Skin-to-Skin Is Not Optional: Why Canada’s NICUs Are Reclaiming Kangaroo Care

What if one of the most powerful tools in neonatal care was already in the room? 

Skin-to-skin care, also known as kangaroo care, is not new. The evidence is clear: it stabilizes infants, supports brain development, improves breastfeeding outcomes, and protects parental mental health. Yet, across Canada, it isn’t consistently happening. 

In 2025, the national Family Engagement EPIQ (Evidence-based Practice for Improving Quality) Group was formed with a bold vision: to make family engagement a vital part of every NICU in Canada. This starts first with national recognition that families are not visitors; they are essential partners in their baby’s care. 

Led by co-chairs Fabiana Bacchini (Executive Director of CPBF and preemie mom), Dr. Marsha Campbell-Yeo (NNP and globally-renowned researcher), and Dr. Jessica Duby (neonatologist), the group began by asking a hard question: 

If parents are present in the NICU, why aren’t more babies receiving skin-to-skin care?

An audit of 13 NICUs revealed wide variation in practice. Many infants were excluded from skin-to-skin during their first 72 hours of life. Some were excluded due to umbilical catheters, intubation, or cardiorespiratory events. In some units, minimal handling policies unintentionally prevented early kangaroo care altogether. 

In other words, practice was not always aligned with current evidence. Wit that in mind, the group developed a six-step strategy to change that. 

First, they collected and reviewed skin-to-skin protocols from across the country. Then they partnered with the Canadian Neonatal Network to begin collecting national skin-to-skin data. So far, there are 24 NICUs are already contributing. 

Next comes the development of a national skin-to-skin care bundle: clear, evidence-informed recommendations that can be implemented across NICUs. This work includes aligning with other EPIQ groups, including Brain Health, to ensure policies don’t unintentionally block family-centred care. 

Now, a national observational study is also being planned to explore a critical question: Is there a “dose effect” of skin-to-skin care in the first 14 days of life? How does duration impact neonatal outcomes and parental mental health? 

Amidst all these exciting plans, all Level 2 and Level 3 NICUs in the country will get to show their tangible support. CPBF is hosting a National Kangaroo-A-Thon this May 2026. It is a two-week, nationwide effort encouraging Level 2 and 3 NICUs across Canada to boost kangaroo care.  

Skin-to-skin care is not a bonus. It is foundational. And together, we are making sure it becomes standard practice across Canada!