ABSTRACT
Aims Hospital Miri is a district hospital with NICU that caters neonatal care service in Northern Sarawak. Preterm birth rate in our centre makes up of 10% (n=487) in 2019 and 11% (n=491) in 2020 of the live births, with mortality rate of 3% for preterm infants less than 33 weeks. According to WHO and Cochrane review (2016), Kangaroo mother care helps to reduce mortality, nosocomial infection, hypothermia, and improved growth and exclusive breastfeeding. Methods This is a retrospective observational study. Kangaroo Mother Care (KMC) Project was introduced in 2020 in Hospital Miri NICU as part of quality improvement project. Stable preterm infants with postmenstrual age 30 weeks to 34 weeks 6 days were enrolled with mother's consent into the project. It was carried out in 3 phases, with phase 1 of stable infants under room air or HFNC, phase 2 of stable infants on NIV and phase 3 with intubated infants. As COVID-19 endemic encroached, the project was put on hold at phase 2. Infants' demographic data was analysed using frequency and percentage. Outcomes were measured in mean, frequency and percentage. Maternal mental health score, knowledge score were taken prior to implementation of KMC and upon discharge. The mental health score is described as median and knowledge score is compared by wincoxon signed-rank test. Overall experience score was taken as median and mean. Results A total of 41 infants with the gestation of 32 to 34 weeks 6 days participated, 22 (53.7%) with majority of 41.5% aged 34 to 34 weeks 6 days post menstrual age at the time of enrolment. Mean length of stay was 38.34 days (SD:24.4), time taken to achieve birth weight was 11.4 days (SD: 4.05). Time taken to initiate breastfeeding range from 8 to 14 days to >22 days of life, mean: 24.78. Eighteen infants (43.9%) achieved exclusive breastfeeding on discharge. Mother's mental health, knowledge and experience were measures using Likert scale with the total score of 15 for mental health and 18 for knowledge and experience. For mental health score, pre-KMC median score:14, post-KMC median score was 15. There was improvement in the mother's experience upon discharge (p-value: <0.001). For overall experience, median was 18 with the mean score of 16.88 (SD:1.56). Conclusion Our study was suspended prematurely as per local pandemic control guideline. Knowing about the benefit of KMC to both mother and infants, we suggest that it should be encouraged and continued with adaptation and modification of the procedure during COVID-19 pandemic.