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

The 24-year-old gave birth to twin boys, Ilyas and Yahya, on September 25.

While Yahya was born healthy, Ilyas was admitted to the neonatal intensive care unit at Nasser Medical Complex in Khan Younis, in southern Gaza, where he remained for nearly two weeks.

Born prematurely, Ilyas weighed just 1.4 kilogrammes (3 pounds) at birth, according to his mother. He had medical issues affecting his blood and lungs, she said, and needed specialised care in an incubator.

Rania herself was recovering from a Caesarean section when her son was taken into intensive care. For days, she could not hold him.

“When they called me to hold him, I rushed over,” she recalled. “I was in a hurry to get to him. It was such a feeling.”

As Ilyas’s condition improved and he moved from intensive care to the hospital’s neonatal care unit, Rania was able to hold him against her bare chest, introducing her to a form of care for low-birthweight newborns known as kangaroo mother care, part of a newly-launched programme at the hospital.

It involves prolonged skin-to-skin contact between a caregiver – ideally the mother – and baby, with exclusive breast milk feeding, and has been shown to have important health benefits for premature and low-birthweight babies.

“I was so happy. It was such a beautiful feeling,” Rania said.

During the session, a nurse helped Rania position Ilyas against her chest, with his skin touching hers. Rania said he remained there for about 90 minutes.

“He started breastfeeding from me, and he stayed a little longer,” she said. “I felt he was improving.”

For Rania, the contact also brought a sense of closeness after days of separation.

“The baby feels that his mother is there,” she said. “He feels safe. Honestly, it makes me very happy.”

Skin-to-skin

Kangaroo mother care involves placing a baby against a parent’s bare chest for skin-to-skin contact, alongside breastfeeding and appropriate medical care.

For premature and low-birthweight babies, it can help regulate body temperature, support breastfeeding and improve health outcomes.

World Health Organization (WHO) guidance says that kangaroo mother care has been shown to reduce neonatal mortality by 32 percent, and mortality by six months of age by 25 percent, compared with conventional care.

At Nasser Medical Complex, Khawla al-Madhoun, director of nursing at the hospital’s maternity and neonatal departments, described it as an integrated approach to newborn care that supports growth and strengthens the bond between mother and baby.

“When we place a baby on the mother’s chest, it helps the baby grow,” she said.

“We have seen babies who were unwell or underweight begin to grow faster with kangaroo care. This can help them leave the hospital sooner.”

The hospital has begun introducing kangaroo care through a pilot programme supported by WHO, the United Nations Children’s Fund (UNICEF), and the UN Population Fund (UNFPA). The agencies announced the initiative at Nasser Hospital in September, but the practice is being introduced gradually in its external neonatal care unit, where babies stay with their mothers, and in maternity wards after delivery.

Al-Madhoun said the team was also preparing a dedicated room and seeking equipment to make the sessions more comfortable.

The team aims for longer periods of skin-to-skin contact – WHO recommends at least eight hours per day – although its immediate target is at least two hours, depending on each family’s circumstances.

At Nasser, the team is currently prioritising babies who are medically stable and do not require oxygen support. Nurses monitor their vital signs and assess them throughout the process.

Al-Madhoun stressed that the technique cannot replace an incubator or other treatment when a baby needs intensive care.

“It can help babies grow, gain weight and leave the hospital earlier, but some babies need other interventions, such as respiratory support,” she said. “Those babies still need the incubator and the care it provides.”

Shortage of neonatal equipment

The need for specialised newborn care comes as Gaza’s health system continues to struggle with damaged facilities, shortages of equipment and overcrowded neonatal units.

Before Israel’s genocidal war on Gaza began in October 2023, Gaza had eight neonatal intensive care units with a total of 178 incubators, according to UNICEF.

By November 2024, three of those units had been destroyed by Israel, and the number of available incubators had fallen to about 54, a reduction of 70 percent. The shortage of equipment, compounded by limited supplies of fuel and electricity as a result of Israeli restrictions, put premature newborns at serious risk.

Israeli strikes have continued since an October 2025 “ceasefire”. Despite this supposed truce, and despite the delivery of some new equipment, the shortage of incubators and other equipment has persisted.

In May, UNICEF said it and its partners had supplied incubators and ventilators to hospitals in Gaza, while warning that neonatal units were still managing large numbers of fragile infants with limited equipment, space and power.

The war in Gaza has worsened living conditions for pregnant women with economic hardship, food shortages, poor nutrition and the harsh realities of displacement, including cooking over open fires and carrying water.

“These conditions have contributed to the rise in premature births and babies born with low birth weight who need specialised neonatal care,” al-Madhoun said.

Meanwhile, repeated displacement and overcrowding have placed further pressure on hospitals, including Nasser Medical Complex, which is already struggling with limited space and shortages of incubators and other essential neonatal equipment.

Newborn in a tent

Linda Abu Nasira’s baby girl is only three days old.

The infant initially developed a fever, which has since subsided, according to 23-year-old Linda.

As her daughter was being treated and breastfed, Linda was learning how to hold her against her chest under the guidance of the medical team.

The sessions were brief. Linda said she held her daughter against her chest for about 30 minutes at a time, repeating the process roughly every two hours, according to the instructions she had received.

“She is a little better than yesterday,” Linda said. “Little by little.”

Away from the hospital, Linda lives in a tent in al-Mawasi, in Khan Younis, where she is raising her two older children – aged three and two – while caring for her newborn.

She described the conditions as difficult, particularly when it comes to securing food and drinking water.

“We try to manage,” she said. “But it is not like before, or like the conditions you would expect when giving birth.”

She does not know how long the baby will need to remain under observation in the hospital’s external neonatal care unit.

“As a mother, it means a lot to me to feel that I am helping my daughter recover,” Linda said. “I hope she will recover and be discharged as soon as possible.”