Kangaroo care benefits: how skin-to-skin helps your baby, how to do it at home, and hospital programmes in Singapore

Kangaroo care means holding your baby, in just a nappy and a hat, upright against your bare chest with a cover over their back. SingHealth lists the benefits for babies as a steadier heart rate and breathing, better oxygen levels, more sleep, faster weight gain, less crying and earlier discharge for babies in hospital; for parents, closer bonding, more breast milk and more confidence. It started in Bogota in the late 1970s to save premature babies. In Singapore, KKH, NUH, SGH and Raffles Hospital are Baby-Friendly hospitals that put babies skin to skin with their mothers right after birth for at least an hour, and the NICUs at KKH, SGH and NUH encourage parents to keep it up. At home, do it when you are awake and alert, sitting semi-upright with your baby's face visible, and fathers can do it too.

What kangaroo care is

SingHealth describes kangaroo care as a way of holding a baby with skin-to-skin contact: the baby, in a nappy, is placed upright against the parent's bare chest. SGH uses "skin-to-skin contact" and "kangaroo care" for the same thing. It began as a response to the high death rate among premature babies in Bogota, Colombia, in the late 1970s, when SingHealth says 70% of premature infants died.

The World Health Organization updated its advice in 2022: babies born before 37 weeks or under 2.5kg should start skin-to-skin care immediately after birth, with no first period in an incubator, for as many hours as possible.

Kangaroo care benefits

SGH's neonatal team, quoted in its newsroom, says babies who received regular kangaroo care gained more weight a day and went home sooner, and that the earlier skin-to-skin starts, the bigger the effect on breastfeeding.

Skin-to-skin in Singapore hospitals

In the delivery room

Singapore's Baby-Friendly Hospital Initiative (BFHI) asks hospitals to place babies skin to skin with their mothers immediately after birth for at least an hour. HealthHub lists four BFHI-accredited hospitals: KKH, NUH, Raffles Hospital and SGH.

• KKH: the nurse places your baby on your chest straight after birth, and KKH aims for skin-to-skin and the first breastfeed within the first hour. After a caesarean with an epidural or spinal, you can still have skin-to-skin contact.
• SGH: early skin-to-skin and rooming-in are part of its Baby-Friendly care, and its caesarean recovery plan includes one hour of skin-to-skin bonding straight after the operation if you and your baby are well.
• NUH: encourages skin-to-skin and breastfeeding as soon as possible after birth.

Put skin-to-skin in your birth plan, with a line on what you want if you need a C-section.

In the NICU

• KKH's NICU runs Family Integrated Care, which brings parents into their baby's care, and encourages kangaroo care as soon as your baby is ready.
• SGH's NICU, in a new ward since 30 January 2023, has curtains around each bed so parents can breastfeed or do kangaroo care in privacy. SGH also developed "Joey", a wearable seat strapped to the parent that keeps breathing tubes secure so babies on a ventilator can be held.
• NUH's neonatal service encourages parents to visit and care for babies in its NICU and high-dependency unit, and runs a Neonatal Parental Support Group.

Ask the NICU nurses when your baby can start and how long each session can be. SGH says its maternity wards and KKH's encourage holding for an hour or so at a time. Our guide to premature labour signs covers what happens in the NICU.

How to do kangaroo care at home

In an air-conditioned Singapore home, the cover over your baby's back matters; in a warm room, a light cloth is enough. Fathers can do kangaroo care too, SingHealth says, and SGH's doctors note that because many mothers stay home for a month of confinement, fathers can give early skin-to-skin during hospital visits too. Our newborn care basics and bonding with your baby through play guides have more ways to connect, and breastfeeding support in Singapore covers milk supply.

Safety during skin-to-skin

HealthHub's safe-sleep advice applies: if you are tired, put your baby back in their own cot, on their back on a firm surface, rather than dozing off together on a sofa or bed.

Frequently asked questions

What are the benefits of kangaroo care?

For babies, SingHealth lists a steadier heart rate and breathing, better temperature control, more sleep, less crying, faster weight gain and earlier discharge from hospital. For parents, it helps bonding, breast milk supply and confidence.

How long should kangaroo care last?

SGH says Singapore's maternity wards encourage about an hour at a time. The WHO advises as many hours as possible for small and premature babies.

Can fathers do kangaroo care?

Yes. SingHealth says fathers can provide kangaroo care too, and SGH's doctors suggest it during hospital visits while mothers are in confinement.

Can I do kangaroo care after a C-section?

Usually yes. KKH says you can have skin-to-skin contact after a caesarean with an epidural or spinal, and SGH aims for an hour of skin-to-skin straight after the operation if you and your baby are well.

Is kangaroo care only for premature babies?

No. It began with premature babies, but skin-to-skin helps full-term babies too, which is why Baby-Friendly hospitals do it right after every birth.