A major new meta-analysis published in The Lancet Child & Adolescent Health has found that kangaroo care (holding a low-birthweight newborn skin-to-skin against a caregiver's chest) significantly reduces the risk of death, sepsis, and serious infection in vulnerable infants. The findings draw on data from nearly 17,500 babies across 29 clinical trials and represent some of the strongest evidence yet that this simple, low-cost practice should be standard care in every neonatal unit worldwide.

What the Study Looked At

Researchers from the University Children's Hospital Basel, Karolinska Institute, and City St. George's University of London conducted a systematic review and meta-analysis of randomized controlled trials comparing kangaroo care with conventional neonatal care in low-birthweight infants (babies born weighing less than 2,500 grams -about 5.5 lbs).

They looked specifically at outcomes that have historically been less studied: not just survival, but whether kangaroo care could also protect babies from sepsis (blood infection), invasive infections like pneumonia, meningitis, and necrotizing enterocolitis, and the deaths caused by those infections.

The analysis covered 29 trials involving 17,513 low-birthweight infants, most from lower-middle income countries. The study is registered with PROSPERO and was published in May 2025.

What They Found

The results were striking across every outcome measured.

• Kangaroo care reduced the risk of death by 23%. Across 25 trials , the highest-quality subset of the analysis, babies who received kangaroo care had 23% lower odds of dying compared to those receiving conventional neonatal care (odds ratio 0.77). This was rated as high-quality evidence with virtually no variation between studies.
• It nearly halved the risk of sepsis. Among the 17 trials that tracked blood infections, kangaroo care was associated with 45% lower odds of sepsis (odds ratio 0.55). Sepsis is one of the leading killers of premature and low-birthweight newborns, and this reduction is clinically significant.
• It cut the risk of serious infection almost in half. Across trials tracking invasive infections , including pneumonia, meningitis, and severe gut infections, kangaroo care was associated with 51% lower odds (odds ratio 0.49).
• It also reduced infection-related deaths, hypothermia, and breathing pauses Babies receiving kangaroo care were significantly less likely to die specifically from infection, less likely to develop dangerous drops in body temperature (hypothermia), and less likely to experience apnea (episodes where breathing temporarily stops, which are common and dangerous in premature infants).

Why This Matters

Despite decades of evidence supporting kangaroo care, the researchers note that it remains far from universally practiced in hospital neonatal units, even in high-income countries.

Part of the reason is a longstanding concern among some neonatal care staff that moving fragile infants for skin-to-skin contact could increase infection risk. This study directly challenges that assumption. Not only does kangaroo care not increase infection risk, it substantially reduces it. The researchers argue this means kangaroo care should be formally integrated into infection prevention and control protocols in NICUs worldwide, not treated as an optional add-on or something parents need to advocate for.

The WHO already recommends kangaroo care for low-birthweight and premature infants, including beginning it as early as possible and aiming for 8 to 24 hours per day. This new meta-analysis reinforces that guidance with the most comprehensive evidence to date.

How Kangaroo Care Works

Kangaroo care involves placing the baby (typically wearing only a nappy) upright against the bare chest of a parent or caregiver, covered with a blanket or wrap. The baby rests between the caregiver's breasts or on their chest, with their head turned to one side.

The skin-to-skin contact does multiple things simultaneously. It regulates the baby's body temperature more effectively than an incubator in many studies. It supports breastfeeding and breast milk production. It stabilizes the baby's heart rate and breathing. And it appears to protect against infection through mechanisms that may include transfer of beneficial bacteria from parent to infant, immune factors in breast milk, and reduced exposure to hospital pathogens when babies can be discharged earlier.

What This Means for Parents

If your baby is in the NICU or was born premature or low-birthweight, this research is directly relevant to you.

• You have the right to ask about kangaroo care from day one. Even medically unstable infants have been included in trials of early kangaroo care, and the evidence supports its safety and benefit across settings.
• Both parents can participate. Kangaroo care doesn't have to be performed exclusively by the mother: fathers and other caregivers have been included in research and provide the same physiological benefits.
• More time matters. The WHO recommends targeting 8 to 24 hours of skin-to-skin per day for low-birthweight infants. Even if you can't reach that threshold, any amount appears beneficial.
• If your NICU discourages kangaroo care out of infection concerns, this study provides direct evidence that kangaroo care does not increase infection risk, it reduces it. You can share it with your care team.
• Ask your hospital about their policy. Many NICUs have structured kangaroo care programs. If yours doesn't, asking the question helps raise awareness.

The Bottom Line

This is not a new idea; kangaroo care has been studied and recommended for decades. What this meta-analysis adds is the clearest evidence yet that the benefits go well beyond comfort and bonding. For low-birthweight and premature infants, holding your baby skin-to-skin is one of the most powerful medical interventions available: one that reduces death, protects against the most dangerous infections, and costs nothing. If your baby is in the NICU, this is worth knowing and worth asking about.

Read the research: Minotti et al., The Lancet Child & Adolescent Health (2025) — All-cause mortality and infection-related outcomes of hospital-initiated kangaroo care versus conventional neonatal care for low-birthweight infants: a systematic review and meta-analysis