A randomized controlled trial of intermittent kangaroo mother care versus conventional care in increasing the rate of weight gain among low-birth-weight neonates

Objective@#To determine the effectiveness of Kangaroo Mother Care (KMC) in increasing the rate of weight gain and decreasing hypothermia, apnea, and sepsis rate, and shorten hospital stay among low-birth-weight infants. @*Methods@#Very low birth weight (VLBW) infants (≤1500 grams) were randomized to either the KMC or conventional care group. KMC provided skin-to-skin contact at least 6 hours per day while the conventional group received the usual care in the newborn intensive care unit (NICU). Daily weight measurements and weekly measurements of length, head, and chest circumference were recorded until discharge. Occurrence of hypothermia, apnea, sepsis, and length of stay was noted. @*Results@#KMC group had a higher mean weight gain per day (p=0.0102). There was no difference in the length, head, and chest circumference between the two groups. Sepsis and apnea rates were not significant between the two groups. Significantly more neonates experience hypothermia in the control group (p<0.0069). @*Conclusion@#KMC is effective in increasing the weight per day compared with the control group. KMC protects the neonates against hypothermia. There is not enough evidence to show a difference in the incidence of sepsis, apnea, and the length of hospital stay between the two groups.

Effect of kangaroo mother care in terms of hospital stay among preterm infants in a tertiary health care center

Background: Hypothermia, infections and ineffective breastfeeding are some of the commonest cause of deaths among premature and low birth weight infants. Kangaroo mother care is a well-known intervention to address the issues related to preterm births, such as hypothermia, infection and prolonged hospitalisation.Methods: This study was carried out in a tertiary care centre in Bengaluru on all preterm neonates of birth weight less than 2500 grams with stable hemodynamic conditions over a period of 18 months. Gestational age assessed by the new Ballard's score, within 24 hours of life and anthropometry details of the neonate were recorded at 24 hours of life by the single observer. Kangaroo mother care was given for a minimum of one hour at a stretch per day and the effect on the preterm neonate in terms of hospital stay was assessed.Results: Kangaroo mother care has positive effects on the infants growth, neurodevelopmental outcome, reduction in the morbidities associated with preterm infants, and breastfeeding practices in mothers of preterm neonates.Conclusions: The study promotes awareness of KMC on preterm neonates considering all the benefits and positive effects of KMC on the infant as well as baby, and to the family and nation amongst the health care personnel as well as the society.

Kangaroo mother care for low birth weight babies: supportive factors and barriers

Background: Kangaroo mother care (KMC) is skin-to-skin contact between mother and low birth weight (LBW) baby. It keeps the baby warm, increases accessibility to breast feeding, and protects the baby from infections. This study was done to identify supportive factors and barriers in practicing KMC as perceived by mothers of LBW babies and health care personnel (HCP).Methods: It was a questionnaire based descriptive study. Mothers of LBW babies and HCP were enrolled in study. Mothers and HCP were sensitized regarding KMC and after practicing KMC for 3 days, mothers were interviewed with the help of a predefined proforma. Feedback from the HCP was also taken. Data analysis was performed by using IBM SPSS ver. 20 software.Results: Most common factor in initiation and practice of KMC were, knowledge regarding KMC after training (100%), environmental factors (privacy and resources) (87.27%) and support from HCP (94.54%). Most common barriers perceived during performance of KMC were lack of knowledge about KMC during pregnancy (80%), pain due to LSCS/episiotomy (64.54%) and lack of support from family members (51.81%). Majority of the HCP strongly agree that parents must be encouraged to adopt KMC (82.92%), KMC is hampered due to presence of visitors in the ward (73.17%). KMC needs separate room (68.29%) and it is difficult due to LSCS (51.21%).Conclusions: To increase KMC practice, mother's knowledge about KMC can be improved by educating them in antenatal clinics and all HCP should receive training on KMC.

The evaluation of effectiveness of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital: a before and after study

Background: Kangaroo mother care (KMC) is a standard of care for preterm and low birth weight babies. To implement KMC in institutional care it was often practiced inside intensive care unit and also in separate ward. In present study authors have tried to evaluate effect of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital.Methods: Uncontrolled study before and after establishment of separate kangaroo mother care ward comparing kangaroo mother care in sick new-born care unit versus kangaroo mother care in separate ward.Results: In separate ward, as compared to kangaroo mother care practice in sick newborn care unit, mean (SD) duration of kangaroo mother care increased from 5.3 (1.6) to 11.4 (7.4) hours/day (95%CI 5.0-7.1, p value <0.0001). Mean (SD) weight gain increased from 10.7 (7.0) g/day to 13.7 (11.1) g/day (95% CI 1.0-4.8, p value <0.0024). Incidence of sepsis diminished from 14.0% to 28.9% (95% CI 6.4-23, p value <0.0006). Exclusive breast-feeding rate at discharge (42.3% vs. 57.3%) (95% CI 4.8- 24.9, p value <0.0041) and follow up (49.4% vs. 65.0%) (95% CI 1-29.4, p value <0.0378) increased. Mortality also decreased in this group of patients (8.6% vs.2.3%) (95% CI-1.6-11.4, p value <0.0082).Conclusions: Kangaroo mother care ward is better place than sick new born care unit for providing kangaroo mother care in tertiary care hospital.