摘要
Background Immediate kangaroo mother care,a continuous skin-to-skin contact initiated within 24 hours after birth,often before full clinical stabilization,has emerged as a recommended approach to improve outcomes in preterm and low-birth-weight neonates.Unlike delayed kangaroo mother care,which begins after clinical stabilization,immediate kangaroo mother care promotes early exclusive breastfeeding and early discharge with follow-up support,which has been endorsed by the World Health Organization following evidence of reduced morbidity and mortality.This narrative review synthesizes the current literature comparing immediate kangaroo mother care to delayed kangaroo mother care across implementation practices,benefits,and challenges to inform future recommendations for optimizing kangaroo mother care delivery and consistency in neonatal care.Methods A comprehensive search across Medline(PubMed),Scopus,EuropePMC,and Google Scholar up to June 2024 was conducted.Studies comparing immediate and delayed kangaroo mother care in premature or low-birth-weight infants reporting on at least one of the major clinical outcomes or implementation barrier were included.Review quality was assessed via the Scale for the Assessment of Narrative Review Articles.Results Evidence from the included trials,including five major randomized controlled trials conducted in low-and high-resource settings,revealed that immediate kangaroo mother care significantly reduces 28-day neonatal mortality,the risk of hypothermia,and the incidence of sepsis.Immediate kangaroo mother care improves exclusive breastfeeding and growth outcomes in infants,and has shown benefits not only for infants but also for their mothers.It also demonstrated greater cost-effectiveness,especially in low-resource settings.While immediate kangaroo mother care is associated with numerous benefits,its implementation remains constrained by several barriers,including sociocultural,medical,logistical,and financial factors.Conclusions While immediate kangaroo mother care offers substantial potential to improve neonatal outcomes,addressing the barriers in implementing immediate kangaroo mother care is essential.
