Impact of season and discharge weight on complications and growth of Kangaroo Mother Care treated low birthweight infants in Mozambique

Abstract

This study aimed to determine the impact of season and weight at discharge on growth rate and complications in low birthweight infants treated with Kangaroo Mother Care (KMC) in Maputo, Mozambique. The study population included 246 infants of birthweight < 2000 g. Follow-up until 2400 g was obtained in 64%. There were no seasonal differences in weight gain and the risk of complications of infants treated with KMC in hospital. During the cold season after discharge, the risk of serious complications, including death, was higher (risk ratio 1.96; p = 0.02) and more readmissions occurred (risk ratio 2.77; p = 0.04). We postulate that after discharge mothers are unable to comply with the kangaroo position at all hours of the day and that exposure to low ambient temperatures may explain the more frequent occurrence of complications in the cold season. The weight at discharge did not affect complications or growth rate. We conclude that the current policy to discharge infants when having gained weight on 3 consecutive days, regardless of the actual weight, or whether the weight at birth has been regained, is adequate. In the cold season particularly, more efforts may be needed to ensure compliance with kangaroo position after discharge and to educate mothers on early signs of complications such as bronchopneumonia to encourage timely care seeking. With this method, low birthweight infants can grow adequately.