Systematic Review of Kangaroo Care Duration's Impact in Neonatal Intensive Care Units on Infant-Maternal Health

Objective: Kangaroo care (KC), skin-to-skin contact between infants and caregivers, is encouraged in neonatal intensive care units (NICUs) to support health through improved weight, growth, and infant-maternal attachment while reducing the incidence of sepsis and infant pain. However, the optimal duration and frequency of KC to maximize health outcomes is unknown. Given parents' time stressors, identifying optimal KC time is critical. Study Design: A literature review was undertaken on May 28, 2021 via querying the PubMedR database from January 1, 1995 to May 28, 2021 regarding kangaroo care and NICUs with 442 results. Eleven studies met eligibility criteria of (1) comparative kangaroo care between infants and adult caregivers in NICUs as a randomized controlled trial, (2) peer-reviewed articles in English (3) study subjects ≥5, (4) health outcomes and (5) kangaroo care sessions >1. Results: Infant physical growth parameters, infant neurodevelopment, infant stress via salivary cortisol levels, and breastfeeding outcomes appear to increase with KC as compared to standard care without KC (SC). Improvements for greater amounts of KC duration, 2 hours/day as compared to 1 hour/day, for neurodevelopment and breastfeeding outcomes appear but no greater improvement with greater KC duration was shown for reducing infant stress through salivary cortisol levels. Regarding maternal stress, KC duration influence on PSS:NICU scores was mixed. Conclusion: Further study of KC duration and frequency to health outcome dose-response relationship would help determine how much and how frequent KC is needed to improve specific health outcomes for infants and their mothers.