{ "release_id": "15708f235d73cd42", "id": "maternal:immediate-kmc", "owner": "maternal", "kind": "intervention", "slug": "immediate-kmc", "name": "Immediate kangaroo mother care", "aliases": [], "atlases": [ "maternal" ], "summary_plain": "Starting skin-to-skin care within hours of birth, even before a small baby is fully stable, with the mother staying in the newborn unit.", "summary_technical": "KMC started as soon as possible after birth, before clinical stabilization. WHO's evidence review counts KMC started within 24 hours of birth as early. In the iKMC trial it was delivered in a Mother-NICU.", "editorial_state": "draft", "last_substantive_edit": "2026-10-09", "last_evidence_check": null, "next_review_due": null, "external_ids": [], "navigation": { "maternal": { "life-stage": [ "newborn" ] } }, "payload": { "subtype": "service", "mechanism": null, "taxonomy_codes": [] }, "content_digest": "bd3026b5ef2a9268df90b50e0f99c1703bfa7a40809c1fa898888aa403bf0df5", "review": { "content_digest": "bd3026b5ef2a9268df90b50e0f99c1703bfa7a40809c1fa898888aa403bf0df5", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "15708f235d73cd42", "id": "maternal:claim-ikmc-28d-mortality", "owner": "maternal", "subject_entity_id": "maternal:immediate-kmc", "category": "effect", "statement": "In the iKMC trial, babies weighing 1.0 to under 1.8 kg at birth who started continuous skin-to-skin care with their mother within hours of birth were less likely to die in their first 28 days than babies who started it only after they were stable. 191 of 1596 babies died in the immediate group and 249 of 1587 in the control group (adjusted risk ratio 0.75, 95% CI 0.64 to 0.89).", "context": { "id": "maternal:ctx-ikmc-newborns-1000-1799g", "label": "Liveborn infants weighing 1.0 to under 1.8 kg at birth in five tertiary hospitals in sub-Saharan Africa and India (iKMC trial)", "recipient": "newborn", "population": "Liveborn infants with a birth weight of 1.0 to under 1.8 kg (abstract: \"between 1.0 and 1.799 kg\"), of any gestational age, singleton or twin, by any mode of delivery, enrolled with their mothers within 2 hours of birth. About 20% of infants in this weight band born in the study hospitals were not enrolled because mother or newborn was too sick.", "care_setting": "Tertiary hospitals. Intervention infants: a Mother-NICU (a neonatal intensive care unit with beds for mothers), then a KMC ward. Control infants: the NICU without the mother, then a KMC ward after stabilization.", "geography": "Ghana (Kumasi), India (New Delhi), Malawi (Blantyre), Nigeria (Ile-Ife) and Tanzania (Dar es Salaam); cities per ANZCTR. The ICTRP mirror of the CTRI record does not name the fifth country; it lists it only as other.", "life_stage": "Neonatal period", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": 0, "postnatal_age_max_days": 0, "gestational_age_status": "any", "postnatal_age_status": null, "followup_description": "From enrolment to 28 days of age, with a home visit on day 29. The second primary outcome window was enrolment to 72 hours.", "eligibility": { "inclusion": [ "Liveborn infant", "Birth weight 1.0 kg to under 1.8 kg", "Any gestational age, mode of delivery, or singleton or twin status", "Enrolled with the mother within 2 hours of birth" ], "exclusion": [ "Mother younger than 15 years", "Mother, or the guardian of a minor mother aged 15 to 17, unable or unwilling to consent", "Triplets or higher-order multiples", "Mother unlikely to provide KMC within the first 3 days (registry examples: eclampsia, shock, major surgery)", "Cannot be enrolled within 2 hours of birth", "Residence outside the study area", "Infant unable to breathe spontaneously by 1 hour of age", "Major congenital malformation (registry: one that interferes with, or is interfered with by, the intervention)" ] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "One trial in five tertiary hospitals in low- and middle-income countries, with an open-label design. It stopped early for benefit before reaching its target of 4200 infants. About 20% of infants in the eligible weight band were not enrolled because mother or baby was too sick. The authors say the effect of starting early cannot be separated from the mother's continuous presence (author manuscript, Discussion para 5), and that applicability to low-mortality, high-resource settings is untested (author manuscript, Discussion para 3). The per-arm denominators (1596 and 1587) are smaller than the numbers randomized (1609 and 1602). They come from the author manuscript's Table 3 only, its text does not state their basis, and they were not checked against the version of record.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 3: \"relative risk of death, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P = 0.001\"", "applicability_note": "Abstract of the primary report, for the same infants and time window as this context.", "snapshot": { "id": "maternal:pubmed-34038632-2026-10-09", "retrieved_at": "2026-10-09T15:56:27Z", "content_hash": "5dde5eaa4d684f398f7f3cfab05816eb73207b8adbaac5c4163e7e480567ecf6", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Table 3, row \"Death between enrolment and 28 days of age\": \"191/1596 (12.0%)\" and \"249/1587 (15.7%)\"", "applicability_note": "Author accepted manuscript (CC BY 4.0); not checked against the version of record.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). 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The version of record is not redistributed.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Table 3, column header: \"Adjusted RR (95%CI)\"", "applicability_note": "The ratios are adjusted, not crude; see the Table 3 footnote.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Discussion, para 5: \"20% of infants 1.0 to <1.8 kg born in study hospitals were not enrolled because mother or newborn was too sick\"", "applicability_note": "Limits who the result describes.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } } ], "review": { "content_digest": "3e20cf5eb23f4c291f0942262d73e5a45cb6e1d6f6063a719fbf292c4a769a21", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/maternal--claim-ikmc-28d-mortality.json" }, { "release_id": "15708f235d73cd42", "id": "maternal:claim-ikmc-72h-mortality", "owner": "maternal", "subject_entity_id": "maternal:immediate-kmc", "category": "effect", "statement": "In the first 72 hours, 74 of 1606 babies died with immediate skin-to-skin care and 92 of 1599 with the control approach (adjusted risk ratio 0.77, 95% CI 0.58 to 1.04). The interval includes no difference, so the trial did not show a clear effect in this window.", "context": { "id": "maternal:ctx-ikmc-newborns-1000-1799g", "label": "Liveborn infants weighing 1.0 to under 1.8 kg at birth in five tertiary hospitals in sub-Saharan Africa and India (iKMC trial)", "recipient": "newborn", "population": "Liveborn infants with a birth weight of 1.0 to under 1.8 kg (abstract: \"between 1.0 and 1.799 kg\"), of any gestational age, singleton or twin, by any mode of delivery, enrolled with their mothers within 2 hours of birth. About 20% of infants in this weight band born in the study hospitals were not enrolled because mother or newborn was too sick.", "care_setting": "Tertiary hospitals. Intervention infants: a Mother-NICU (a neonatal intensive care unit with beds for mothers), then a KMC ward. Control infants: the NICU without the mother, then a KMC ward after stabilization.", "geography": "Ghana (Kumasi), India (New Delhi), Malawi (Blantyre), Nigeria (Ile-Ife) and Tanzania (Dar es Salaam); cities per ANZCTR. The ICTRP mirror of the CTRI record does not name the fifth country; it lists it only as other.", "life_stage": "Neonatal period", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": 0, "postnatal_age_max_days": 0, "gestational_age_status": "any", "postnatal_age_status": null, "followup_description": "From enrolment to 28 days of age, with a home visit on day 29. The second primary outcome window was enrolment to 72 hours.", "eligibility": { "inclusion": [ "Liveborn infant", "Birth weight 1.0 kg to under 1.8 kg", "Any gestational age, mode of delivery, or singleton or twin status", "Enrolled with the mother within 2 hours of birth" ], "exclusion": [ "Mother younger than 15 years", "Mother, or the guardian of a minor mother aged 15 to 17, unable or unwilling to consent", "Triplets or higher-order multiples", "Mother unlikely to provide KMC within the first 3 days (registry examples: eclampsia, shock, major surgery)", "Cannot be enrolled within 2 hours of birth", "Residence outside the study area", "Infant unable to breathe spontaneously by 1 hour of age", "Major congenital malformation (registry: one that interferes with, or is interfered with by, the intervention)" ] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "One trial in five tertiary hospitals in low- and middle-income countries, with an open-label design. It stopped early for benefit before reaching its target of 4200 infants. About 20% of infants in the eligible weight band were not enrolled because mother or baby was too sick. The authors say the effect of starting early cannot be separated from the mother's continuous presence (author manuscript, Discussion para 5), and that applicability to low-mortality, high-resource settings is untested (author manuscript, Discussion para 3). Fewer deaths in this window make the estimate less precise. The per-arm denominators (1606 and 1599) come from the author manuscript's Table 3 only, its text does not state their basis, and they were not checked against the version of record.", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 3: \"relative risk of death, 0.77; 95% CI, 0.58 to 1.04; P = 0.09\"", "applicability_note": "Abstract of the primary report, for the same infants and time window as this context.", "snapshot": { "id": "maternal:pubmed-34038632-2026-10-09", "retrieved_at": "2026-10-09T15:56:27Z", "content_hash": "5dde5eaa4d684f398f7f3cfab05816eb73207b8adbaac5c4163e7e480567ecf6", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Table 3, row 2 (death between enrolment and 72 hours of age): 74/1606 (4.6%) and 92/1599 (5.8%)", "applicability_note": "Author accepted manuscript (CC BY 4.0); not checked against the version of record.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Table 3, column header: \"Adjusted RR (95%CI)\"", "applicability_note": "The ratios are adjusted, not crude; see the Table 3 footnote.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Discussion, para 5: \"20% of infants 1.0 to <1.8 kg born in study hospitals were not enrolled because mother or newborn was too sick\"", "applicability_note": "Limits who the result describes.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.", "public_text": "quote" } } ], "review": { "content_digest": "4991c1fe6778b10f0abe89b6de600214cbcf5efe12d0becb8ad675bd875311e9", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/maternal--claim-ikmc-72h-mortality.json" }, { "release_id": "15708f235d73cd42", "id": "maternal:claim-ikmc-hypothermia", "owner": "maternal", "subject_entity_id": "maternal:immediate-kmc", "category": "effect", "statement": "Fewer babies in the immediate skin-to-skin group had a recorded low temperature (under 36 °C at the armpit) during their hospital stay: 90 of 1609 versus 133 of 1602 (adjusted risk ratio 0.65, 95% CI 0.51 to 0.83).", "context": { "id": "maternal:ctx-ikmc-newborns-1000-1799g", "label": "Liveborn infants weighing 1.0 to under 1.8 kg at birth in five tertiary hospitals in sub-Saharan Africa and India (iKMC trial)", "recipient": "newborn", "population": "Liveborn infants with a birth weight of 1.0 to under 1.8 kg (abstract: \"between 1.0 and 1.799 kg\"), of any gestational age, singleton or twin, by any mode of delivery, enrolled with their mothers within 2 hours of birth. About 20% of infants in this weight band born in the study hospitals were not enrolled because mother or newborn was too sick.", "care_setting": "Tertiary hospitals. Intervention infants: a Mother-NICU (a neonatal intensive care unit with beds for mothers), then a KMC ward. Control infants: the NICU without the mother, then a KMC ward after stabilization.", "geography": "Ghana (Kumasi), India (New Delhi), Malawi (Blantyre), Nigeria (Ile-Ife) and Tanzania (Dar es Salaam); cities per ANZCTR. The ICTRP mirror of the CTRI record does not name the fifth country; it lists it only as other.", "life_stage": "Neonatal period", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": 0, "postnatal_age_max_days": 0, "gestational_age_status": "any", "postnatal_age_status": null, "followup_description": "From enrolment to 28 days of age, with a home visit on day 29. The second primary outcome window was enrolment to 72 hours.", "eligibility": { "inclusion": [ "Liveborn infant", "Birth weight 1.0 kg to under 1.8 kg", "Any gestational age, mode of delivery, or singleton or twin status", "Enrolled with the mother within 2 hours of birth" ], "exclusion": [ "Mother younger than 15 years", "Mother, or the guardian of a minor mother aged 15 to 17, unable or unwilling to consent", "Triplets or higher-order multiples", "Mother unlikely to provide KMC within the first 3 days (registry examples: eclampsia, shock, major surgery)", "Cannot be enrolled within 2 hours of birth", "Residence outside the study area", "Infant unable to breathe spontaneously by 1 hour of age", "Major congenital malformation (registry: one that interferes with, or is interfered with by, the intervention)" ] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Secondary outcome. Its confidence interval is not adjusted for multiplicity, and the authors say such intervals should not be used to infer definitive effects. Temperatures were measured in an open-label trial. The trial's hypothermia definition differs from other studies. One trial in five tertiary hospitals in low- and middle-income countries, with an open-label design. It stopped early for benefit before reaching its target of 4200 infants. About 20% of infants in the eligible weight band were not enrolled because mother or baby was too sick. The authors say the effect of starting early cannot be separated from the mother's continuous presence (author manuscript, Discussion para 5), and that applicability to low-mortality, high-resource settings is untested (author manuscript, Discussion para 3).", "editorial_state": "draft", "checked_at": null, "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Table 3, hypothermia row: \"90/1609 (5.6%) 133/1602 (8.3%) 0.65 (0.51–0.83)\"", "applicability_note": "Author accepted manuscript (CC BY 4.0); not checked against the version of record.", "snapshot": { "id": "maternal:pmc-pmc8108485-2026-10-09", "retrieved_at": "2026-10-09T15:57:07Z", "content_hash": "0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:ikmc-nejm-2021", "source_type": "publication", "title": "Immediate \"Kangaroo Mother Care\" and Survival of Infants with Low Birth Weight", "canonical_url": "https://doi.org/10.1056/NEJMoa2026486", "identifier_namespace": "doi", "identifier_value": "10.1056/NEJMoa2026486", "publication_date": "2021-05-27", "publisher": "Massachusetts Medical Society (N Engl J Med 384(21):2028-2038)", "edition": "Version of record not fetched (HTTP 403). The abstract comes from PubMed. Full-text facts come from the PMC author accepted manuscript PMC8108485.", "reuse_basis": "Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). 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This is broader than the iKMC trial's 1.0 to under 1.8 kg band.", "care_setting": "Health-care facility or home. The A.1b remarks give separate conditions for each.", "geography": "Global (WHO guideline; the setting text says \"any country or setting\")", "life_stage": "Newborn, from birth", "gestational_age_min_days": null, "gestational_age_max_days": null, "postnatal_age_min_days": 0, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (recommendation context)", "eligibility": { "inclusion": [ "Preterm or low-birth-weight infant" ], "exclusion": [ "In a facility: an infant who cannot breathe spontaneously after resuscitation, is in shock or needs mechanical ventilation. 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The non-commercial and share-alike terms need a licensing decision before any text is adapted.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "A.1 Remarks, Immediate KMC, PDF p. 25: \"immediate KMC can be initiated before the infant is clinically stable\"", "applicability_note": "Applies in facilities.", "snapshot": { "id": "maternal:who-9789240058262-pdf-2026-10-09", "retrieved_at": "2026-10-09T15:58:39Z", "content_hash": "650354ec6f6cfdc81bd9b542ef488eb32de0d2675cdc574fd26a529c2275d532", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:who-2022-preterm-lbw", "source_type": "guideline", "title": "WHO recommendations for care of the preterm or low-birth-weight infant", "canonical_url": "https://www.who.int/publications/i/item/9789240058262", "identifier_namespace": "isbn", "identifier_value": "978-92-4-005826-2", "publication_date": "2022-11-15", "publisher": "World Health Organization", "edition": "2022. 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The non-commercial and share-alike terms need a licensing decision before any text is adapted.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "A.1 Remarks, Immediate KMC, PDF p. 25: \"unless the infant is unable to breathe spontaneously after resuscitation, is in shock or needs mechanical ventilation\"", "applicability_note": "Facility exceptions.", "snapshot": { "id": "maternal:who-9789240058262-pdf-2026-10-09", "retrieved_at": "2026-10-09T15:58:39Z", "content_hash": "650354ec6f6cfdc81bd9b542ef488eb32de0d2675cdc574fd26a529c2275d532", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:who-2022-preterm-lbw", "source_type": "guideline", "title": "WHO recommendations for care of the preterm or low-birth-weight infant", "canonical_url": "https://www.who.int/publications/i/item/9789240058262", "identifier_namespace": "isbn", "identifier_value": "978-92-4-005826-2", "publication_date": "2022-11-15", "publisher": "World Health Organization", "edition": "2022. 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