Summary: Very preterm infants who received more skin-to-skin contact during their hospital stay showed stronger development in brain regions tied to stress and emotional regulation. Brain scans revealed that longer skin-to-skin sessions were linked to changes in white matter pathways that support attention, memory, and emotional health.
These associations held even after accounting for socioeconomic status and other factors. The findings suggest that caregiving experiences in the earliest weeks of life may influence long-term brain development.
Key Facts
- Study Group: 88 infants born at ~29 weeks, average weight 2.65 pounds.
- Brain Benefits: More skin-to-skin linked to stronger white matter development in emotion-related regions.
- Caregiving Impact: Findings add evidence that early experiences shape brain health.
Source: AAN
Preterm infants born before 32 weeks who received more skin-to-skin contact while in the hospital showed stronger brain development in areas tied to emotion and stress regulation than babies who received less skin-to-skin care, according to a study published in the September 24, 2025, issue of Neurology.
The study does not prove that skin-to-skin care directly causes stronger brain development, it only shows an association.
“Skin-to-skin contact in preterm infants has been shown to have many benefits, with previous studies linking it to improved bonding, sleep, heart and lung function and growth, as well as reduced pain and stress,” said study author Katherine E. Travis, PhD, of Burke Neurological Institute in White Plains, New York.
“Our findings in infants born very preterm suggest skin-to-skin care may also play a role in shaping early brain development, highlighting the potential importance of caregiving experiences during the earliest weeks of a preemie’s life.”
The study included 88 preterm infants with an average gestational age of 29 weeks who weighed an average of 2.65 pounds. The average stay in the hospital was two months. The goal was to find out whether skin-to-skin holding—also called kangaroo care—was linked to brain development in areas that help regulate emotions and stress.
Researchers tracked skin-to-skin care with family members throughout each infant’s hospitalization, including how long each session lasted and the total minutes per day. Families visited an average of once per day.
When they provided skin-to-skin care, the average session was around 70 minutes with 73% of sessions provided by mothers. For the entire hospital stay, the average amount of skin-to-skin care per day was 24 minutes.
Each infant received a brain scan before going home from the hospital—around the time they would have reached full-term age of around 40 weeks. The brain scans measured how water moves through brain tissue.
This movement helps reveal how white matter—the brain’s communication network—is developing. Researchers then compared the markers of white matter with the amount of time the preemies received skin-to-skin care per session and per day.
For skin-to-skin duration per session, researchers found longer sessions were linked to higher mean diffusivity—how freely water moves through the brain—in two key brain regions: the cingulum, which supports attention and emotion regulation; and the anterior thalamic radiations, which connects areas involved in emotional processing and memory.
Longer sessions were also linked to lower fractional anisotropy—how water movement is influenced by developing cellular tissues—in the anterior thalamic radiations.
For daily total minutes of skin-to-skin care, researchers found higher amounts were linked to higher mean diffusivity in the anterior thalamic radiations. They were also linked to lower fractional anisotropy in the anterior thalamic radiations.
These associations remained significant even after researchers accounted for factors that could influence brain development, including gestational age at birth, age at time of scan, socioeconomic status and how often family visited.
“Our findings add to growing evidence that white matter development is sensitive to a preterm infant’s experience while in the hospital,” said Travis. “Skin-to-skin care not only provides preterm infants with family connections through bonding, it may also be encouraging new connections within the brain itself, improving a baby’s brain health overall.”
A limitation of the study is that it was conducted at a single hospital and researchers reviewed existing medical records. The authors note that future research should explore how early caregiving experiences—like skin-to-skin care—might shape brain development and support later behavioral outcomes as preterm infants grow.
Funding: The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Questions Answered
A: Longer and more frequent skin-to-skin sessions were linked to stronger brain development in regions tied to emotion and stress regulation
A: MRI scans showed changes in white matter microstructure, the brain’s communication network.
A: No, the study shows an association, but findings suggest caregiving may shape early brain growth.
About this neurodevelopment research news
Author: Renee Tessman
Source: AAN
Contact: Renee Tessman – AAN
Image: The image is credited to Neuroscience News
Original Research: Closed access.
“Skin-to-Skin Holding in Relation to White Matter Microstructure in Infants Born Preterm” by Katherine E. Travis et al. Neurology
Abstract
Skin-to-Skin Holding in Relation to White Matter Microstructure in Infants Born Preterm
Background and Objectives
Preterm birth is associated with altered white matter development and long-term neurodevelopmental impairments. Skin-to-skin care has known benefits for physiologic regulation and bonding in preterm infants, but impacts on early brain structure remain unclear. The aim of this study was to describe the association between in-hospital skin-to-skin care and white matter microstructure in very preterm infants, focusing on frontolimbic tracts involved in stress regulation and socioemotional development.
Methods
The design was a single-center retrospective observational analysis of clinical data from the electronic medical records and diffusion MRI scans. Participants were infants born at <32 weeks gestational age (GA) who received a routine predischarge MRI. Skin-to-skin care was quantified as duration per instance and daily exposure rate (in minutes) before the MRI was obtained. Diffusion MRI assessed mean diffusivity (MD) and fractional anisotropy (FA) in the cingulum, anterior thalamic radiations (ATRs), and uncinate fasciculus. Hierarchical regression models evaluated associations between skin-to-skin care and white matter metrics, adjusting for GA, medical acuity, postmenstrual age at scan, and MRI coil type.
Results
A total of 88 preterm infants (mean GA 29 weeks; 49% female) were included. Skin-to-skin care duration per instance was positively associated with MD in the cingulum (B = 0.002, 95% CI 0.0004–0.003, ΔR2 = 0.080) and ATRs (B = 0.002, 95% CI 0.0003–0.003, ΔR2 = 0.057). Skin-to-skin care daily exposure rate was also positively associated with ATR MD (B = 0.038, 95% CI 0.001–0.076, ΔR2 = 0.046). Both skin-to-skin metrics were negatively associated with ATR FA (duration: B = −0.0005, 95% CI −0.001 to −0.0001, ΔR2 = 0.046; rate: B = −0.016, 95% CI −0.028 to −0.004, ΔR2 = 0.075). No significant associations were found for the uncinate fasciculus. Findings remained significant after adjusting for socioeconomic status and visitation frequency and after excluding infants with white matter injury.
Discussion
Skin-to-skin care was associated with neonatal white matter microstructure in specific frontolimbic tracts. Limitations include the retrospective design and single-center setting. Future studies should consider how early caregiving experiences, such as skin-to-skin care, may influence brain development in preterm infants.