Effectiveness of Kangaroo Mother Care in the Management of Twin Low-Birth-Weight Neonates: A Non-Randomized, Open, Controlled Trial

Abstract

Background: Twin low-birth-weight (LBW) neonates are exposed to the increased risk of mortality and morbidity due to poor prognosis. The present study aimed to evaluate the effectiveness of kangaroo mother care (KMC) in the management of twin LBW neonates. Methods: This prospective, observational study was conducted on 150 neonates with the birth weight of <2,200 grams during one year. The neonates were divided into three groups of KMC I (receiving KMC; n=60), KMC II (singletons receiving KMC; n=30), and twins receiving conventional method of care (CMC; n=60). The neonates were assessed before and after the intervention in terms of thermoregulation, growth rate, breastfeeding, and self-confidence of the mothers managing the neonates based on a Likert scale. The subjects were followed-up until reaching the target weight of 2.5 kilograms. Data analysis was performed in SPSS software 20.0. Results: Neonates in the KMC groups were euthermic. Mean weight gain increased in KMC I (13.48±1.76 g/kg/day) and KMC II (13.15±1.66 g/kg/day) compared to the CMC group (11.99±1.20 g/kg/day) (P=0.0014). Length (43.55±1.90, 43.86±1.34, and 43.40 ± 1.94 cm, respectively) (P=0.567) and head circumference (31.13±0.77, 31.43±1.15, and 31.30±1.07 cm, respectively (P=0.498) were comparable in the CMC, KMC I, and KMC II groups. Early initiation of breastfeeding was observed in KMC I (2.68±1.55 days) and KMC II (2.97±2.88 days) compared to the CMC group (5.17±2.65 days) (P<0.0006). In addition, the mothers’ self-confidence to manage the LBW neonates was significantly higher in both the KMC groups compared to the CMC group (P<0.0001). Conclusion: According to the results, KMC is a cost-effective, humane intervention, which could effectively alleviate the burden of managing twin and singleton LBW neonates in low-income countries.