Daily Skin-to-Skin Contact Duration in Preterm and Low Birth Weight Infants Admitted to a Kangaroo Care Unit

Overview

Kangaroo Mother Care promotes prolonged skin-to-skin contact between newborns and their parents. Although this practice is routinely encouraged in Kangaroo Care Units, the daily duration of skin-to-skin contact varies substantially between families. This prospective observational study aims to estimate the average daily duration of skin-to-skin contact among newborns admitted to the Kangaroo Unit at Valenciennes Hospital and to identify maternal, neonatal, and organizational factors associated with this practice. This non-interventional study does not modify routine clinical care. Data are collected from routinely available medical records, a brief parental questionnaire completed at enrollment, and the daily recording of skin-to-skin contact performed throughout hospitalization. The study will provide a description of skin-to-skin practice in a specialized Kangaroo Unit and may help inform future strategies to support the implementation of Kangaroo Mother Care.

Background Kangaroo Mother Care (KMC) combines prolonged skin-to-skin contact between the newborn and a parent with breastfeeding support whenever possible. Evidence from randomized trials and systematic reviews has demonstrated that KMC improves physiological stability, breastfeeding, sleep organization, pain management, neurodevelopment, parent-infant bonding, and parental well-being in preterm infants. Although KMC is widely recommended for clinically stable preterm infants, substantial variation exists in its implementation across neonatal units. Daily skin-to-skin duration differs considerably between families, even in dedicated Kangaroo Units where continuous parent-infant proximity is encouraged. The reasons for this variability remain incompletely understood. The Kangaroo Unit at Valenciennes Hospital has routinely implemented Kangaroo Mother Care since 2005. A previous observational evaluation demonstrated that prolonged daily skin-to-skin contact could be achieved safely within this setting. However, important differences in practice between families were observed. Rationale Characterizing the actual duration of skin-to-skin contact and identifying factors associated with longer or shorter daily practice may improve understanding of how Kangaroo Mother Care is implemented in routine clinical care. Identifying modifiable determinants may help optimize support for families and improve organization of care within Kangaroo Units. Study Description This is a prospective, single-center, observational study conducted in the Kangaroo Unit of the Neonatal Department at Valenciennes Hospital. Eligible newborns admitted to the Kangaroo Unit will receive standard clinical care according to routine practice. No study-specific intervention, treatment, or additional examination is performed. Clinical and demographic information is obtained from routinely collected medical records. Additional information regarding parental characteristics and information received about Kangaroo Mother Care is collected using a brief questionnaire administered at enrollment. The duration of skin-to-skin contact is recorded prospectively throughout hospitalization using the routine daily documentation completed by healthcare professionals. The primary objective is to estimate the average daily duration of skin-to-skin contact during hospitalization in the Kangaroo Unit. Secondary analyses will explore maternal, neonatal, and organizational factors that may be associated with variations in daily skin-to-skin duration. Significance This study will provide contemporary data describing the implementation of Kangaroo Mother Care in a specialized Kangaroo Unit. Better understanding of the factors associated with skin-to-skin practice may support future quality improvement initiatives aimed at facilitating prolonged parent-infant skin-to-skin contact during neonatal hospitalization.