too. The kangaroo group were found to be less aggressive, less antisocial and more nurturing.

Radhika’s baby was born premature and very low weight. Her female community health volunteer visited every day and taught the entire family how to apply kangaroo mother care to the baby. (Credit: Save the Children)

Radhika’s baby was born premature and very low weight. Her community health volunteer visited every day and taught the entire family how to use kangaroo mother care to the baby. (Credit: Save the Children)

“We firmly believe that this is a powerful, efficient, scientifically based health-care intervention that can be used in all settings, from those with very restricted to unrestricted access to health care,” lead researcher Nathalie Charpak of the Kangaroo Foundation in Bogotá said in a statement.

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Kangaroo care may alter the way individual parents care for their babies, the researchers suggested. The long-term importance of exclusive breastfeeding is well established, but there may be something to the kind of care that develops as a result. They suggest that kangaroo care may increase the sensitivity of parents to the needs of their children.

“Introduction of [kangaroo care]immediately after neonatal intensive care, without other developmental programs, motivates families to become more child-oriented and shortens this suboptimal period. We hypothesize that the results would be even more significant if [kangaroo care]was introduced as soon as the infant could tolerate it, even in [intensive care units],” according to the authors.

Earlier this year, the U.K.-based medical study evaluator Cochrane published an analysis of 21 studies on kangaroo care for preterm babies. Cochrane’s researchers concluded that the simple solution helps reduce mortality and prevents other immediate health problems preterm babies are susceptible to experiencing.

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The review and results are particularly important to countries with limited health resources. Some 15 million children are born before completing 37 weeks of gestation each year, according to the World Health Organization (WHO). Rates globally are going up, too, as 62 of 65 countries with reliable health data are experiencing more preterm births.

Complications related to preterm birth are the leading cause of death for children under 5 years old, and the burden of those deaths are on the world’s poorest families. More than 60 percent of preterm births occur in Africa and South Asia.

The gap between rich and poor countries is striking. More than 90 percent of extremely preterm babies born in low-income countries die a few days after birth. The fatality rate for the same children in high-income countries is just 10 percent.

Kangaroo care will not completely close that gap, but increasing the use of the world’s oldest technology saves lives and has long-lasting positive effects.

“This study demonstrates that kangaroo mother care can make all the difference in the world for premature and low-birth-weight infants,” said Karlee Silver, vice president of programs at Grand Challenges Canada, in a statement. “Kangaroo mother care is a cost-effective, modern method of care that can and should be applied in every country.”

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Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.