Surrogate skin-to-skin care: the “donor milk” of kangaroo mother care

Skin-to-skin care (SSC) significantly decreases mortality and improves preterm infants' outcomes. The World Health Organization recommends that every preterm baby receive 8-24 h per day of SSC beginning as soon as possible after birth but in many settings this goal is rarely met. An important barrier for SSC is parent availability; lack of parental leave, siblings who require care, and other factors often limit parents' availability for SSC. In many studies that demonstrated the benefits of SSC, including infection rate reduction, both parents and surrogates participated in SSC. Though not as ideal as parental SSC, surrogate SSC can be compared to donor human milk which does not provide all benefits of mother's own milk but is considered superior to formula. An analogous benefit could be true for infants who receive less than recommended parental SSC if surrogates support parents in providing extended periods of SSC.