Community-based Randomized Controlled Trial Evaluating Effect of Kangaroo Mother Care on Neonatal and Infant Outcomes

Abstract

In this randomized controlled trial, 8402 babies weighing 1500–2250 g at home within 72 h of birth, if not already initiated in kangaroo mother care, irrespective of place of birth, who were stable and feeding were enrolled. Intervention group comprised of 4480 babies initiated on community-initiated kangaroo mother care (KMC) and 3922 were assigned to the control group. Mothers and infants in the intervention group were visited at home to support KMC and breast feeding. The control group received routine care. Primary outcomes were mortality between enrolment and 180 days. 81.4% occurred at a health facility and 36.2% had initiated breastfeeding within 1 h of birth, and infants were enrolled at an average of about 30 hours of age. From enrolment to 28 days, 73 infants died in 4423 periods of 28 days in the intervention group and 90 deaths in 3859 periods of 28 days in the control group (hazard ratio [HR] 0.70, 95% CI 0.51–0.96; p=0.027). From enrolment to 180 days, 158 infants died in 3965 periods of 180 days in the intervention group and 184 infants died in 3514 periods of 180 days in the control group (HR 0.75, 0.60–0.93; p=0.010). The risk ratios for death were almost the same as the HRs (28-day mortality 0.71, 95% CI 0.52–0.97; p=0.032; 180-day mortality 0.76, 0.60–0.95; p=0.017). The authors concluded that community-initiated kangaroo mother care substantially improves newborn baby and infant survival.