Looking after preemies demands specialized knowledge and nuanced care. But what if they just need warm cuddles to boost their cognitive skills? A study revealed that even small increases in the amount of skin-to-skin time with them could make a measurable difference in their neurologic development in the first year.

The skin-to-skin time with parents, often called kangaroo care, is a simple intervention where a newborn, dressed only in a diaper, is held close to the chest. Kangaroo care has been a prevalent technique for improving newborn survival rates in low-income countries, benefiting not only preterm infants but also healthy full-term newborns. The caring technique helps them keep warm, improves parent-child bonding, and helps initiate breastfeeding.

The new study suggests kangaroo care as an effective technique for improving cognitive skills in babies, particularly those born prematurely, who are at risk for long-term neurodevelopmental problems, including developmental delays and learning disabilities.

"It is interesting and exciting that it doesn't take much to really improve babies' outcomes. It didn't matter if the baby was from a high- or low-income family; the effects we found were the same. And it didn't matter if the baby was sicker or less sick — both responded to this treatment," Katherine Travis, the study's senior author, said in a news release.

For the study, the researchers looked at the medical records of 181 premature infants, those born at least eight weeks early at Lucile Packard Children's Hospital Stanford, California, between May 1, 2018, and June 15, 2022. The amount of skin-to-skin care given to babies was estimated from patients' medical charts kept at the hospital.

All the infants were free from genetic or congenital conditions known to affect their neurodevelopment. They were born on average, at around 28 weeks gestation, or roughly 12 weeks before their expected due dates, and spent an average of about two and a half months in the hospital.

During the follow-up evaluations at six months and 12 months, the infants were assessed for their visual-motor problem-solving skills and expressive and receptive language skills using simple tests such as dropping a cube into a cup or testing to see if they turn to where the sound of a bell comes from.

The results showed that even small increases in skin-to-skin care made a large difference in their neurodevelopmental scores at 12 months, with an average of 20 minutes more of kangaroo care tied to a 10-point increase in the neurodevelopment score.

The link between increased frequency and duration of skin-to-skin contact and cognitive scores existed even after controlling for possible confounding factors, such as their gestational age, medical complications, frequency of getting admitted to NICU, and the family's socioeconomic status.

"We think of the womb as our benchmark for preterm babies. In utero, a fetus is physically contained, listening to the maternal heartbeat, hearing mom's voice, and probably hearing her digest her sandwich. In the NICU, they're not next to anybody, and they hear the fan in the incubator; it's a very different environment. Skin-to-skin care is probably the closest we can get to mimicking the womb," study co-author Dr. Melissa Scala explained.

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