Kangaroo Care: The Research Behind the Benefits of Babywearing

Decreased crying, increased physiological regulation, breastfeeding facilitation, improved bonding….the list of how babywearing benefits you and your little one goes on and on and – most importantly – is backed by real science.

Many may not realize that the majority of research used to advocate for babywearing actually stems from investigations of ‘kangaroo care’, which is a specific type of babywearing that involves dedicated time to skin-to-skin contact with the caregiver.

What is kangaroo care?

Around the world, an estimated 4 million infants die during the first month of life, often due to the high risk of infection and malnutrition associated with low birth weight and prematurity.[1] Often, areas with the highest rates of infant mortality are those with lowest access to hospital care – due to rural locations, economic hardship, and/or insufficient medical facilities to accommodate all at-risk infants. Kangaroo care was developed in Colombia in 1978 as an effective and low-cost alternative to standard hospital care for vulnerable preterm and low birth weight infants.[2] Because kangaroo care requires nothing more than a woven or stretchy fabric to secure the baby to the caregiver’s chest, this is a practical, low cost, and effective way to prevent neonatal mortality in high-risk communities by using an adult’s body as a quasi-incubator to regulate the fragile physiology of the new baby.

Benefits of kangaroo care

Though the original kangaroo care intervention required constant skin-to-skin contact, exclusive breastfeeding, and early discharge with follow-up monitoring – because the combination of these treatments provides the strongest protective effect against mortality – most of the conventional research conducted in Western countries uses the term kangaroo care to refer simply to skin-to-skin contact, usually lasting several hours per day.[3] These randomized control studies – the gold standard of scientific research – demonstrate that skin-to-skin contact with preterm or vulnerable infants improves outcomes for their physiology (e.g., stabilizes the heart rate, respiration, and body temperature)[4], behavior (e.g., improves sleep cycles, decreases crying),[5] and social-cognitive development (e.g., promotes improved communication and bonding with caregivers).[6]  Though most work has focused on the first weeks or months post-partum, effects of kangaroo care seem to be long lasting. One study followed infants from birth until age 10, and found that infants assigned to a kangaroo care intervention at birth were more likely to have improved executive functioning at age 10 than those in the control group.[7]

Why these effects?

When taking into account the order of post-natal sensory development, it makes sense that physical skin-to-skin contact is most beneficial to newborn infants. The development of touch precedes the development of the visual and auditory systems, so excessive visual and auditory stimulation too early can be disruptive to the development of the sensory system.[8] Tactile stimulation – on the other hand – helps to improve the state organization, physiological maturity, and attention of newborns, especially in preterm infants.[9]

Kangaroo care isn’t just for at-risk babies. Follow the Tula Blog for updates on the benefits of skin-to-skin contact for all babies and for tips on how to incorporate kangaroo care into your current babywearing routine!

This Guest Blog was written by Emily E. Little, M.A.

Emily is a doctoral candidate in developmental psychology at University of California, San Diego. Her dissertation research examines the social mechanisms underlying the benefits of babywearing, including how increased mother-infant physical contact facilitates higher maternal responsiveness. Her research program more broadly investigates culturally-mediated mother-infant communication, and she has collected data on early teaching in Vanuatu, infant emotional displays in Bolivia, and breastfeeding patterns in Guatemala. She is also specializing in anthropogeny, or the study of human origins, through UCSD’s Center for Academic Research and Training in Anthropogeny (CARTA), which has added an evolutionary perspective to her interests in culture, mother-infant interaction, and babywearing. She is passionate about making a positive contribution in the communities where she works, not just in San Diego – where she volunteers as a Volunteer Babywearing Educator in training with Babywearing International – but also at her international fieldsites, where she volunteers at community health centers and raises money for maternal and infant health services.

1 Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet. 2005;365(9462): 891–900

2 Whitelaw, A., & Sleath, K. (1985). MYTH OF THE MARSUPIAL MOTHER: HOME CARE OF VERY LOW BIRTH WEIGHT BABIES IN BOGOTA, COLOMBIA. The Lancet,325(8439), 1206-1208. doi:10.1016/s0140-6736(85)92877-6

[3] Boundy, E. O., Dastjerdi, R., Spiegelman, D., Fawzi, W. W., Missmer, S. A., Lieberman, E., … Chan, G. J. (2015). Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis.PEDIATRICS137(1), x-16. doi:10.1542/peds.2015-2238

4 Bergman, N. H., Linley, L., & Fawcus, S. (2004). Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns. Acta Paediatrica93(6), 779-785. doi:10.1111/j.1651-2227.2004.tb03018.x

5 Whitelaw, A., Heisterkamp, G., Sleath, K., Acolet, D., & Richards, M. (1988). Skin to skin contact for very low birthweight infants and their mothers. Archives of Disease in Childhood63(11), 1377-1381. doi:10.1136/adc.63.11.1377

6 Feldman, R., Eidelman, A. I., Sirota, L., & Weller, A. (2002). Comparison of Skin-to-Skin (Kangaroo) and Traditional Care: Parenting Outcomes and Preterm Infant Development. PEDIATRICS110(1), 16-26. doi:10.1542/peds.110.1.16

7 Feldman, R., Rosenthal, Z., & Eidelman, A. I. (2014). Maternal-Preterm Skin-to-Skin Contact Enhances Child Physiologic Organization and Cognitive Control Across the First 10 Years of Life. Biological Psychiatry75(1), 56-64. doi:10.1016/j.biopsych.2013.08.012

8 Kathleen Philbin, M., Ballweg, D. D., & Gray, L. (1994). The effect of an intensive care unit sound environment on the development of habituation in healthy avian neonates. Dev. Psychobiol27(1), 11-21. doi:10.1002/dev.420270103

9 FIELD, T. (1995). Massage Therapy for Infants and Children. Journal of Developmental & Behavioral Pediatrics16(2), 105???111. doi:10.1097/00004703-199504000-00008

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