Maternal-newborn skin-to-skin contact (kangaroo care) was provided in 73 preterm infants for 14 days and the results compared to 73 matched controls receiving standard incubator care. Infants were followed for 10 years. Kangaroo care increased autonomic functioning and maternal attachment behavior in the postpartum period, reduced maternal anxiety, and enhanced child cognitive development and executive functions from 6 months to 10 years. By 10 years of age, children who received kangaroo care showed attenuated stress response, organized sleep, and better cognitive control. Autonomic function and maternal behavior were dynamically interrelated over time, leading to improved physiology, executive functions, and mother-child reciprocity at 10 years.