Parental knowledge and experience of kangaroo care for preterm infants in neonatal intensive care unit: a qualitative study

Background: Kangaroo care is a low-cost, evidence-based neonatal intervention known to reduce morbidity and promote infant development and parental bonding. However, in NICUs in Saudi Arabia, parent uptake remains low, and little is known about how cultural, educational, and institutional factors shape parents' experience and decision-making. Objective: This study aimed to assess parental knowledge and experiences regarding kangaroo care in Saudi Arabia and explore the factors influencing their decisions to practice it. Methods: A phenomenological qualitative research design was employed. A purposive sampling was used to select parents of stable preterm infants (32-37 weeks' gestational age), in the NICU using semi-structured interviews. Data was analyzed using reflexive thematic analysis. Results: Eighteen mothers (aged 28-40 years) were interviewed. From the analysis, seven themes and five sub-themes were constructed, emphasizing the profound emotional, physical, and relational impact of kangaroo care on mothers. Mothers described kangaroo care as empowering, supporting infant recovery, enhancing breastfeeding, and fulfilling psychological and spiritual needs, often drawing strength from religious practices. A significant concern was the timing of kangaroo care education, which was typically provided after delivery when mothers felt overwhelmed, leading participants to advocate for antenatal education to improve awareness and preparedness. Additionally, multiple mothers attributed their husbands' limited participation to hesitancy and fear. Conclusion: The study emphasizes the significance of early, culturally sensitive education and the routine incorporation of kangaroo care into neonatal care protocols, as endorsed by clinical guidelines and institutional policies. The findings underscore the central role of cultural and religious values in shaping parental experiences and emphasize the need for healthcare systems to adopt holistic, family-centered approaches. Implementing early education and culturally tailored support can enhance parental engagement, maternal empowerment, and neonatal outcomes, ultimately improving care during this critical period. This approach not only benefits individual families but also contributes to the advancement of public health and pediatric care in Saudi Arabia and beyond.