Kangaroo Care | Research & References
Kangaroo Care, also known as skin-to-skin contact, is a caregiving practice in which a newborn—often wearing only a diaper—is placed directly on a parent or caregiver’s bare chest. The practice was first developed in Bogotá, Colombia, in the late 1970s as a response to limited incubator availability for premature infants. Since then, Kangaroo Care has become a widely recommended practice in neonatal units and maternity settings around the world.
A growing body of research has examined the effects of Kangaroo Care on infant physiology, development, and parent–infant bonding. Studies suggest that skin-to-skin contact can help stabilize body temperature, regulate breathing and heart rate, promote breastfeeding, and support early attachment between caregiver and infant. For premature and low-birth-weight infants, Kangaroo Care has also been associated with reduced mortality and improved physiological stability.
While Kangaroo Care does not replace medical treatment or neonatal monitoring, evidence suggests that it can be a valuable complementary practice that supports infant health and caregiver wellbeing during the early stages of life.
The studies and references below summarize key findings from research on Kangaroo Care and skin-to-skin contact.
Benefits of Kangaroo Care | Physiological Stability and Survival
Kangaroo Care has been shown to improve physiological stability in newborns, including better regulation of heart rate, breathing, and body temperature.
Charpak, N., Ruiz-Peláez, J. G., Figueroa de C., Z., & Charpak, Y. (1997). Kangaroo mother versus traditional care for newborn infants ≤2000 grams: A randomized, controlled trial. Pediatrics, 100(4), 682–688. https://doi.org/10.1542/peds.100.4.682
Systematic reviews of multiple randomized trials have found that Kangaroo Mother Care significantly reduces mortality, infection, and severe illness among low-birth-weight infants when compared with conventional neonatal care.
Conde-Agudelo, A., Díaz-Rossello, J. L., & Belizán, J. M. (2016). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews, (8), CD002771. https://doi.org/10.1002/14651858.CD002771.pub4
Thermoregulation and Cardiovascular Stability
Skin-to-skin contact helps newborns maintain stable body temperature and supports physiological regulation during the early postnatal period. This is particularly beneficial for premature infants whose thermoregulatory systems are still developing.
Moore, E. R., Bergman, N., Anderson, G. C., & Medley, N. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, (11), CD003519. https://doi.org/10.1002/14651858.CD003519.pub4
Research also suggests that infants receiving skin-to-skin care may demonstrate more stable oxygen saturation levels and improved cardiovascular regulation compared with those receiving conventional care.
Pain Reduction and Stress Regulation
Skin-to-skin contact has been shown to reduce behavioral and physiological indicators of pain in premature infants during routine medical procedures such as heel sticks.
Ludington-Hoe, S. M., Hosseini, R., & Torowicz, D. L. (2005). Skin-to-skin contact (kangaroo care) analgesia for preterm infant heel stick. AACN Clinical Issues, 16(3), 373–387. https://doi.org/10.1097/00044067-200507000-00010
Studies also suggest that Kangaroo Care may reduce stress responses in infants by supporting parasympathetic nervous system activity and promoting physiological regulation.
Neurodevelopment and Cognitive Outcomes
Skin-to-skin contact may support early neurodevelopment by providing sensory stimulation and reducing stress during a critical period of brain development.
Feldman, R., Eidelman, A. I., Sirota, L., & Weller, A. (2002). Comparison of skin-to-skin (kangaroo) and traditional care: Parenting outcomes and preterm infant development. Pediatrics, 110(1), 16–26. https://doi.org/10.1542/peds.110.1.16
Some studies have found that increased parent-infant skin-to-skin contact is associated with improved regulatory behavior and developmental outcomes in preterm infants, although findings vary across studies.
Parent–Infant Bonding | Attachment and Emotional Connection
Kangaroo Care supports early parent–infant attachment by encouraging close physical contact and sensory communication between caregiver and baby.
Ferber, S. G., & Makhoul, I. R. (2004). The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term infant: A randomized, controlled trial. Pediatrics, 113(4), 858–865. https://doi.org/10.1542/peds.113.4.858
Research also indicates that parents who engage in regular Kangaroo Care often report increased confidence in caregiving and stronger emotional bonding with their infants.
Feldman, R., Weller, A., Sirota, L., & Eidelman, A. I. (2003). Testing a family intervention hypothesis: The contribution of mother–infant skin-to-skin contact (kangaroo care) to family interaction, proximity, and touch. Journal of Family Psychology, 17(1), 94–107. https://doi.org/10.1037/0893-3200.17.1.94
Maternal Wellbeing and Stress Reduction
Engaging in Kangaroo Care may also support parental wellbeing. Studies suggest that skin-to-skin contact can help reduce parental stress and support emotional connection between caregiver and infant, particularly for parents of premature infants receiving neonatal care.
Research also indicates that Kangaroo Care may help increase parental confidence and feelings of closeness during the early postpartum period.
Mechanisms and Theoretical Frameworks | Biological and Developmental Mechanisms
Researchers propose several biological and behavioral mechanisms that may explain the benefits of Kangaroo Care, including:
• stimulation of the parasympathetic nervous system
• increased oxytocin release in both caregiver and infant
• improved thermoregulation and metabolic stability
• reduced cortisol levels and stress responses
• enhanced sensory and emotional co-regulation between parent and infant
These mechanisms may help support early physiological regulation and attachment during the newborn period.
Feldman, R. (2012). Bio-behavioral synchrony: A model for integrating biological and microsocial behavioral processes in the study of parenting. Parenting: Science and Practice, 12(2–3), 154–164. https://doi.org/10.1080/15295192.2012.683342
The information provided on this page summarizes findings from published scientific studies on Kangaroo Care and skin-to-skin contact. This content is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Parents and caregivers should consult their pediatrician, midwife, or qualified healthcare provider regarding any medical concerns about their infant.
The studies cited here include peer-reviewed research published in medical and developmental science journals, as well as systematic reviews from sources such as the Cochrane Database of Systematic Reviews and the journal Pediatrics. These references represent widely cited research examining the physiological, developmental, and relational effects of Kangaroo Care.
Research & References
Charpak, N., Ruiz-Peláez, J. G., Figueroa de C., Z., & Charpak, Y. (1997). Kangaroo mother versus traditional care for newborn infants ≤2000 grams: A randomized, controlled trial. Pediatrics, 100(4), 682–688. https://doi.org/10.1542/peds.100.4.682
Conde-Agudelo, A., Díaz-Rossello, J. L., & Belizán, J. M. (2016). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews, (8), CD002771. https://doi.org/10.1002/14651858.CD002771.pub4
Feldman, R. (2012). Bio-behavioral synchrony: A model for integrating biological and microsocial behavioral processes in the study of parenting. Parenting: Science and Practice, 12(2–3), 154–164. https://doi.org/10.1080/15295192.2012.683342
Feldman, R., Eidelman, A. I., Sirota, L., & Weller, A. (2002). Comparison of skin-to-skin (kangaroo) and traditional care: Parenting outcomes and preterm infant development. Pediatrics, 110(1), 16–26. https://doi.org/10.1542/peds.110.1.16
Feldman, R., Weller, A., Sirota, L., & Eidelman, A. I. (2003). Testing a family intervention hypothesis: The contribution of mother–infant skin-to-skin contact (kangaroo care) to family interaction, proximity, and touch. Journal of Family Psychology, 17(1), 94–107. https://doi.org/10.1037/0893-3200.17.1.94
Ferber, S. G., & Makhoul, I. R. (2004). The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term infant: A randomized, controlled trial. Pediatrics, 113(4), 858–865. https://doi.org/10.1542/peds.113.4.858
Ludington-Hoe, S. M., Hosseini, R., & Torowicz, D. L. (2005). Skin-to-skin contact (kangaroo care) analgesia for preterm infant heel stick. AACN Clinical Issues, 16(3), 373–387. https://doi.org/10.1097/00044067-200507000-00010
Moore, E. R., Bergman, N., Anderson, G. C., & Medley, N. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, (11), CD003519. https://doi.org/10.1002/14651858.CD003519.pub4