Recently I was perusing a Mommy blog when I stumbled across a post asking how long moms should practice skin to skin. That post took me back to when my daughters were young and I was told that I should do skin to skin for a myriad of reasons. When my second daughter was born they immediately placed her skin to skin because they said that she wasn’t breathing normally and that holding her skin to skin might help normalize her breathing pattern—-but no one really tells you for how long.
So, here is what the research says.
Skin to skin is a component of kangaroo mother care which was first documented by two neonatologists, Edgar Rey and Hector Martinez in 1979. [1,2] The pair did not have enough incubators for all of the neonates so they instead placed them skin-to-skin with their mothers in order to keep them warm. Later, Kangaroo Mother Care (KMC) evolved to include frequent and exclusive or nearly exclusive breastfeeding and early discharge from the hospital. 
Overtime, skin to skin has been further found to:
- Lead to longer duration of breastfeeding [4, 5]
- Lead to infant spending less time in the hospital 
- Lead to longer duration of quiet sleep for infant 
- Increase mother’s ability to recognize infant cues 
- For newborns, lower risk of mortality, sepsis, hypothermia, hypoglycemia, and hospital readmission 
- For newborns, lower average respiratory rate and pain 
- For newborns, higher oxygen concentration and temperature 
Most of the research discussed skin to skin in reference to preterm infants in low to middle income countries. Therefore, the findings above are most optimal for such mom and baby pairings.
We know that skin to skin is good for many things, but for how long? Are the benefits only evident immediately after birth? Should you continue skin to skin until your baby is 2 weeks old? 2 months old? 6 months old? Should we be walking around with our 2 year olds trying to practice skin to skin? What is the real deal here?
I read multiple mommy blogs/breastfeeding sites and most overwhelmingly agreed that moms should practice kangaroo care for as long as possible. Yet, there were not any cited sources in these blogs. So, I had to do a little more digging. I did a review of PubMed using the search terms ‘Kangaroo Care’ as well as ‘Skin to skin’. Upon looking at the first 50 articles, I could not find any evidence to support continuing skin to skin beyond leaving the hospital for full term infants. Even after extensive research, I saw that most studies were not specific with duration of skin to skin. A recent meta-analysis thoroughly reviewed this topic and noted that one of the limitations was that there was not enough data to determine the dose-response relationship–which means that we don’t truly have enough information to say how long mothers should practice skin to skin. 
Hope this helps.
Ileisha Sanders, mother of 2
- Filho FL, Silva AAMD, Lamy ZC, et al. Evaluation of the neonatal outcomes of the kangaroo mother method in Brazil. J Pediatr (Rio J) Jornal de Pediatria 2008;84(5):428–435.
- Charpak N, Ruiz-Peláez JG, Charpak Y. Rey-Martinez Kangaroo Mother Program: an alternative way of caring for low birth weight infants? One year mortality in a two cohort study. Pediatrics 1994;94(6):804–810.
- Conde-Agudelo A, Belizán JM. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Protocols Cochrane Database of Systematic Reviews 2003.
- Hake-Brooks SJ, Anderson GC. Kangaroo Care and Breastfeeding of Mother–Preterm Infant Dyads 0–18 Months: A Randomized, Controlled Trial. Neonatal Network: The Journal of Neonatal Nursing 2008;27(3):151–159.
- Boundy EO, Dastjerdi R, Spiegelman D, et al. Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis. Pediatrics 2015;137(1):x-16.
- Ramanathan K, Paul VK, Deorari AK, Taneja U, George G. Kangaroo mother care in very low birth weight infants. The Indian Journal of Pediatrics 2001;68(11):1019–1023.
- Charpak N, Ruiz-Pelaez JG, C. ZFD, Charpak Y. A Randomized, Controlled Trial of Kangaroo Mother Care: Results of Follow-Up at 1 Year of Corrected Age. Pediatrics 2001;108(5):1072–1079.
- Ferber SG, Makhoul IR. The Effect of Skin-to-Skin Contact (Kangaroo Care) Shortly After Birth on the Neurobehavioral Responses of the Term Newborn: A Randomized, Controlled Trial. Pediatrics 2004;113(4):858–865.
- Field T. Touch for socioemotional and physical well-being: A review. Developmental Review 2010;30(4):367–383.
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