Kangaroo care helps premature babies in Gaza grow healthier

Khan Younis, Gaza Strip – For 11 days after giving birth to her youngest son last month, Rania Fadel could not hold her newborn.

The 24-year-old woman gave birth to twin boys Ilyas and Yahya on September 25. While Yahya was healthy, Ilyas was admitted to the neonatal intensive care unit at Nasser Medical Centre in Khan Younis, southern Gaza, and remained there for nearly two weeks.

According to Rania, Ilyas was born premature, weighing only 1.4 kg at birth. He had blood- and lung-related medical problems that required specialised care in an incubator. Rania herself was recovering from a caesarean section, so for days she could not hold her son.

“When they called me in to hold him, I rushed over. I just wanted to be by my child’s side as quickly as possible. That feeling is hard to describe,” she recalled.

When Ilyas’s condition improved and he was moved from intensive care to the hospital’s neonatal care unit, Rania was able to hold him against her bare chest – a method of caring for low-weight infants known as “kangaroo mother care”, part of a programme newly introduced at the hospital.

The method involves prolonged skin-to-skin contact between a caregiver – ideally the mother – and the baby, combined with exclusive breastfeeding. Studies show it delivers significant health benefits for premature and low-weight infants.

“I was very happy. It was a wonderful feeling,” Rania said.

During the session, a nurse guided Rania in placing Ilyas against her chest, skin to skin. She said he stayed that way for about 90 minutes.

“He started breastfeeding and stayed a while longer. I felt he was making progress,” she said. For Rania, the contact also brought a sense of closeness after days apart. “The baby senses that his mother is there. He feels safe. Honestly, that made me very happy.”

Skin to skin

Kangaroo care is the practice of placing a baby against a parent’s bare chest for skin-to-skin contact, combined with breastfeeding and appropriate medical care. For premature and low-weight infants, it helps regulate body temperature, supports breastfeeding and improves health outcomes.

According to World Health Organization guidelines, kangaroo care has been shown to reduce newborn mortality by 32 percent and mortality up to six months of age by 25 percent compared with conventional care.

At Nasser Medical Centre, Khawla al-Madhoun, the hospital’s nursing director for obstetrics and neonatology, described it as a holistic approach to newborn care that supports development and strengthens mother-baby bonding.

“When we place the baby on the mother’s chest, it helps the baby develop,” she said. “We have seen weak or low-weight babies begin to grow faster thanks to kangaroo care. This can help them be discharged sooner.”

The hospital began rolling out kangaroo care through a pilot programme supported by WHO, the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA). The organisations announced the initiative at Nasser Hospital in September, but the method is being introduced gradually in the outpatient neonatal care unit – where babies stay with their mothers – and in postnatal obstetric wards.

Al-Madhoun said her team is also preparing a dedicated room and seeking equipment to make the sessions more comfortable. The team aims for longer skin-to-skin periods – WHO recommends at least eight hours a day – though the immediate target is at least two hours, depending on each family’s circumstances.

At Nasser, the team currently prioritises babies whose condition is stable and who do not need oxygen support. Nurses monitor vital signs and assess the infants throughout the process. Al-Madhoun stressed that the method cannot replace incubators or other treatments when a baby needs intensive care.

“It can help babies develop, gain weight and be discharged sooner, but some babies need other interventions such as respiratory support. Those babies still need incubators and the care they provide,” she said.

Shortage of neonatal equipment

The need for specialised newborn care comes as Gaza’s health system continues to struggle with damaged facilities, equipment shortages and overcrowded neonatal units. According to UNICEF, before Israel’s war in Gaza began in October 2023, Gaza had eight neonatal intensive care units with a total of 178 incubators.

By November 2024, three of those units had been destroyed by Israel, and the number of remaining incubators had fallen to about 54 – a 70 percent drop. The equipment shortage, compounded by limited fuel and power supplies due to Israeli restrictions, puts premature infants at serious risk.

Israeli air strikes have continued since a ceasefire in October 2025. Despite the nominal truce and some new equipment having entered, shortages of incubators and other equipment persist. In May, UNICEF said it and its partners had provided incubators and ventilators to hospitals in Gaza, while warning that neonatal units were still handling large numbers of fragile babies with limited equipment, space and power.

The war in Gaza has worsened living conditions for pregnant women through economic hardship, food insecurity, poor nutrition and the harsh realities of displacement, including cooking over campfires and hauling water.

“These conditions contribute to a rise in premature births and low-birth-weight babies who need specialised neonatal care,” al-Madhoun said. Meanwhile, repeated displacement and overcrowding add further pressure on hospitals, including Nasser Medical Centre, which was already struggling with limited space and a lack of incubators and other essential neonatal equipment.

A baby in a tent

Linda Abu Nasira’s baby girl is just three days old. According to Linda, 23, the infant initially had a fever but it has come down. As her daughter was treated and breastfed, Linda was taught how to hold her against her chest under the guidance of the medical team.

The sessions are short. Linda said she holds her baby to her chest for about 30 minutes at a time, repeated roughly every two hours as instructed. “She is a little better than yesterday. Bit by bit,” she said.

Outside the hospital, Linda lives in a tent in al-Mawasi, Khan Younis, where she raises two older children – aged three and two – while caring for her newborn. She described the living conditions as very difficult, especially finding food and water. “We try to manage. But it is not like before, or like the conditions you would expect when giving birth,” she said.

She does not know how long her daughter will need monitoring at the hospital’s outpatient neonatal care unit. “As a mother, feeling that I am helping my daughter recover means a great deal to me. I hope she recovers and is discharged as soon as possible,” Linda said.