"Kangaroo mother care(KMC)," defined as both continuous skin-to-skin contact of the infant with the chest of the mother (or another caregiver when not possible with the mother) and feeding exclusively with breast milk, is among the most effective interventions for preventing death in infants with low birth weight. WHO recommends initiation of KMC once the infants condition begins to stabilize or is stabilized.
In the latest issue of NEJM, researchers from five hospitals found significant reduction in neonatal mortality after immediate KMC.
A randomized, controlled trial in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania was conducted involving infants with a birth weight between 1.0 and 1.799 kg who were assigned to receive immediate kangaroo mother care (intervention) that included 1609 neonates or conventional care in an incubator or a radiant warmer until their condition stabilized and kangaroo mother care thereafter (control) including 1602 neonates. The primary outcomes were death in the neonatal period (the first 28 days of life) and in the first 72 hours of life.
The existing NICU's were modified with reclining chairs and mothers' beds for providing immediate KMC.
Key findings of the study include:
1. The median time to initiation of skin-to-skin contact in the intervention group was 1.3 hours and that in the control group was 53.6 hours.
2. During NICU stay, the median daily duration of skin to-skin contact in the intervention group was 16.9 hours and that in the control group was 1.5
hours.
3. From enrollment to 28 days of age, mortality was found to be 12.0%(191 infants) in the intervention group and 15.7%(249 infants) in the control group which is statistically significant (p-0.001).
4. Neonatal death occurred in 74 infants (4.6%) in the intervention group and 92 infants (5.8%) in the control group in the first 72 hours of life.
5. Proportion of infants with sepsis and hypothermia was less in the intervention group compared to control group.
The trial was stopped early on the recommendation of the data and safety monitoring board owing to the finding of reduced mortality among infants receiving immediate kangaroo mother care.
Authors conclude-" the initiation of continuous kangaroo mother care soon after birth in low birth weight infants improved neonatal survival by 25% as compared with kangaroo mother care initiated after stabilization."
Source: NEJM