KMC basically uses a person -- usually the mother or father -- as a substitute for an incubator. Babies weighing 2000g (4 lbs.) or less at birth are placed in skin to skin contact with their mothers', fathers' or other carers' chests in an upright position 24 hours a day. This provides ideal conditions for them to thrive.

At Least as Good as Incubators

Current evidence indicates that KMC is at least as good as traditional care with incubators, write the authors. Studies have shown that KMC is safe, works at a fraction of the cost of an incubator, improves breastfeeding rates, and improves bonding between mother and infant. Parental sense of fulfilment and confidence are also improved.

KMC is now practised in 25 developing countries in Asia, Africa, and Latin America. Its use is also supported in industrialised countries such as France, Sweden, the United Kingdom, and the United States.

Almost two decades of implementation and research have made it clear that KMC is more than an alternative to incubator care and should be encouraged in affluent settings, say the authors. KMC, has not been outperformed by standard care, and is deemed a sound, evidence based alternative to treat premature babies in most settings, they conclude.

Baby Sensitive Care

There is little doubt that KMC appears a safe and effective approach to caring for premature infants, writes Neil Marlow, Professor of Neonatal Medicine in an accompanying commentary.

He explains that scientific study has provided us with evidence for a range of effective interventions that should be widely practised in all neonatal units. In his view, "KMC forms a valuable and evidence based part of this important repertory of increasingly baby sensitive care."