Table of contents
Kangaroo mother care: A clinical practice guide
PMNCH / Isabel Pinto
Eunice and twins. Skin-to-skin contact between mother and newborn baby after birth is practiced.
Eunice and twins. Skin-to-skin contact between mother and newborn baby after birth is practiced.
©
Credits
Overview
This guide is intended to assist health workers in supporting mothers and families in practicing Kangaroo Mother Care (KMC) both in health facilities and at home.
It also offers brief guidance for policymakers, health facility administrators, and local programme managers on how to create a supportive environment and provide the necessary health system resources to support health workers in assisting mothers and families in practicing KMC.
- Section 1. Introduction to the guide
- Section 2. Understanding KMC
- Section 3. Implementing KMC: requirements for health facilities
- Section 4. Providing KMC in health facilities
- Section 5. Supporting mothers and families to practise KMC at home
- Resources
- Communication materials
- Links to other related materials
What is new in this updated guide?
Key updates
/maternal-newborn-child-adolescent-health-ageing-(mca)/newborn-health-(nbh)/ikmc-at-home.tmb-1920v.jpeg?sfvrsn=d2889a3b_1 "ikmc at home")
1. Immediate KMC and KMC at home
- New guidance included on immediate KMC (i.e. starting KMC as soon as possible after birth), even for newborns requiring special or intensive care, includes step-by-step instructions and videos.
- Guidance also covers continuation and initiation of KMC at home, following latest WHO recommendations.
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2. Use of the term “kangaroo mother care” (KMC)
- KMC refers to the combined practice of prolonged skin-to-skin contact (SSC) and breast milk feeding.
- If only one component is being discussed (e.g. SSC), only that specific term is used.
- KMC is not used for skin-to-skin contact, provided by additional caregivers, to emphasize the mother’s central role.
- The term “skin-to-skin care” is not used, as it may refer to any SSC, regardless of duration, position and/or feeding.
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3. Terminology update: “Kangaroo position” – “KMC position”
- The term “kangaroo position” has been replaced with “KMC position” to improve clarity and global relevance as the word “kangaroo” may not be well understood in all contexts.
- The description of the newborn’s position has been revised for accuracy. Terms such as “frog-leg” and “fetal” have been removed, as: – “frog-leg” positioning is not standardized and varies widely; – the fetal position typically involves a flexed head, which is unsafe.
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4. Discharge and follow up
- KMC can lead to earlier discharge, but specific discharge criteria are not included in this guide, due to wide variations in discharge criteria across countries and the difficulty of standardizing it globally. Instead, general guidance is provided to allow countrylevel adaptation.
- Follow-up care for small and/or sick newborns is also kept broad,
recognizing differing health system capacities and evolving
global guidance.
Section 1. Introduction to the guide
General TWG Long An Hospital /KC. Luong
A mother provides immediate KMC to her preterm newborn, who requires CPAP support, in the presence of the father.
A mother provides immediate KMC to her preterm newborn, who requires CPAP support, in the presence of the father.
©
Credits
This section introduces the Guide – why and how it was prepared, who it is for, and how to use it. This section is relevant for all readers.
1.1 Context for updating Kangaroo mother care: a practical guide
1.2 Process of developing this guide
1.3 Intended audience
1.4 How this guide is intended to be used
Section 2. Understanding KMC
General TWG Long An Hospital /KC. Luong
A mother breastfeeds her newborn in the kangaroo position in Vietnam.
A mother breastfeeds her newborn in the kangaroo position in Vietnam.
©
Credits
This section explains what KMC is, why it is important, and the key aspects of KMC practice that align with the latest evidence or best practice. This information will be useful for those who are unfamiliar with KMC, as well as for experienced health workers.
2.1 What is Kangaroo Mother Care (KMC)?
2.2 Why is KMC important?
2.3 Who should receive KMC?
2.4 Who can provide KMC?
2.5 Where KMC should be provided?
2.6 How long should KMC continue?
Section 3. Implementing KMC: requirements for health facilities
WHO /Blink Media - H.Abebe
New mothers with their infants providing KMC at Felege Hiwot Hospital in Bahir Dar, Ethiopia.
New mothers with their infants providing KMC at Felege Hiwot Hospital in Bahir Dar, Ethiopia.
©
Credits
This section explains how KMC can be implemented as a core component of small and/or sick newborn care at all health system levels. It outlines the essential requirements and actions for implementing KMC in primary, secondary and tertiary-level health facilities and at home. This information is useful for health facility administrators, program managers, and senior health workers who are in a position to influence and strengthen facility-level processes.
3.1 Favourable health facility policies and protocols
3.2 Infrastructure
3.3 Equipment and supplies
3.4 Health facility records
3.5 Health workforce
3.6 Costs of care
Section 4. Practical guidance on providing KMC in health facilities
General TWG Long An Hospital /KC. Luong
A healthcare worker examines a newborn on kangaroo position in Vietnam.
A healthcare worker examines a newborn on kangaroo position in Vietnam.
©
Credits
This section provides practical guidance for health workers on supporting mothers and families in practising KMC in health facilities starting at birth and continuing through to discharge. It is intended for those directly involved in providing maternal and newborn care within health facilities.
4.1 Antenatal preparation and counselling
4.2 Starting KMC in birthing areas
4.3 Continuing KMC in the health facility
4.4 Monitoring the initiation, duration and quality of KMC in the health facility
4.5 Preparing for discharge for continued KMC at home
Links to videos
Section 5. Supporting mothers and families in practicing KMC at home
Fundación Canguro /Kangaroo Foundation
A father provides skin-to-skin contact to his newborn at home in Colombia.
A father provides skin-to-skin contact to his newborn at home in Colombia.
©
Credits
This section describes how mothers and families can be supported in practising KMC at home. This section is relevant for program managers and community-based health workers involved in supporting maternal and newborn care at the community level.
5.1 Key requirements and considerations for KMC at home
5.2 Specific considerations for KMC started at home
5.3 Practical considerations for supporting effective KMC at home
54. Monitoring and follow-up
Links to videos
Resources
29 October 2025
Parent counselling guide on kangaroo mother care (KMC)
This guide supports health workers in counselling parents and families of preterm and low birth weight (LBW) newborns on the essential practice of Kangaroo...
Annexes
/maternal-newborn-child-adolescent-health-ageing-(mca)/newborn-health-(nbh)/semi-reclining-laid-back-breastfeeding-position.tmb-1920v.jpeg?sfvrsn=ff714709_1 "semi-reclining-laid back breastfeeding position")
Breastfeeding positions
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Sample KMC monitoring forms
/maternal-newborn-child-adolescent-health-ageing-(mca)/newborn-health-(nbh)/baby-on-scale-during-growth-monitoring-for-poor-weight.tmb-1920v.jpg?sfvrsn=3862b93d_1 "Baby on scale during growth monitoring for poor weight")
Growth monitoring and guidance on management of poor weight gain
/maternal-newborn-child-adolescent-health-ageing-(mca)/newborn-health-(nbh)/a-pregnancy-wheel.tmb-1920v.jpg?sfvrsn=c776e27c_1 "A pregnancy wheel")
How to use a pregnancy wheel to determine if a newborn is preterm
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WHO conditional recommendations on micronutrient supplementation
Related resources
Communication materials
KMC advocacy video
Link to infographics
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Links to other related materials
WHO guidelines and guidance
The recommendations in this guideline are intended to inform development of national and subnational health policies, clinical protocols and programmatic...
16 May 2023
Kangaroo mother care - Implementation strategy for scale-up adaptable to different country contexts
The KMC implementation strategy targets a broad audience. These include policy-makers and programme managers at national, regional and local levels,...
This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC)...
