The life-saving power of skin-to-skin care: Small actions, big impact for preterm babies

On World Prematurity Day 2024,Dr R Kishore Kumar, Founder Chairman, Pediatrician and Neonatologist, Cloudnine Group of Hospitals explains how KMC and KFC have emerged as life-saving methods that deliver enormous health benefits to preterm babies—benefits that every child, everywhere, should have access to

Premature birth continues to be one of the most significant challenges in global healthcare, affecting millions of families worldwide. Each year, around 15 million babies are born too soon—before 37 weeks of gestation—accounting for more than 10 per cent of all births globally. Preterm birth is the leading cause of death in children under five, and even for those who survive, the journey can be fraught with complications and long-term health risks. However, there is one simple yet profoundly effective intervention that can significantly enhance the chances of survival and improve outcomes for these tiny, vulnerable babies: skin-to-skin contact, commonly referred to as Kangaroo Mother Care (KMC) and Kangaroo Father Care (KFC).

The theme for World Prematurity Day 2024, “Small Actions, BIG IMPACT: Immediate Skin-to-Skin Care for Every Baby, Everywhere,” highlights this vital practice. Once considered a low-tech alternative in resource-poor settings, KMC and KFC have emerged as life-saving methods that deliver enormous health benefits to preterm babies—benefits that every child, everywhere, should have access to.

Premature birth: A global crisis

The statistics surrounding premature birth are staggering. Every year, 15 million babies are born prematurely, with over one million of these infants dying due to complications related to preterm birth. While high-income countries have made tremendous strides in improving the survival rates of preterm babies, the situation in low- and middle-income countries remains dire. In these regions, the lack of access to specialised care, such as neonatal intensive care units (NICUs), leads to a much higher risk of death or disability for preterm infants.

Babies born between 34-37 weeks typically have high survival rates (above 90 per cent) when provided with appropriate care. However, for babies born before 28 weeks, survival can be as low as 10-50 per cent, depending on the availability of NICUs and trained healthcare professionals. The disparity in survival rates between rich and poor countries underscores the urgent need for more accessible and effective interventions, such as KMC and KFC.

The transformative power of Kangaroo Care

In my decades of experience as a neonatologist, I have witnessed the life-saving power of KMC firsthand. This simple practice—holding the baby in direct skin-to-skin contact on the mother’s chest—has been shown to reduce neonatal mortality by 40 per cent for infants weighing less than 2kg at birth. Skin-to-skin contact stabilises the baby’s heart rate, improves breathing, and promotes better temperature regulation, helping the baby to conserve energy and fight infections. Additionally, it has been proven to improve breastfeeding rates, which is critical for preterm babies who rely on mother’s milk for optimal growth and development.

KMC and KFC are not just about physical warmth—they offer emotional warmth and comfort as well. Studies show that babies who receive skin-to-skin care have improved long-term neurocognitive outcomes, including better cognitive and motor development. More importantly, this practice strengthens the bond between parents and their fragile newborns, providing them with the emotional support they need to thrive.

MaternalNICU (MNICU): A new era of neonatal care

At Cloudnine we have embraced the concept of MNICU, a transformative approach to neonatal care that integrates mothers and fathers directly into the NICU environment. Instead of merely visiting their babies, parents are encouraged to spend as much time as possible with them, allowing for continuous skin-to-skin contact through KMC and KFC.

This shift towards parental involvement in the NICU has had profound effects on both short-term and long-term outcomes for preterm infants. Studies have shown that continuous KMC significantly increases the chances of survival for preterm babies and promotes better cognitive development. The power of a mother’s or father’s touch cannot be overstated, literally helps these tiny babies not just to survive but to thrive.

Scaling up access to KMC and neonatal care

Governments and healthcare systems around the world must prioritise universal access to comprehensive maternal and neonatal care. In low- and middle-income countries, where the majority of preterm births occur, it is crucial to ensure that NICUs are available and equipped to care for moderate and extreme preterm babies. This includes training healthcare professionals such as obstetricians, neonatologists, and NICU nurses in the latest neonatal care techniques, with a strong focus on KMC.

KMC should be integrated into national health programs as a standard practice, particularly in settings where advanced medical equipment like incubators may not always be available. Governments should also promote KMC and KFC through public health policies that focus on educating both healthcare providers and parents about the benefits of skin-to-skin care. In countries with high rates of preterm births, this simple intervention could save hundreds of thousands of lives each year.

Predicting and preventing preterm births

Preterm birth is a complex issue, but advances in technology are making it easier to predict and prevent. At Cloudnine, we have incorporated Artificial Intelligence (AI) into our Hospital Management System (HMS) to help identify pregnant women who are at risk of preterm labor. By providing early alerts to obstetricians, AI allows us to take preventive measures that protect both mother and baby, improving outcomes for preterm infants. Early detection of preterm labor enables timely interventions, which can reduce complications and increase survival rates. Governments should support policies that encourage the use of AI and other predictive tools in healthcare systems to improve maternal and neonatal care, especially in high-risk pregnancies.

The role of breastfeeding and nutrition

Nutrition plays a critical role in the survival and long-term health of preterm babies. Breast milk, especially from the baby’s own mother, provides the optimal balance of nutrients that preterm infants need to grow and develop. It also contains essential antibodies that protect against infections. In contrast, animal milk, which is not tailored to human infants, can lead to serious health complications for preterm babies.

Governments should invest in breastfeeding support programs to ensure that mothers of preterm infants can provide the breast milk their babies desperately need. In addition, human milk banks should be established in countries with high rates of preterm births, providing life-saving breast milk to infants whose mothers are unable to produce it.

Supporting parental mental health

Having a pre-term baby in the NICU can be an emotionally overwhelming experience for parents. Healthcare policies must include provisions for maternal and paternal mental health support during and after NICU stays. Providing emotional support for parents is not just about helping them cope—it’s about fostering a strong bond between parents and their fragile newborns, which is crucial for the baby’s long-term development.

Call to action

On World Prematurity Day 2024, we are reminded that small actions—like immediate skin-to-skin care and involving parents in neonatal care—can have a BIG impact on the survival and development of preterm babies. But to make this a reality for every baby, everywhere, we need to ensure that healthcare systems, governments, and policymakers work together to provide access to the best possible care for the most vulnerable infants.

Every baby deserves a fighting chance. Let’s make sure we give it to them.