Improving survival of infants with low birthweight cared for outside hospitals

Abstract

In 1978, Edgar Rey was the director of a large and overcrowded neonatal unit in Bogota, Colombia. Shortage of incubators and prolonged hospital stay were harming and resulting in the deaths of already stable premature infants. To overcome those circumstances, Rey started an early discharge programme in which infants were placed in skin-to-skin contact on top of their mothers' chests to ensure thermal stability (kangaroo position), and if the babies tolerated the position well and regulated their temperature, the mother and baby were sent home in the kangaroo position while receiving breastmilk-based nutrition and close ambulatory follow-up—ie, after discharge from hospital, kangaroo mother care was provided in specifically designated ambulatory outpatient clinics, where the family came for follow-up visits from discharge until up to 1 year after birth.