Effects of Kangaroo Care on the Attainment of Full Enteral Feeding in Neonatal Intensive Care Unit Infants: A Systematic Review and Meta-analysis.

Background

Delayed attainment of full enteral feeding (FEF) remains a challenge in preterm infants and is associated with gastrointestinal maturation and readiness for hospital discharge. Although kangaroo care (KC) is widely implemented in neonatal intensive care units (NICUs), its effect on time to FEF is unclear.

Purpose

To synthesize evidence from randomized controlled trials (RCTs) examining the effect of KC on time to FEF in preterm infants.

Methods

A systematic review and meta-analysis were conducted in accordance with Joanna Briggs Institute methodology and PRISMA 2020 guidelines. RCTs comparing KC with standard NICU care and reporting time to FEF were identified by searching 5 databases from inception to October 17, 2025. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool.

Results

Five RCTs involving 624 preterm infants were included. Meta-analysis showed that KC significantly shortened time to FEF compared with standard care (mean difference = -3.32 days, 95% CI [-5.88, -0.76], P = .01; I2 = 91%). Infants receiving KC also demonstrated greater weight gain than controls (mean difference = 5.68 g, P = .0002). No significant difference was observed between groups in length of hospital stay (P = .62). IMPLICATIONS FOR PRACTICE AND RESEARCH KC may serve as an effective, nursing-led intervention to support feeding progression and early growth in preterm infants while reinforcing family-centered care in the NICU. Given variability in protocols and outcome definitions, further multicenter RCTs are needed to confirm these findings and clarify implications for hospital resource utilization.