Early Kangaroo Mother Care in Preterm Infants, Implications, Timing, and Feasibility: A Systematic Review.

BACKGROUND: Kangaroo mother care (KMC) is an effective care practice for preterm infants, based on early and continuous skin-to-skin contact between mother and newborn, with benefits on physiological stability, reduction of mortality, and promotion of lactation. However, the optimal timing for early initiation of KMC is still under investigation. PURPOSE: To explore the clinical and organizational implications of early initiation of KMC in preterm infants, with particular attention to the timing of initiation. DATA SOURCES: Systematic review conducted in April 2025 on Medline (PubMed) and Cochrane Library. STUDY SELECTION: Studies published since 2016 in Italian or English were included. Articles prior to 2016, reviews and irrelevant studies were excluded. Four studies were selected for the final analysis. DATA EXTRACTION: Two independent reviewers selected and analyzed the studies, extracting data on clinical context, timing of initiation, and main outcomes. RESULTS: Early KMC, started within 24 hours of birth in preterm or low birth-weight infants, promotes greater physiological stability; reduces mortality by up to 25%; and improves breastfeeding, growth, and neurodevelopment. Ultra-early initiation (within 1.3 hours) is effective even in newborns with moderate clinical instability. The nurse plays a central role in the promotion and management of early KMC. IMPLICATIONS FOR PRACTICE AND RESEARCH: The integration of early KMC into routine care requires specific training, organizational support, and active involvement of families. Further studies are needed to consolidate the evidence and define universal protocols.