Community Kangaroo Mother Care: implementation and potential for neonatal survival and health in very low-income settings

Objective:immediate kangaroo mother care (kmc), an intervention following childbirth whereby the newborn is placed skin-to-skin (sts) on mother's chest to promote thermal regulation, breastfeeding and maternal-newborn bonding, is being taught in very low-income countries to improve newborn health and survival. existing data are reviewed to document the association between community-based kmc (ckmc) implementation and its potential benefits.study design:new analyses of the sole randomized controlled study of ckmc in bangladesh and others' experiences with immediate kmc are presented.result:newborns held sts less than 7 h per day in the first 2 days of life do not experience substantially better health or survival than babies without being held sts.conclusion:most women who were taught ckmc hold their newborns sts, but do so in a token manner unlikely to improve health or survival. serious challenges exist to provide effective training and postpartum support to achieve adequate sts practices. these challenges must be overcome before scaling up.