Kangaroo Mother Care (KMC) for improving survival and growth outcomes among low birth weight and preterm infants: A comprehensive review

Abstract

Low birth weight (LBW) and preterm births present a persistent, severe threat to global child survival and long-term neurodevelopment, accounting for the vast majority of early neonatal mortality in low- and middle-income countries (LMICs). Kangaroo Mother Care (KMC)—an evidence-based standard of care defined by continuous or prolonged skin-to-skin contact, exclusive or near-exclusive breastfeeding support, and early facility discharge coupled with structured follow-up—has revolutionized global neonatology. This review provides an expanded synthesis of the biochemical, physiological, clinical, and systemic dynamics of KMC. Current research demonstrates that continuous KMC reduces all-cause neonatal mortality by up to 40% in stabilized LBW infants, lowers rates of severe nosocomial sepsis, stabilizes vital cardiopulmonary and thermoregulatory parameters, and significantly improves somatic weight gain and head growth trajectories. Recent paradigm shifts favor immediate KMC (iKMC) initiated prior to stabilization, which yields distinct survival advantages during the highest-risk early neonatal period. Despite clear clinical benefits, full-scale implementation is constrained by maternal physical exhaustion, health facility spatial limitations, staffing shortages, and entrenched cultural barriers. Overcoming these hurdles requires systemic infrastructure upgrades, including Mother-Baby NICUs (M-NICUs), integrated community care models, and supportive national health policy frameworks.