Immediate skin-to-skin contact advised for premature newborns by WHO

Premature or low-birth-weight babies who are clinically unstable should have skin-to-skin contact, known as kangaroo care, before incubation, according to updated guidance from the World Health Organization (WHO).

“The guidelines apply to all babies except those that need mechanical ventilation,” says Harish Chellani at the Vardhman Mahavir Medical College in India.

Around 15 to 20 per cent of newborns globally are premature – born before 37 weeks – or have a low birth weight, below 2.5 kilograms, which can make them clinically unstable. This is partly defined as needing intravenous fluids or having an unhealthy breathing or heart rate.

Since 2015, the WHO had recommended that such babies were incubated until they became clinically stable and only then receive kangaroo care. This was based on research that examined the care of newborns in hospital, with the results suggesting that having kangaroo care post-incubation cuts the risk of death by 40 per cent compared with incubation alone.

The new advice follows a trial with more than 3200 low-birth-weight infants and their mothers who gave birth in hospitals in five African or Asian countries.

Chellani and his colleagues compared babies who received immediate, prolonged kangaroo care before incubation with those who had limited skin-to-skin contact after incubation.

The babies who had immediate kangaroo care that continued for about 17 hours a day until they were discharged were 25 per cent less likely to die within one month than those who were incubated first.

This 25 per cent drop occurred on top of the previously mentioned 40 per cent fall. Outside this 17-hour window, the babies were in an incubator.

Kangaroo care may boost a baby’s immunity and lower stress.