Why kangaroo mother care should be standard for all newborns.

It has been 35 years since Edgar Rey Sanabria responded to the high rate of morbidity and mortality among low-birth-weight (LBW)/preterm newborns in Bogotá, Colombia, with guidelines that have become known as kangaroo mother care.1−4 To address a shortage of incubators and medical personnel, Dr. Sanabria, in a classic case of reverse engineering, analyzed what standard incubator care provided for LBW/preterm newborns and concluded that mothers were ideally suited to provide the warmth and nourishment that even the neediest neonates required.1−4 The kangaroo mother care model is simple: 1) place the undressed newborn vertically between the mother’s breasts to provide warmth with continuous skinto-skin contact, 2) establish early and exclusive breastfeeding, and 3) enable early hospital discharge.1−4 Although it is firmly established that kangaroo mother care saves lives in low-resource areas,1−3,5 should industrialized nations that boast state-of-the-art neonatal intensive care units (NICUs) consider kangaroo mother care standard treatment for LBW/preterm newborns? A 2011 Cochrane review of kangaroo mother care by Conde-Agudelo et al was appropriately conservative in its assessment of the data within its study criteria and supported kangaroo mother care as an alternative to conventional neonatal care for LBW newborns, defined as weighing less than 2500 g (5.5 lbs.), in resourcelimited settings.1 However, we might ask if kangaroo mother care is better for all newborns in all settings, even healthy fullterm newborns in affluent areas. Taking a wider view, what would the economic and societal implications of kangaroo mother care be if it were to become the established norm? If we look beyond studies focusing solely on kangaroo mother care and consider the most recent research available regarding skin-to-skin contact6,7 and breastfeeding8 as they apply to all newborns, kangaroo mother care emerges as superior to standard care for all newborns in all settings. Further, there is reason to believe that if widely practiced, kangaroo mother care would result in substantial health care savings and improve communities. If kangaroo mother care is best for all newborns, midwives are in a pivotal position to teach women the rewards and responsibilities it entails. Midwives can also help women to appreciate that what is good for the newborn is good for the mother by explaining the shortand long-term maternal health benefits of early skin-to-skin contact 6 and breastfeeding.8