The World Health Organization (WHO) has estimated that 15 million babies are born prematurely worldwide every year, and the number is increasing (WHO, 2018). These preterm infants are nursed in incubators to maintain their temperature and to enable them to gain weight adequately. Whilst being nursed in incubators, the infants are separated from their mothers. Kangaroo care (KC) is a humanistic approach that began in Bogota, Colombia in the late 1970s as an alternative intervention in the neonatal intensive care unit (NICU) to maintain premature infants' body temperature when incubators were insufficient (Nieder-Heitmann, 2010). It is based on a familycentered care model which was developed to foster the role of mothers in the NICU (Davy et al., 2011). Kangaroo care refers to

Purpose Kangaroo care is a complementary humanistic intervention based on a family-centered care model. This study investigated the effects of a locally contextualized, structured kangaroo care education program on weight gain, breastfeeding rate and length of hospitalization for premature infants. Patients and Methods This longitudinal quasi-experimental study with pre- and post-intervention design involved 96 infants born between 28 and 37 weeks of gestation for three months, and was carried out at a neonatal intensive care unit in Malaysia. The experimental group received a structured education program and careful monitoring of their kangaroo care practices, while the control group received routine care without a structured education program. The institutional review board approved the study design and registered at ClinicalTrials.gov (NCT04926402). Results The kangaroo care hours performed by mothers at baseline in the experimental and control group was 4.12 and 0.55 hours per week, respectively. At three months post-discharge, the experimental group had significantly higher weight gain, higher breastfeeding rates and shorter lengths of hospitalization than the control group. Conclusion A locally contextualized and structured kangaroo care education program is effective in the performance of kangaroo care. One hour per day of kangaroo care is positively associated with an extended period of breastfeeding, improved weight gain and shorter hospitalization of premature infants.