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Bilal Qammar
Maryyam Tariq
Maryam Ahmad
Makeesa Taskeen
Maha Khalil


Skin to skin contact, Nurses, Knowledge, Beliefs, Practicing


The exposed child is placed face down on the naked chest of mother during the first skin-to-skin contact (SSC), with a warm blanket covering the back. At the time of delivery, skin-to-skin interaction between the mother and child decreases crying, enhances mother-infant communication, keeps the baby warm, and aids in successful breastfeeding. In order to lower the amount of milk given before nursing and to enhance the mother's role, prolonged postpartum CSS is crucial. Skin-to-skin (SSC), chest-to-chest contact among newborns as well as their mothers is defined as Kangaroo Mother Care. Psychological and physiological advantages of skin-to-skin care for mothers and newborns are well-developed in literature. WHO (World Health Organization) advised to use SSC for preterm and term newborns. SSC are not being used as widely as advised. When practice is not optimal, inadequate knowledge and personal beliefs and attitudes are usually the contributing factors. Insufficient evidences in relation to nurse's perspective and information regarding SSC. The main theme of the study is to understand and evaluate the significance of nurse’s knowledge, belief and expertise with regard to skin to skin contact therapeutic applications. This cross-sectional descriptive study collects data from 40 nurses using knowledge and beliefs questionnaire developed by Dr. Ludington-Hoe. This study has used SPSS version 16 in order to evaluate the collected data in an efficient manner. Results: The malicious age of nurses was 42.4 (SD=3.2) with the practice of 12 (SD = 2.1) years. The knowledge level of nurses was 2.7 (SD = 0.8) where 37.5% of the nurses were unsure in relation to the impact of SSC in reducing the danger of lessened brain development in neonate. Pearson correlation test revealed significant link among implementation of SSC and knowledge level (r = 0.297, P = 0.031), SSC implementation and nurse education (r = 0.85, p = 0.015), and implementation of SSC and nurses’ beliefs (r = 0.31, r = 0.024). It is likely that SSC will be practiced as widely as recommended if the nurses have adequate knowledge and education and positive beliefs in relation to SSC.


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1. World Health Organization. Reproductive Health, World Health Organization, UNAIDS. Kangaroo mother care: a practical guide. World Health Organization; 2003 Apr 17.
2. Baley J, Committee on Fetus and Newborn, Watterberg K, Cummings J, Eichenwald E, Poindexter B, Stewart DL, Aucott SW, Puopolo KM, Goldsmith JP. Skin-to-skin care for term and preterm infants in the neonatal ICU. Pediatrics. 2015 Sep;136(3):596-9.
3. Zhang Y, Deng Q, Zhu B, Li Q, Wang F, Wang H, Xu X, Johnston L. Neonatal intensive care nurses’ knowledge and beliefs regarding kangaroo care in China: a national survey. BMJ open. 2018 Aug 1;8(8):e021740.
4. Utami S, Huang MC. Health care providers’ perception, knowledge, barriers and practice of kangaroo care for preterm baby in Indonesia. Journal of Neonatal Nursing. 2019 Aug 1;25(4):205-8.
5. Vesel L, Bergh AM, Kerber KJ, Valsangkar B, Mazia G, Moxon SG, Blencowe H, Darmstadt GL, de Graft Johnson J, Dickson KE, Ruiz Pelaez JG. Kangaroo mother care: a multi-country analysis of health system bottlenecks and potential solutions. BMC pregnancy and childbirth. 2015 Dec;15(2):1-6.
6. Smith ER, Bergelson I, Constantian S, Valsangkar B, Chan GJ. Barriers and enablers of health system adoption of kangaroo mother care: a systematic review of caregiver perspectives. BMC pediatrics. 2017 Dec;17(1):1-6.
7. Mörelius E, Anderson GC. Neonatal nurses’ beliefs about almost continuous parent–infant skin‐to‐skin contact in neonatal intensive care. Journal of clinical nursing. 2015 Sep;24(17-18):2620-7.
8. McGrath JM, Brock N. Efficacy and utilization of skin-to-skin care in the NICU. Newborn and Infant Nursing Reviews. 2002 Mar 1;2(1):17-26.
9. Bera A, Ghosh J, Singh AK, Hazra A, Som T, Munian D. Effect of kangaroo mother care on vital physiological parameters of the low birth weight newborn. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2014 Oct;39(4):245.
10. Ludington-Hoe SM. Kangaroo care as a neonatal therapy. Newborn and Infant Nursing Reviews. 2013 Jun 1;13(2):73-5.
11. Heidarzadeh M, Hosseini MB, Ershadmanesh M, Tabari MG, Khazaee S. The effect of kangaroo mother care (KMC) on breast feeding at the time of NICU discharge. Iranian Red Crescent Medical Journal. 2013 Apr;15(4):302.
12. Vohra AS, Shah BH, Mehariya KM. Effect of kangaroo mother care on feeding, morbidity, and neurodevelopment of low birth weight neonates. Int. J. Contemp. Med. Res. 2017;4:1029-32.
13. Saptaputra SK, Kurniawidjaja M, Susilowati IH, Pratomo H. How to improve the effectiveness and efficiency of Kangaroo Mother Care: a literature review of equipment supporting continuous Kangaroo Mother Care. Gaceta Sanitaria. 2021 Jan 1;35:S98-102.
14. Chan GJ, Labar AS, Wall S, Atun R. Kangaroo mother care: a systematic review of barriers and enablers. Bulletin of the World Health Organization. 2016 Feb 2;94(2):130.
15. Al-Shehri H, Binmanee A. Kangaroo mother care practice, knowledge, and perception among NICU nurses in Riyadh, Saudi Arabia. International Journal of Pediatrics and Adolescent Medicine. 2021 Mar 1;8(1):29-34.
16. Deng Q, Zhang Y, Li Q, Wang H, Xu X. Factors that have an impact on knowledge, attitude and practice related to kangaroo care: National survey study among neonatal nurses. Journal of Clinical Nursing. 2018 Nov;27(21-22):4100-11.
17. Valizadeh L, Ajoodaniyan N, Namnabati M, Zamanzadeh V. Nurses' viewpoint about the impact of Kangaroo Mother Care on the mother–infant attachment. Journal of Neonatal Nursing. 2013 Feb 1;19(1):38-43.
18. Almutairi WM, Ludington-Hoe SM. Kangaroo care education effects on nurses' knowledge and skills confidence. The Journal of Continuing Education in Nursing. 2016 Nov 1;47(11):518-24.
19. Vittner D, Cong X, Ludington-Hoe SM, McGrath JM. A survey of skin-to-skin contact with perinatal nurses. Applied Nursing Research. 2017 Feb 1;33:19-23.
20. Abdulghani N, Edvardsson K, Amir LH. Worldwide prevalence of mother-infant skin-to-skin contact after vaginal birth: a systematic review. PloS one. 2018 Oct 31;13(10):e0205696.
21. Sanchez-Espino LF, Zuniga-Villanueva G, Ramirez-GarciaLuna JL. An educational intervention to implement skin-to-skin contact and early breastfeeding in a rural hospital in Mexico. International breastfeeding journal. 2019 Dec;14(1):1-9.
22. Kostandy RR, Ludington‐Hoe SM. The evolution of the science of kangaroo (mother) care (skin‐to‐skin contact). Birth defects research. 2019 Sep 1;111(15):1032-43.
23. Abdulghani N, Amir LH, Edvardsson K. Observational study found that skin-to-skin contact was not common after vaginal birth in Saudi Arabia. Acta Paediatrica (Oslo, Norway: 1992). 2020 Mar 4;109(8):1681-2.
24. Palinkas, Lawrence A., Sarah M. Horwitz, Carla A. Green, Jennifer P. Wisdom, Naihua Duan, and Kimberly Hoagwood. "Purposeful sampling for qualitative data collection and analysis in mixed method implementation research." Administration and policy in mental health and mental health services research 42 (2015): 533-544.