Effects of kangaroo mother care on neonatal jaundice and breastfeeding after delivery by cesarean section

Abstract

Objective To examine the effects of kangaroo mother care on breastfeeding by women who delivered via cesarean section and on neonatal jaundice. Methods The study sample consisted of 120 pairs of women who delivered via cesarean section and newborns born by cesarean delivery between August 2017 and February 2018 in the Second Hospital of Shanxi Medical University. They were randomly divided into a conventional nursing group and a kangaroo mother care group by random number table method. A total of 120 pairs of newborns and mothers met the exclusion criteria. The conventional nursing group received routine nursing, while the kangaroo mother care group was given routine nursing and received the kangaroo mother care. By determining the lactation start time, and using the Breastfeeding Assessment Tool (BAT) and Breastfeeding Self-Efficacy Scale (BSES), we evaluated the condition of breastfeeding by the women who delivered via cesarean section. We measured the transcutaneous bilirubin level using the jaundice measuring instrument to evaluate neonatal jaundice. Results The subjects in both groups were of Han nationality and delivered via cesarean section at a gestational age of >37 weeks. No statistically significant differences were found between the two groups in terms of age, occupation, number of pregnancies, and educational background (P>0.05). No statistically significant differences were found between the two groups in terms of the newborns’ sex, birth weight, Apgar score, and birth length (P>0.05). The lactation start time in the kangaroo mother care group (42.1±10.9 h) was earlier than that in the conventional nursing group (52.7±12.8 h), with a statistically significant difference (t=4.880, P<0.001). The success rate of the initial breastfeeding in the kangaroo mother care group reached 80%, which is significantly higher than that in the conventional nursing group by 43% (χ2=17.062, P<0.001). The breastfeeding self-efficacy score (117.0±13.7) in the kangaroo mother care group was significantly higher than that in the conventional nursing group (111.3±15.9, t=2.126, P=0.036). The transcutaneous bilirubin levels in the forehead, chest, and legs (173.7±39.3, 174.1±40.1, and 120.4±32.7 μmol/L, respectively) at 72 h after birth in the kangaroo mother care group were lower than those in the conventional nursing group (194.3±43.9, 193.1±39.0, and 138.0±34.6 μmol/L, respectively), with statistically significant differences (t=-2.706, -2.640, and -2.852, respectively, P<0.05). The newborns’ defecation frequencies at 24, 48, and 72 h after birth in the kangaroo mother care group (5.5±1.7, 5.2±1.9, and 5.2±2.3, respectively) were higher than those in the conventional nursing group (4.5±1.7, 4.3±1.9, and 4.3±1.6, respectively), with statistically significant differences (t=3.122, 2.631, and 2.332, P<0.05). Conclusion The kangaroo mother care method can effectively improve the success rate of first breastfeeding and early lactation initiation time, and increase breastfeeding confidence in women who undergo cesarean section, and reduce the incidence of neonatal jaundice. Key words: Nursing Care; Cesarean section; Kangaroo mother care method; Breastfeeding; Neonatal jaundice