Kangaroo Mother Care (KMC) originated in 1978 in Columbia, South America, and has since been identified an important strategy to reduce neonatal mortality in low birthweight and preterm infants globally (Bergh 2011). Building on 2000 and 2003 Cochrane systematic reviews, a 2011 review concluded that KMC is an effective and safe alternative to conventional neonatal care in low birthweight infants in underresourced settings (Conde-Agudelo, Belizan, & Diaz-Rossello, 2011). Not only have reductions in morbidity and mortality been noted globally when KMC is practiced, positive psychosocial outcomes such as neonatal comfort are also associated with KMC although there is less research documentation of such outcomes.

Multiple materials have been developed to guide the implementation of this evidence-based practice, including a KMC Toolkit compiled by Save the Children's Saving Newborn Lives (http://www.healthynewbornnetwork.org/page/kangaroo-mother-care-toolkit). A 2012 KMC Implementation Guide has also been developed through the joint efforts of the United States Agency for International Development, the Maternal and Child Health Integrated Program, Save the Children, and the White Ribbon Alliance http://www.healthynewbornnetwork.org/resources/kingaroo-mother-care-implementati. Country-specific training manuals are available, including such settings as Bangladesh, Ethiopia, India, Mali, Mozambique, Nigeria, the Phillipines, Rwanda, South Africa, and Tanzania.

One Filipino mother whose premature son weighed 1.16 kg wrote about her experience with kangaroo care, "The moment I had my newborn son on my chest, I felt so happy and all I could say was, 'finally!' It was the first time I held my baby boy and it felt oh, so good! I loved doing Kangaroo Mother Care! It gave me the reassurance that my son was doing okay, that he was breathing, that he was alive! I loved the feel of his breath on my chest, his arms on my chest and shoulder, his legs near my belly. I especially loved how I could feel his heart beating next to mine. The whole time we did Kangaroo Mother Care, my son's heartbeat remained strong and normal and he maintained his body temperature. He always seemed content and happy where he was. Kangaroo Mother Care helped me a lot, giving me the reassurance that I needed by letting me feel my son's steady heartbeat, smell his sweet fragrance and feel his little body next to mine"http://www.healthynewbornnetwork.org/topic/kangaroo-mother-care-kmc.

In spite of the many benefits, global implementation of KMC for preterm newborns has not kept pace with the robust, long-standing evidence (Engmann, Wall, Darmstadt, Valsangkar, & Claeson, 2013). Reasons include cultural and social barriers, reluctance of healthcare providers, and lack of inclusion of KMC in government newborn priorities and policies. Strategies for overcoming these obstacles include encouraging professional associations in both high- and low-resource countries to adopt KMC as a standard of care, addressing cultural and social barriers, and educating communities and families about importance of supporting mothers in the practice of KMC. Working with healthcare providers and government policy makers to promote advocacy for widespread use of KMC is essential. The KMC Acceleration Partnership with multiple stakeholders was created in 2013 to address barriers and hasten use of KMC globally.

Further research is warranted, such as replicating a study conducted by Sylla et al. (2011) in Bamako, Mali, evaluating feasibility, acceptability, and outcomes of KMC in low birthweight infants. Worldwide, mothers are blogging and describing on Facebook their experiences with KMC, sharing mother to mother. Use of social media has potential to "spread the word" about KMC. Qualitative studies documenting perspectives of mothers participating in KMC with their preterm infants are also recommended. Providing comfort through such a caring intervention is an important strategy to promote good outcomes, particularly for preterm and low birthweight babies.

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