Skin-to-skin contact between mother and child immediately after birth leads to better emotional bonding one year postpartum

A research group including Assistant Professor Kayoko Saito of the Department of Maternal Nursing, Faculty of Medicine, Academic Assembly at the University of Toyama, investigated the relationship between "Kangaroo Care," skin-to-skin contact, between mother and child immediately after birth and the mother's emotional bonding with her child one year postpartum. The study revealed that mothers who had early contact with their children immediately after birth showed better bonding at one year postpartum compared to those who did not have such an opportunity. These findings were derived from analyzing data from approximately 80,000 mother-child pairs in the "Japan Environment and Children's Study (JECS)." The results were published in the British perinatal academic journal BMC Pregnancy and Childbirth on March 9.

In the field of perinatal psychiatry, the love a mother directs toward her child is expressed by the term "bonding." Pediatricians Klaus and Kennell first proposed this concept, asserting that physical contact between mother and child immediately after birth is vital for the formation of maternal attachment. Subsequent research has clarified that bonding is not determined solely by the moment after birth but is formed through continuous interactions such as breastfeeding and holding.

Kangaroo Care involves holding a naked newborn directly against the mother's (or father's) bare chest to ensure skin-to-skin contact, with the aim of promoting bonding. Originally developed in response to a lack of medical resources, it is now recommended in many countries for attachment purposes. However, in recent years, there have been reports of sudden changes in newborns' conditions during Kangaroo Care, making it essential to perform the care under sufficient observation by medical staff.

While Kangaroo Care has been shown to potentially promote bonding with low-birthweight or preterm infants, its effects on full-term infants remained unclear. To address this, the research group analyzed data from 81,634 mother-child pairs participating in JECS to see if they had practiced Kangaroo Care immediately after birth.

Implementation of Kangaroo Care was confirmed via a questionnaire sent one month postpartum asking, "Did you hold your baby immediately after giving birth?" Bonding at one year postpartum was evaluated using the "Mother-to-Infant Bonding Scale, Japanese version (MIBS-J)," a questionnaire for parents. JECS is a large-scale, long-term birth cohort study launched by the Ministry of the Environment in fiscal year 2010. It involves approximately 100,000 parent-child pairs nationwide to clarify the effects of chemical exposure from the fetal period through childhood on children's health. The experience of holding a newborn early after birth was associated with fewer cases of bonding failure at one year postpartum, even if the contact was through clothing. The results again support the importance of mother-child contact immediately after birth.

The benefits of Kangaroo Care include helping the newborn maintain body temperature through skin contact, stabilizing respiration, promoting weight gain, increasing breast milk secretion, extending the duration of breastfeeding, and facilitating the formation of the mother-child bond.

Saito stated: "Kangaroo Care is only possible when conditions such as the circumstances of delivery, the physical stability of the mother and child, and the human and physical environment are met. It is not a care method applicable to every case. Furthermore, the fact that it was not performed does not immediately lead to bonding problems. However, I hope these results reach practitioners involved in perinatal medicine, allowing those who practice it to reconfirm its significance, and those who do not, to reconsider care that encourages better mother-child interaction."

Journal Information
Publication: BMC Pregnancy and Childbirth
Title: Kangaroo mother care and maternal bonding 1 year after childbirth: a nationwide birth cohort—the Japan environment and children's cohort study
DOI: 10.1186/s12884-026-08729-7