Kangaroo Mother Care: A Randomized Controlled Trial on Effectiveness of Early Kangaroo Mother Care for the Low Birthweight Infants in Addis Ababa, Ethiopia

WHO Global Position Paper and Implementation Strategy on kangaroo mother care call for fundamental reorganisation of maternal–infant care

Background: Kangaroo Mother Care (KMC) was developed for caring of low birth weight (LBW) babies in developing countries. Study was done with the objective to evaluate the factors affecting initiation of breast feeding and effect of Kangaroo Mother Care (KMC) on morbidity problems and developmental outcome in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) babies.Methods: Prospective follow-up cohort study was carried out at Neonatal Intensive Care Unit (NICU) at Narayana medical college hospital Nellore from January 2018 to December 2019 and details of neonates were recorded on prestuctured proforma. Kangaroo mother care was given to one group. ASQ 3 questionnaire was used to assess the developmental outcome of the infants.Results: In this study, 100 babies were divided into two groups, case group consists of 50 babies where KMC is given and another control group consists 50 babies where KMC is not given. Mean gestational age for case and control group babies were 34.5 and 33.7 weeks respectively. Mean Birth weight in cases (1700 gr) and control (1580) grams respectively. Number of Male babies were more in cases (51%) and Group B (53%). Main factors affecting the initiation of breastfeeding in babies are LSCS (62% and 48%), RDS (50% and 40%), Apnea (24% and 25%) and seizures (20% and 14%) respectively in case and controls. Rates of exclusive breastfeeding is significantly increased in cases (90%) when compared to control (72%). Morbidity in cases is comparatively lesser than controls. At 6 months of corrected gestational age, mean weight in cases (5.2 kg) is significantly more than mean weight in control (4.7 kg). Significant development is noticed in communication (p=0.036), gross motor (0.04), and fine motor (0.05) compare to controls. Percentage of babies who acquired better personal social skills are more in cases (80%).Conclusions: The main factors affecting the initiation of breastfeeding in LBW and VLBW babies are LSCS, RDS, not secreted milk and seizures. KMC helps to achieve smooth and early transition to direct breastfeeding, increases the exclusively breastfeeding rate, better growth and developmental outcome and reduces the morbidities in LBW neonates.

Low Birth Weight (LBW) infants are at higher risk for developmental delays, stunting, and increased morbidity. Non-pharmacological interventions such as Kangaroo Mother Care (KMC) and Touching Therapy have been shown to improve the physical growth and emotional well-being of LBW infants. This case study aims to evaluate the effect of Kangaroo Mother Care (KMC) combined with Touching Therapy on weight gain in an infant with Very Low Birth Weight (VLBW). A single-case report was conducted on a neonate diagnosed with severe asphyxia and VLBW (birth weight 1130 grams) at RSUD Tidar Magelang. The intervention consisted of KMC and Touching Therapy sessions performed for 2 hours daily over six consecutive days. Body weight was measured before and after each intervention to assess daily changes. The infant's weight increased steadily from 1266 grams on day one to 1397 grams on day six, resulting in a total weight gain of 131 grams. This suggests that the combination of KMC and Touching Therapy may support short-term weight gain in VLBW infants. The findings demonstrate a notable improvement in body weight following six days of combined KMC and Touching Therapy. These interventions may be recommended to parents and caregivers both in clinical and home settings to promote healthy growth in LBW infants.

Background. Kangaroo mother care (KMC) is a low-cost but high-impact intervention for preterm and low birth weight (LBW) infants.
 Objectives. To determine the effect of KMC on in-hospital mortality among preterm and LBW infants, taking into consideration their gestational age, birth weight, income category of the country of birth, and medical stability.
 Materials and Methods. A comprehensive search of several databases, as well as local listings of research papers, was performed to look for randomized controlled studies with KMC as intervention, and mortality and length of hospitalization as outcome measures. The risk of bias and publication bias was assessed. We did subgroup analyses based on income category of the country of birth, gestational age, birth weight, and medical stability of the infants.
 Results. Sixteen randomized controlled trials (RCTs) with 1738 infants in the KMC group and 1674 infants in the control group were included. Based on the GRADE approach, although all the studies were RCTs, the evidence is assessed as moderate certainty due to the nature of the intervention (KMC) that prevented blinding. There was a 41% reduction in risk of dying among preterm and low birth weight infants who received KMC compared to conventional medical care (3.86%% vs 6.87%; RR = 0.59, 95% CI 0.44, 0.79; I2 = 0%; number needed to treat for additional benefit (NNTB) = 34; 16 RCTs; 3,412 infants). Furthermore, there were also reductions in the risk of dying among infants who were <34 weeks AOG (KMC: 4.32% vs CMC: 8.17%, RR = 0.55, 95% CI 0.38, 0.79; I2 = 0%; NNTB = 26; 10 RCTs; 1795 infants), with birthweight of >1500 g (KMC: 3.97% vs CMC: 6.83%, RR = 0.60; 95% CI 0.45, 0.82; I2 = 0%; NNTB = 35; 10 RCTs; 2960 infants), and born in low- and middle income countries (LMIC) (3.77% vs 6.95%; RR = 0.57, 95% CI 0.43, 0.77; I2 = 0%; NNTB = 32; 14 RCTs; 3281 infants). There was a significant reduction in mortality (KMC: 11.05% vs CMC: 20.94%; RR = 0.54; 95% CI 0.34, 0.87; I2 = 0%; NNTB = 11; 5 RCTs; 387 infants) even among medically unstable infants who received KMC compared to those who did not. The length of hospitalization did not significantly differ between the KMC and the control groups. Due to high heterogeneity, subgroup analyses were performed, which showed a trend towards a shorter length of hospital stay among preterm infants <34 weeks AOG, with birthweight ≥1500 g, medically unstable during admission, and belonging to LMIC but did not reach statistical significance.
 Conclusion. There was moderate certainty evidence that KMC can decrease mortality among preterm and LBW infants. Furthermore, KMC was beneficial among relatively more premature, bigger, medically unstable preterm infants and born in low to middle-income countries.

Backgrounds:Kangaroo Mother Care is one of the methods used for babies with low birth weight, especially those with birth weight < 2000 grams. Kangaroo Mother Care is skin-to-skin contact between mother and baby, known as skin-to-skin contact. Kangaroo Mother Care is a natural approach that costs nothing and is very easy to use. aim: The objective of this research was to the effectiveness of Kangaroo Mother Care on Rooting – Sucking Reflex on low birth weight infant Methods:This type of study is a quasi-experimental research design with pre-test and post-test with control group design. This research was conducted at RSUD Dr RM Djoelham Binjai in October - November 2021. The population in this study were all 40 LBW people with a total sampling technique (saturated sampling). This study has been approved by the Health Research Ethics Committee from Prima Indonesia University. The statistical test used is the Wilcoxon Signed Rank Test Results:The result of the study showed that there was a difference in the mean Rooting – Sucking Reflex on Low Birth Weight for the pre-test of the intervention group and the post-test of the intervention group (P value = <0.001). In the control group, a P value of 0.001 was obtained, which means that there was a difference in the average Rooting – Sucking Reflex on Low Birth Weight infant for the pre-test of the control group and the post-test of the control group (P value = 0.001). Conclusion: Kangaroo Mother Care has effectiveness against Rooting – Sucking Reflex on Low Birth Weight infant.

Background of the study In 1978, kangaroo mother care (KMC) was proposed as a caring alternative for low birth weight infants. The method of skin to skin contact has shown physiologic, cognitive and emotional gains for preterm infant, however, kangaroo mother care has not been studied adequately in term newborns. The present study reporting early outcomes of comparing the kangaroo mother care to radiant warmer care. Objectives of the study: • To assess the neurobehavioral response of the newborn during radiant warmer care (RWC) and kangaroo mother care • The effect of radiant warmer care and kangaroo mother care on neurobehavioral response of the newborn. Methods A quasi-experimental post-test design was used in this study to compare the effect of kangaroo mother care and radiant warmer care on neurobehavioral response of term newborn. A total of 40 subjects who met the inclusion criteria were randomized—20 to KMC and 20 to RWC by simple random sampling technique. The data was collected by using the following tools: 1. Observational check list 2. Modified Brazelton Behavioral Assessment Scale. Results Both study groups were similar regarding all physiologic state variables. There is a slight difference in the behavioral state, the mean behavioral response scores of the RWC and KMC were 5.6500 and 5.9500 respectively, and the mean difference was 0.300. Interpretation and conclusion: The findings of the study showed that kangaroo mother care seems to influence state organization and physiologic state regulation of the newborn infant shortly after birth.

Kangaroo mother care (KMC) is a nonconventional low-cost method of newborn care. Our aim was to assess the effect of sustained KMC on the growth and development of low birthweight Indian babies up to the age of 12months. We enrolled 500 mother and baby pairs, in groups of five, in a parallel group controlled clinical trial. The three infants with the lowest birthweight in each group received KMC, while the other two received conventional care. All babies were exclusively breastfed for 6months. Babies in the intervention group were provided KMC until the infant was 40weeks of corrected gestation or weighed 2500g. Weight, length and head, chest and arm circumferences were evaluated at birth and at the corrected ages of 0, 3, 6, 9 and 12months. Development was assessed using the Developmental Assessment Scales for Indian Infants (DASII) at 12months. The KMC babies rapidly achieved physical growth parameters similar to the control babies at 40weeks of corrected age. But after that, they surpassed them, despite being smaller at birth. DASII motor and mental development quotients were also significantly better for KMC babies. The infants in the KMC group showed better physical growth and development than the conventional control group.

Background: Low Birth Weight (LBW) is a condition of babies born weighing <2,500 grams regardless of gestational age. Stabilization of the general condition is an important thing to do during the treatment period, there are several treatments for LBW babies, namely standard care with an incubator, monitoring nutritional intake and doing kangaroo mother care. This study aims to analyze the effect of kangaroo mother care on weight gain in LBW infants, with a meta-analysis of primary studies conducted by previous authors. Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: infants with low birth weight. Intervention: Kangaroo Mother Care. Comparison: Conventional Method Care. Outcome: weight gain. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, Science Direct and Springerlink. Keywords to search for articles “kangaroo mother care” AND “weight gain” OR “growth” AND “neonatal outcome” AND “low baby weight infants” OR “skin to skin contact” OR “kangaroo care” OR “kangaroo method” AND “Randomized Controlled Trial” OR “RCT”. The articles included are full-text English and Indonesian with a study design of a Randomized Controlled Trial from 2007 to 2020 and reporting on the Mean and SD in multivariate analysis. The selection of articles is done by using PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application. Results: A total of 11 randomized controlled trials from India, Nepal, Pakistan, Bangladesh, Malay­sia, Kenya, and Egypt were selected for a systematic review and meta-analysis. The data collected showed that kangaroo mother care increased the weight of LBW infants and was statistically significant (SMD= 1.05; 95% CI= 0.56 to 1.54; p<0.001). Conclusion: Kangaroo mother care increases weight in LBW babies.

Kangaroo mother care (KMC) intervention involves skin-to-skin contact between mother and infant. Some studies have shown a decrease in postpartum depression (PPD) in mothers of preterm and low birth weight (LBW) infants. However, the literature is scattered and of variable quality. To conduct a systematic review of available literature and provide a comprehensive picture of the effect of KMC on PPD among mothers of preterm and LBW infants. The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. After PROSPERO registration, a systematic search was conducted using PubMed, Cochrane Central Library, and Google Scholar from the inception of the databases till 14 June 2021. Of the 2944 studies assessed for titles and abstracts, nine studies with 2042 participants were included in the review. Included articles targeted mothers with LBW (<2500g) or preterm infants (<37 weeks), used an authentic PPD tool, and had standard care or an incubator as the control group. Studies not published in English and in which mothers had a previous psychiatric illness were excluded. The risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized control trials and the Newcastle-Ottawa Scale for observational studies. All the results were converted to standard mean deviation and pooled together using a random-effects model with a 95% CI. A P-value of less than 0.05 is considered significant. KMC Intervention was significantly associated with a lower depression score than control groups. The reduction in depression in the intervention (KMC) group was moderate: SMD=-0.38 (-0.68 to -0.08; 95% CI; I 2=86%; P=0.013). No significant difference was found between the PPD scores of both groups using the Edinburgh Postpartum Depression Scale score. The authors conclude that the negative effects of LBW and preterm birth experience on maternal mental health can be avoided to a moderate degree by KMC. Due to a lack of methodological uniformity, different scales for outcome measurement, and discrepancies in intervention features, significantly high heterogeneity was detected. The authors need further larger-scale studies with a uniform study design to better predict the efficacy of KMC better.

Background. One of the World Health Organization (WHO) nutrition target by 2025 is 50% exclusive breastfeeding rate among infants until age 6 months. Kangaroo mother care (KMC) known to increase breastfeeding rates, especially in preterm and low birth weight (LBW) infants.&#x0D; Objectives. This study determined the effect of KMC to the rate of exclusive breastfeeding among preterm and LBW infants at 6 months of age.&#x0D; Methods. Conducted searches in MEDLINE and CENTRAL databases, likewise hand searched local publications December 1996 until June 2018. Included several randomized controlled trials and prospective observational studies comparing KMC and conventional care among preterm and LBW infants. The primary outcome was exclusive breastfeeding of infants at six months of age. Two authors independently assessed trial quality and extracted data the statistical analysis applied using Review Manager version 5.3.&#x0D; Results. Identified nine eligible trials involving 1,202 neonates. All studies had low-to-moderate risk of bias. KMC significantly noted to increase the likelihood of exclusive breastfeeding by 1.9 times at birth up to 6 months (OR 1.93 [1.18,3.17], p=0.009).&#x0D; Conclusion. KMC can increase exclusive breastfeeding among preterm and LBW infants from birth up to 6 months of age.

Background: Low birth weight (LBW) babies are among the most vulnerable new-borns, facing high risks of hypothermia, sepsis, feeding difficulties, and delayed growth. In low-resource countries like India, where incubator access is limited, Kangaroo Mother Care (KMC) provides a simple, cost-effective alternative. It promotes thermoregulation, breastfeeding, emotional bonding, and maternal confidence while reducing neonatal morbidity and mortality. Recognizing its importance, this study aimed to assess the effectiveness of KMC on the health parameters of LBW babies and its impact on maternal–infant bonding and maternal stress among mothers admitted to the NICU at NMCH, Jamuhar. Methods: A quasi-experimental one-group pre-test and post-test design was adopted. Sixty postnatal mothers with LBW babies were selected using purposive sampling. A structured questionnaire and observation checklist were used to assess maternal knowledge and practice. After the pre-test, mothers received a 45-minute structured teaching programme including demonstrations and visual aids. Post-test data were collected three days later. Statistical analysis used descriptive statistics for frequency, mean, and percentage, and inferential statistics (t-test and chi-square) to test the hypotheses and associations. Results: Before the intervention, 80% of mothers had average knowledge and 20% had poor knowledge regarding Kangaroo Mother Care (KMC). After the educational programme, 95% of mothers achieved good knowledge, and only 5% remained average. The mean pre-test knowledge score was 21.38 (SD = 3.39), while the post-test mean rose to 29.46 (SD = 2.00), showing a statistically significant improvement (t = 22.75, p &lt; 0.001). Educational qualification and occupation were significantly associated with post-test scores, whereas age and family type were not. In addition to knowledge improvement, observational findings indicated notable behavioral and clinical changes among both mothers and infants. There was a marked improvement in maternal handling confidence, increased frequency and duration of skin-to-skin contact, enhanced breastfeeding initiation, and better feeding responses in infants. Post-intervention observations also showed visible emotional bonding between mother and baby, with mothers reporting reduced anxiety and greater satisfaction in new-born care. Babies receiving KMC demonstrated stable body temperature, consistent weight gain, deeper sleep patterns, and calmer behavior compared to pre-intervention observations. Conclusion: The study concluded that KMC is an effective and feasible method to improve neonatal outcomes and strengthen maternal–infant relationships. Structured education substantially increased maternal knowledge, confidence, and adherence to KMC practices. It contributed to better infant thermoregulation, weight gain, and reduced maternal anxiety and stress. KMC should be promoted as a standard practice for all mothers of LBW babies, especially in resource-limited neonatal units. The findings highlight the nurse’s pivotal role in initiating, teaching, and supporting mothers to maintain KMC both in hospital and at home. Implications: The study underscores the need for regular, comprehensive food safety education reinforced by policy mandates. Institutional kitchens should implement supervision, periodic evaluations, and infrastructural support to maintain compliance. Adapting teaching methods to the language and literacy of workers and using visual, participatory materials enhances reach and efficacy. These interventions have broad potential to reduce foodborne disease risks and improve public health outcomes across diverse institutional settings..

BackgroundKangaroo mother care is a comprehensive intervention given for all newborns especially for premature and low birthweight infants. It is the most feasible and preferred intervention for decreasing neonatal morbidity and mortality. Even though time to initiating breastfeeding has been examined by randomized controlled trials, varying findings have been reported. Therefore, the main objective of this meta-analysis was to estimate the pooled mean time to initiate breastfeeding among preterm and low birthweight infants.MethodsThe authors searched for randomized controlled trial studies conducted on the effects of kangaroo mother care on the time to breastfeeding initiation among preterm and low birthweight infants. Published articles were identified through a computerized search of electronic databases that includes MEDLINE via PubMed, EMBASE, CINAHL and CENTRAL. The search terms were kangaroo mother care or (skin to skin), or conventional care, newborns, preterm infants, low birthweight infants and randomized controlled trial. A total of 467 eligible titles were identified and eight studies met the inclusion criteria. The extracted data were entered and analyzed using Cochrane Review Manager-5-3 software. Heterogeneity across studies was evaluated by Chi2 test and inconsistency index (I2). Publication bias was assessed using a funnel plot. The random effect model was applied to estimate the pooled mean time to initiate breastfeeding with 95% confidence interval.ResultsIn this meta-analysis, the overall pooled mean time to initiate breastfeeding was 2.6 days (95% CI 1.23, 3.96). Preterm and low birthweight infants receiving kangaroo mother care intervention initiated breastfeeding 2 days 14 h 24 min earlier than conventional care of radiant warmer/incubator method.ConclusionsKangaroo mother care promotes early initiation of breastfeeding as compared to conventional care method. Therefore, health facilities need to implement the kangaroo mother care for preterm and low birthweight infants.

This study was conducted (i) to study through a randomized control trial the effect of Kangaroo Mother Care (KMC) on breast feeding rates, weight gain and length of hospitalization of very low birth neonates and (ii) to assess the acceptability of Kangaroo Mother Care by nurses and mothers. Babies whose birth weight was less than 1500 Grams were included in the study once they were stable. The effect of Kangaroo Mother Care on breast feeding rates, weight gain and length of hospitalization of very low birth weight neonates was studied through a randomized control trial in 28 neonates. The Kangaroo group (n = 14) was subjected to Kangaroo Mother Care of at least 4 hours per day in not more than 3 sittings. The babies received Kangaroo Care after shifting out from NICU and at home. The control group (n = 14) received only standard care (incubator or open care system). Attitude of mothers and nurses towards KMC was assessed on Day 3 +/- 1 and on day 7 +/- 1 after starting Kangaroo Care in a questionnaire using Likert's scale. The results of the clinical trial reveal that the neonates in the KMC group demonstrated better weight gain after the first week of life (15.9 +/- 4.5 gm/day vs. 10.6 +/- 4.5 gm/day in the KMC group and control group respectively p < 0.05) and earlier hospital discharge (27.2 +/- 7 vs. 34.6 +/- 7 days in KMC and control group respectively, p < 0.05). The number of mothers exclusively breastfeeding their babies at 6 week follow-up was double in the KMC group than in the control group (12/14 vs. 6/14) (p < 0.05). KMC managed babies had better weight gain, earlier hospital discharge and, more impressively, higher exclusive breast-feeding rates. KMC is an excellent adjunct to the routine preterm care in a nursery.

Objective: This study aimed to compare the cost and effectiveness of Kangaroo mother care (KMC) and conventional methods of care in low birth weight (LBW) neonates. Materials and Methods: A retrospective economic evaluation conducted in Al-Zahra Teaching Maternity Hospital of Tabriz, Iran by participating 45 LBW and preterm neonate in each therapeutic groups (90 neonates). Convenience sampling used to select participants from KMC and conventional care method (CCM) (incubator) groups in 2010-2011. Baseline characteristics, therapeutic interventions, resources utilization data and clinical events during the initial hospitalization and at 2-month follow-up were collected according a detailed case report forms. Data are described as mean (standard deviation) and no (percentage) and were compared with Student's t-test, χ2 and Fisher exact test between groups. P ≤ 0.05 were considered to be statistically significant. Data were analyzed using the SPSS-16 statistical package. Result: The mean birth weight (BW) of the patients in KMC group was 1240.89 (5.98) g and in CCM was 1133.78 (139.06) g, hence differences in BW was statistically significant ( P < 0.001). Greatest cause of problem in groups was icter and after that preterm birth and House Dust Mite (HDM) with icter were the most frequent problem between neonates. In 2 months follow-up period, 3.7% of infants cared with KMC and conventional methods died respectively ( P = 0.078). Daily weight gain was 12.28 g in KMC group and 9.65 g in conventional group ( P = 0.011). The mean cost of hospitalization per individual infant for KMC was 3539.47$, whereas for Conventional group was 2907.27$. Conclusion: KMC promoted weight gain in LBW infants better than conventional care. Although KMC's unit cost is a little higher than Conventional method, but comparing its positive outcomes on breastfeeding's and mortality it can be considered as cost effective method.

Background: Maternal skin contact has impact on physiological parameters in newborns, some studies showed positive effects but as we live in under developing country and the data on impact of kangaroo mother care (KMC) on physiological parameters is very limited. We hypothesized that KMC is effective in stabilizing the heart rate, respiratory rate and maintaining the oxygen saturation and body temperature of low birth weight (LBW) newborns. Objective: The aim of the study was to determine effects of 3 hours KMC on physiological parameters such as body temperature, heart rate, respiratory rate and oxygen saturation in LBW neonates. Study Design: Observational Quasi-experimental study Study Setting: This study was conducted in Department of Neonatology, Children Hospital, PIMS, Islamabad, Pakistan from 1st June 2022 to 1st December 2022. Methodology: The neonates were hemodynamically stable admitted in NICU and Nursery of Children Hospital, PIMS with LBW with the bodyweight &lt;2 kg was enrolled in the study after taking the consents from mother or other female attendant. Data were collected by structured questionnaire and observational checklist after taking consent from each participant. After inclusion neonates was received KMC for 03 hours. Participants physiological parameters were monitored closely before and after KMC. The statistical analysis was done by using SPSS version 20. Results: Out of the 60 mother-child couples enrolled in the study. There was high frequency of neonates between 1-1.5 kgs with 36.7%. Out of 60, 33 were baby boys and 27 were baby girls. After three hours of KMC, temperatures showed significant increased (p&lt;0.001). Most infants' temperatures were maintained during KMC, and no cases of hypothermia were reported. Also, statistically significant increases in heart rate were seen throughout KMC (p&lt;0.001), with mean increases of exhibited bradycardia before starting KMC, but at the end of the session, all of their heart rates were normal (100-170 beats per minute) and stable. Practical implications Though KMC has been proven to be an efficient and feasible approach of caring for LBW infants in a hospital setting, there is a lack of evidence on its outcomes in Pakistan. In light of this, we set out to examine the impact of 3 hours of KMC on vital signs in LBW infants, namely their core temperature, heart rate, respiratory rate, and oxygen saturation. The ultimate goal is to collect enough evidence to advocate for the strategy's widespread adoption. Conclusion: Better quality and more humanized care for preterm and low birth weight babies and their mothers may be achieved by encouraging the use of the Kangaroo Mother Care approach in neonatal intensive care units in Pakistan. Keyword: KMC, temperature, oxygen saturation, respiratory rate, heart rate. Low birth weight