For parents of premature or sick newborns, holding their baby skin-to-skin can feel like the most natural thing in the world. But in the high-tech, high-stress environment of the neonatal intensive care unit (NICU), it doesn't always happen. A new narrative review of existing research digs into why.
The review identifies barriers at multiple levels. Some are clinical: extreme prematurity, the need for respiratory support, or unstable vital signs. Others are organizational: lack of clear protocols, limited staffing, and training gaps. And some are emotional: parents feel stressed or unsure, and staff may not offer enough guidance.
But here's the good news: the review also highlights strategies that work. Multidisciplinary training, simulation-based learning, institutional protocols, safety checklists, and structured parental education can all help. The authors note that current evidence does not support withholding skin-to-skin contact when proper monitoring, preparation, and positioning are in place.
It's important to remember that this is a narrative review, not a new clinical trial. It summarizes what's already known, so the findings are based on the quality of the studies included. Still, for NICU teams looking to improve care, this review offers a practical roadmap.
