12578 Kangaroo Care

Overview

Kangaroo care is a simple way of holding your baby. You place your baby, wearing only a nappy (diaper) and maybe a little hat, directly on your bare chest. A blanket goes over the baby's back. The name comes from kangaroos, who carry their babies in a pouch close to their body. Skin-to-skin contact like this keeps your baby warm, calms them, and helps you and your baby get to know each other. It can be done by mothers, fathers, adoptive parents, grandparents or any close caregiver, and it is safe for healthy full-term babies as well as for babies born early.

Yes. Kangaroo care is used in hospitals around the world and is a standard part of newborn care, especially for babies born early or small. Many maternity and newborn units encourage skin-to-skin contact straight after birth and every day after that.

Kangaroo care is for newborn babies and the people who care for them. Babies who benefit most include those born early (premature), babies with low birth weight, babies who need extra help keeping warm, and babies who have to spend time in a newborn unit away from their parents. It is also good for healthy full-term babies and for parents who want to feel closer to their baby.

Symptoms

Common symptoms

• Kangaroo care is not an illness, so it has no symptoms of its own. Instead, parents and nurses often notice how a baby responds during skin-to-skin time.
• The baby settles and cries less.
• The baby's breathing becomes slower and steadier.
• The baby's skin feels warm and their colour looks good.
• The baby may become alert and look around, or fall into a deep, calm sleep.
• The baby may start to root, nuzzle or move towards the breast and feed more easily.
• Parents often notice they feel calmer too, and more confident about handling their baby.

Symptoms in children

• In newborns and babies, signs that skin-to-skin time is going well include relaxed arms and legs, steady breathing, warm pink skin and a calm or sleepy look.
• Signs that your baby needs a break include turning away, arching their back, squirming a lot, going pale or blotchy, or breathing fast ornoisily. If this happens, try a calmer position or ask your nurse or midwife for help.
• Older children are not the focus of kangaroo care, but cuddles, holding and close contact remain important for comfort and bonding at every age.

Symptoms in older adults

• Kangaroo care is designed for newborn babies, so it does not apply to older adults.
• If you are a grandparent or older caregiver, you can still take part in skin-to-skin contact if you are well and it is comfortable for you. Ask the midwife or nurse on the unit.

Causes

Main causes

• Kangaroo care is not caused by anything and is not a condition. It is a care practice — a way of holding and nurturing a baby.
• It is used when a baby is born early or small and needs help staying warm, feeding and growing.
• It is used when a baby needs to spend time in a newborn unit, to keep parents and baby close.
• It is used straight after birth for healthy babies, to support bonding and the start of breastfeeding.
• It is used for comfort during and after medical procedures, and for babies who are unsettled or having trouble feeding.

Risk factors

• Babies who benefit most include those born before 37 weeks, babies weighing less than about 2.5 kg (5.5 lb), and babies with low body temperature.
• Babies who need help with breathing, feeding or growth often gain the most from skin-to-skin time.
• Things that can make kangaroo care harder to do include a caesarean birth while you are recovering, hospital routines, a parent who is unwell, and feeling nervous about handling a tiny baby.
• Most of these barriers can be worked around with help from your midwife, nurse or partner.

When to see a doctor

See a doctor urgently if:

• Your baby is not feeding well, is hard to wake, or has fewer wet nappies.
• Your baby feels very hot or very cold to touch.
• Your baby's skin or eyes are becoming more yellow.
• You notice any change in your baby's breathing, colour or energy that worries you.
• You feel unwell yourself — for example, a fever, heavy bleeding, or pain that is getting worse after birth.

Book a routine appointment if:

• You would like help getting started with skin-to-skin contact.
• You are finding it uncomfortable to hold your baby for long periods, or you have back, shoulder or wound pain.
• You feel low, anxious or overwhelmed — talk to your midwife, health visitor or doctor.
• You want advice about feeding, sleep or caring for your baby at home.

Diagnosis

There is nothing to diagnose — kangaroo care is a care practice, not a disease. Your midwife or nurse will usually show you how to do it while you are in hospital, help you position your baby, and check that you are both comfortable. They will watch your baby's temperature, breathing, colour and feeding to make sure skin-to-skin time is suiting them.

Tests that may be done

• No tests are needed to do kangaroo care.
• Staff may check your baby's temperature before and during skin-to-skin time, especially for small or premature babies.
• Your baby's breathing, heart rate and oxygen levels may be watched on a monitor if they are in a newborn unit.
• Weight, feeding and nappy output are checked as part of normal newborn care.

What to expect at your appointment

Expect to be shown, not told. A midwife or nurse will help you sit comfortably, undress your baby down to a nappy and hat, and place them upright on your chest. They will show you how to support your baby and cover them with a blanket. You may be offered a screen or quiet space. Start with short sessions of 20 to 30 minutes and build up as you both get used to it. If your baby is in a newborn unit, staff will help you plan times around feeds and checks.

Treatment

Kangaroo care is itself the approach — there is no medicine involved. It is a way of holding your baby that supports warmth, feeding, breathing and bonding, and it sits alongside ordinary newborn care. Your midwife, nurse or health visitor can teach you the technique and adjust it to suit your baby. If your baby is premature or unwell, kangaroo care is planned together with the newborn unit team.

Self-care at home

• Sit somewhere safe and comfortable, ideally in a reclined chair with arm support, so you can relax without holding your baby's full weight.
• Undress your baby to a nappy and a hat, and open or remove your own top so your baby's skin rests directly on your chest.
• Place your baby upright, chest to chest, with their head turned to one side so their nose and mouth are clear and you can see their face.
• Support your baby's bottom with your hands or a soft wrap, and cover their back with a blanket.
• Stay like this for as long as you are both comfortable — 20 to 30 minutes to start, and longer (an hour or more) when you can.
• Keep the room warm and draught-free, and have a drink and anything you need within reach.
• Never fall asleep with your baby on a sofa or armchair. If you feel sleepy, put your baby safely back in their cot or ask someone to take over.
• If your baby is in a newborn unit, ask the staff when you can do skin-to-skin, and let them help you with wires, tubes or monitors.
• Talk, sing or simply breathe slowly with your baby — there is no need to entertain them.

Medical treatments

There are no medicines for kangaroo care. Instead, the wider care around it matters: staff keep your baby warm, support feeding, treat any medical problems your baby has, and plan skin-to-skin sessions around those treatments. Some hospitals use special chairs, wraps or screens to make skin-to-skin easier. Parents of babies in a newborn unit may be encouraged to stay close by, and expressing breast milk may be part of the plan if a baby cannot feed directly at first. Ask your team what is possible for your baby.

When is surgery considered?

Surgery is not part of kangaroo care. If your baby needs an operation or procedure, skin-to-skin contact is usually paused for a short time and then started again as soon as the team agrees it is safe.

Living with this condition

Kangaroo care fits easily into daily life once you get the hang of it. Many parents build it into a routine — for example, after a nappy change or a feed, or in the evening when the house is calm. It does not need special equipment. A quiet room, a comfortable chair and a blanket are enough. If your baby is in hospital, short, frequent sessions are often easier than one long one, and staff will help you plan them around feeds and checks.

Lifestyle tips

• Wear loose clothing that opens at the front, or a top that can be pulled down easily, so skin-to-skin is simple to start.
• Keep the room comfortably warm and away from draughts.
• Take turns with your partner or another trusted adult so nobody gets too tired.
• Ask visitors to wait if you are having skin-to-skin time — quiet, unhurried contact works best.
• Look after your own basic needs: eat, drink and rest when you can. Tired parents find it harder to sit comfortably for long.
• Wash your hands before holding your baby, and keep your baby's face clear and visible.

Diet and exercise

There is no special diet for kangaroo care, but eating and drinking regularly helps you have the energy to sit and hold your baby comfortably. If you are breastfeeding, keep water within reach during sessions. Gentle movement — short walks, stretches for your back and shoulders, and pelvic floor exercises once your clinician says it is safe — can ease the stiffness that comes from sitting still and holding a baby for long stretches. Ask your midwife or physiotherapist for advice after a caesarean birth or if you have pain.

Mental health and emotional wellbeing

Skin-to-skin contact often helps parents feel closer to their baby and more confident in their care, and some parents notice it lowers their own stress. It can also bring up strong feelings, especially if your baby was born early, is in a newborn unit, or if feeding is not going as you hoped. Feeling tearful, anxious or detached is common in the early weeks, and it is not a sign of failure. If low mood, worry or frightening thoughts last more than a couple of weeks or interfere with daily life, please tell your midwife, health visitor or doctor — support is available, and you deserve it.

Prevention

Kangaroo care is not a disease, so there is nothing to prevent. What you can do is plan for it: mention to your midwife before the birth that you would like skin-to-skin contact, pack clothing that opens at the front, and ask about hospital routines and newborn unit visiting so you know what to expect. If your baby arrives early, ask the team early about how you can take part.

Screening programmes

Routine newborn checks — including the newborn physical examination, hearing check and blood spot screening where offered — continue as normal and are not affected by kangaroo care. These checks help find problems early and are separate from skin-to-skin contact.

Complications

If left untreated

• Choosing not to do kangaroo care does not harm your baby, and many babies grow up healthy with other kinds of close cuddling and contact.
• Babies who have less skin-to-skin contact may take longer to settle, may find it harder to keep warm, and may have more trouble getting breastfeeding started.
• Parents may feel less confident or less connected at first, which can make the early weeks harder.
• For premature or small babies, skin-to-skin contact is linked with better warmth, steadier breathing and better feeding, so it is worth trying even in short bursts.

Long-term outlook

Very good. Kangaroo care is one of the simplest, best-studied things a parent can do for a newborn, and it is safe for almost every baby. Small, premature babies often make lovely progress with regular skin-to-skin time alongside their medical care. There is no perfect way to do it — even a few calm minutes a day is worthwhile, and you can build up as you and your baby get used to each other.

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