In a groundbreaking narrative review published recently in the World Journal of Pediatrics, researchers Aryadevi, Putri, Satari, and colleagues have illuminated the profound impact and persistent challenges of Immediate Kangaroo Mother Care (iKMC) in neonatal health. This comprehensive review delves into the multifaceted benefits of iKMC, a practice wherein newborns, especially preterm and low birth weight infants, are placed skin-to-skin with their mothers immediately after birth. It highlights how this simple yet powerful intervention is transforming neonatal care and survival worldwide.
The concept of Kangaroo Mother Care (KMC) originated as an innovative response to the limitations faced by neonates in resource-constrained environments. Immediate Kangaroo Mother Care extends this principle by advocating for uninterrupted skin-to-skin contact right after birth, bypassing the traditional separation for routine medical interventions. The narrative review meticulously examines the mechanisms through which iKMC supports thermoregulation, enhances physiological stability, and boosts immune defense—mechanisms that conventional incubator care sometimes fails to optimize effectively.
At the physiological level, iKMC maintains newborn body temperature more naturally than incubators, reducing the risk of hypothermia, a common and deadly risk for premature infants. The direct skin contact facilitates thermal synchrony, where maternal warmth dynamically adjusts to the infant’s need, a balance no machine can replicate. Additionally, this contact stabilizes the infant’s respiration and heart rate, promoting autonomic regulation vital for premature newborns whose systems are inherently fragile and underdeveloped.
Beyond temperature regulation, the review underscores the role of iKMC in bolstering breastfeeding success. Skin-to-skin contact immediately after delivery enhances maternal milk production and expedites the initiation of breastfeeding. It stimulates the release of oxytocin and prolactin, hormones critical for milk letdown and bonding. This hormonal cascade not only improves infant nutrition but also fortifies the emotional bond, fostering psychological stability for both mother and child, a key determinant in long-term development.
The immunological advantages tied to iKMC cannot be overstated. The narrative details how the close contact facilitates the transmission of beneficial microbiota from mother to infant, which plays a fundamental role in the establishment of the newborn’s gut microbiome. This microbiome influences immune system development and can reduce the incidence of infections, a leading cause of neonatal mortality. The timing of skin-to-skin contact is crucial, as early exposure maximizes microbial colonization and primes the infant’s innate defenses exquisitely.
The article further addresses how iKMC promotes neurological and cognitive development. Early tactile interaction has been linked to improved brain maturation, sensory processing, and reduced stress hormone levels in neonates. These neurological benefits, as outlined in the review, have long-lasting implications, affecting cognitive and behavioral outcomes, particularly in vulnerable preterm infants who face higher risks of developmental delays.
Despite the overwhelming evidence supporting its benefits, the review candidly discusses barriers impeding widespread adoption of iKMC. Cultural beliefs, healthcare infrastructure limitations, and staff training deficits often hinder implementation, especially in low-resource settings. In some cultures, immediate maternal-infant contact may conflict with traditional postpartum customs, thus requiring sensitive community education and engagement strategies to align practices with proven health advantages.
Healthcare systems face challenges including resistance from medical personnel accustomed to conventional neonatal intensive care units (NICUs) practices. The narrative highlights the need for comprehensive training programs to shift clinical perspectives and standardize iKMC protocols. Hospitals must integrate iKMC-friendly designs, such as dedicated spaces that support continuous skin-to-skin contact, without compromising medical vigilance or care quality, a balance crucial for adoption and success.
Instrumentation and monitoring also pose technical challenges in the context of iKMC. Conventional medical devices designed for incubated infants may not be fully compatible with the mobile, intimate nature of skin-to-skin contact. The review advocates for technological innovation aimed at creating wearable or unobtrusive monitoring solutions that ensure newborn safety while enabling uninterrupted maternal contact.
Cost-effectiveness represents another significant dimension explored in the review. iKMC’s potential to reduce hospitalization duration and mitigate complications like infections and hypothermia underscores its economic benefits. These advantages could drive healthcare policy shifts, encouraging governments and international health organizations to promote iKMC as a standard practice in neonatal care.
The authors vividly argue for integrating iKMC into global health strategies to improve neonatal survival rates, particularly in underserved regions where access to incubators and NICUs remains limited. Scaling this intervention could mark a paradigm shift by leveraging natural biological processes and maternal involvement as cornerstones of neonatal care.
Importantly, the narrative review calls for further research to optimize iKMC guidelines, including protocols tailored for various neonatal conditions, and strategies for maternal support throughout the care continuum. Addressing knowledge gaps around long-term developmental trajectories following iKMC and cultural adaptability remains a research frontier necessary to refine recommendations.
In conclusion, this 2025 narrative review not only consolidates current knowledge on the undeniable benefits of Immediate Kangaroo Mother Care but also thoughtfully navigates the practical and systemic barriers that can undermine its implementation. By bridging clinical science, cultural context, and technological innovation, it lays a comprehensive roadmap to harness the full potential of this transformative intervention.
As neonatal care continues to evolve, the integration of Immediate Kangaroo Mother Care offers an inspiring blend of nature and medicine. Through empathy, robust scientific validation, and infrastructural commitment, iKMC promises a future where fragile newborns can thrive against all odds, supported by the life-affirming warmth of maternal contact right from the very first moments of life.
Subject of Research: Immediate Kangaroo Mother Care (iKMC) in neonatal health, benefits, and implementation barriers
Article Title: Immediate kangaroo mother care: a narrative review of the benefits and barriers
Article References:
Aryadevi, N.N.B., Putri, R.S.I., Satari, H.I. et al. Immediate kangaroo mother care: a narrative review of the benefits and barriers.
World J Pediatr (2025). https://doi.org/10.1007/s12519-025-00993-5
Image Credits: AI Generated
DOI: 14 November 2025
