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Skin-to-skin care (SSC), or kangaroo care, is a biologically normal practice.  It is supported by the World Health Organization (WHO), Baby Friendly Hospital Initiative (BFHI), the Academy of Breastfeeding Medicine (ABM), and the American Academy of Pediatrics (AAP). This is an important component of family-centered care.


When a baby is born prematurely, or perhaps has a health issue, he or she may need to go to the Neonatal Intensive Care Unit (NICU) immediately after birth. That can interfere with mother and baby getting to know each other and delay bonding.  Although SSC is still an important part of getting to know your baby and for initiating breastfeeding, it just may not be possible until the baby is stable enough to be held outside of an isolette.


SSC in the NICU consists of placing a baby clothed only in a diaper chest-to-chest with mother. SSC can start before baby is even ready for oral feedings. It is one of the most effective methods for promoting exclusive breastfeeding.


SSC is important for the NICU baby and mother because:

  • It promotes bonding.

  • Parents can be nervous holding a very tiny baby. SSC helps you become more comfortable holding and caring for your NICU baby.

  • It provides for earlier initiation of the first breastfeeding experience.

  • It will help stimulate your hormones that help increase milk supply. Mothers who pump after SSC report getting a higher volume pumped than other pumping times.

  • SSC can reduce maternal stress and postpartum depression which can occur due to the separation.

  • Builds confidence.


Just like with a baby who is born full-term, SSC can help a baby:

  • Cry less.

  • Maintain body temperature, which will help baby move to a regular, open crib sooner.

  • Regulate baby’s breathing and heart rate.

  • Keep baby’s blood sugar level stable.

  • Keep baby’s oxygen level more regular.

  • Feel less pain.

  • Help boost your baby’s immune system from the direct contact with your skin.


SSC will help your body make milk best suited for nourishing and protecting your baby:

  • Builds antibodies to germs in or on baby in the NICU to help baby fight those germs.

  • Builds antibodies to what you have been exposed to help your baby prepare for coming into your home environment.


Practicing SSC in the NICU:

  • Expect to be with your baby for at least an hour of steady skin-to-skin time.

  • Have a snack and a drink and go to the bathroom before you start.

  • Wear a shirt that opens in the front to make access to your chest easier and remove your bra.

  • If the chair provide in the baby’s space will recline, lean back about 45º.

  • Bring one or two pillows to help support your arms and back.

  • The first time, your baby’s nurse will assist you in getting baby out of the bed, arranging any wires or tubes the baby may be connected to so that they are not in the way, and placing baby at your chest. She will help you until you feel confident doing it on your own.

  • Drape a blanket across your baby’s shoulders and below his neck. Tuck the ends of the blanket to your sides where your arms can help hold the blanket snugly in place.

  • Relax and enjoy this special time with your baby!

  • If baby starts to root, you can guide him or her to the nipple for practice. Some babies may only lick in the beginning but others may actually latch. If your baby does, he or she may practice for as long as interested. Do not feel rushed to try both breasts. Baby can practice at the other side the next time.

  • If your baby is able to be held skin-to-skin, but not yet ready to begin oral feedings, you may be asked to pump before beginning SSC. Remember that the breast always is making milk and baby may still enjoy a “reward” with the practice.


Once your baby comes home:

  • Expect some transition time. It is different when there is no nurse to call if you have a question.

  • Room-in with your baby before discharge, if you facility provides this space, to help build your confidence.

  • “Wear” your baby in a wrap or sling designed for use with smaller babies to help baby feel safe, secure and warm, saving calories for growing.

  • SSC and “wearing” your baby will help you better catch feeding cues before baby is needing to cry to get your attention. Crying uses up calories your baby needs for growing.


Premies: Breastfeeding

Premies: Positioning

Premies: Pumping


*Parts of the contents of this page was generously supplied by La Leche League International

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