Mother Care Research Articles

Comparing the effects of oral sucrose and kangaroo mother care on selected physiological variables and pain resulting from venipuncture in premature newborns admitted to neonatal intensive care units

BackgroundPremature newborns admitted to neonatal intensive care units (NICUs) undergo numerous painful interventions during care and treatment. The purpose of this study was to compare the effects of using sucrose and kangaroo mother care by on selected physiological variables and pain resulting from venipuncture in premature infants admitted to NICUs affiliated with Shiraz University of Medical Sciences.MethodsThis clinical trial included premature infants admitted to 2 NICUs. The sample size consisted of 66 neonates, with 22 newborns in each group. Randomization was performed using the block allocation method. Data collection involved a demographic questionnaire, the neonatal infant pain scale, and a pulse oximetry device. Friedman, Kruskal–Wallis, and Dunn’s post hoc tests employed for data analysis, with a significance level of P < 0.05.ResultsThe use of oral sucrose and kangaroo care demonstrated significant differences in breathing rate, heart rate, and average arterial blood oxygen saturation during and after venipuncture (P < 0.05). Oral sucrose was found to be significantly more effective than kangaroo care. Neonates under kangaroo care exhibited more regular heart rates compared to the other group (P < 0.05). The utilization of oral sucrose and kangaroo care had varying effects on the average pain score resulting from venipuncture in premature neonates (P < 0.05).ConclusionsBoth methods proved effective in reducing pain and improving physiological variables. However, due to the superior effectiveness of sucrose administration, it is recommended as a cost-effective and easily implementable method in NICUs.Trial registration: Iranian Registry of Clinical Trials IRCT20191215045749N1. (29/03/2020).

Demographic challenges in the context of the state policy of the Russian Federation in the sphere of maternity and childhood protection

The article examines current demographic trends in Russia in comparison with population changes based on data from the Federal State Statistics Service of Russia (Rosstat) and the UN Population Division. The specifi cs of the age structure of the population of Russia, formed by a number of demographic waves, are such that changes in the number of births and the size of age groups occur in waves; this trend will continue in the coming decades. The state policy of the Russian Federation in the fi eld of family support, aimed at increasing the total fertility rate from 1.3 to 1.6 by 2030 and to 1.8 by 2036, should provide for the introduction of new health-preserving and reproductive health protection technologies, the development of childhood infrastructure, antenatal clinics and perinatal centers for high-quality and aff ordable medical care for mothers and children.

Fathers’ knowledge of neonatal danger signs and its associated factors in Northwest Ethiopia: a community-based cross-sectional study

ObjectiveThis study aimed to assess fathers’ knowledge of neonatal danger signs and their associated factors in Northwest Ethiopia.DesignCommunity-based cross-sectional study.SettingEnarji and Enawga Woreda, Northwest Ethiopia.ParticipantsThe study was conducted on 613...

Kangaroo mother care improves cardiorespiratory physiology in preterm infants: an observational study

ObjectivesTo evaluate whether kangaroo mother care (KMC) in preterm infants on non-invasive respiratory support improves indices of cardiorespiratory wellbeing.Study designProspective quasi-experimental observational study.SettingTertiary perinatal neonatal unit.Patients50 very preterm infants being...

Improving Post-discharge Weight Gain Among Neonates received Kangaroo Mother Care: Two Years Experience of a Tertiary Care Hospital in Dhaka, Bangladesh

Background: “Kangaroo Mother Care” is an effective alternative care strategy for preterm and low birth weight babies. It also causes substantial reduction of neonatal mortality due to hypothermia. Objective: To observe the status of ongoing kangaroo mother care service in a tertiary care hospital and its outcome. Material and method: This retrospective study was carried out over the period of 1st July 2020 to 30th June 2022. Newborns who received kangaroo mother care in neonatal intensive care unit and postnatal ward of Bangabandhu Sheikh Mujib Medical University, Dhaka during the study period, were enrolled in this study. Results: A total of 384 (97% of eligible candidates) newborn received kangaroo mother care. Kangaroo mother care was provided both in Neonatal intensive care unit (86% of total admission) and also in the postnatal ward. Mean gestational age was 32.02+2.85 weeks (28 weeks-41 weeks) and mean weight of starting KMC was 1367.48 g (730 g – 1970 g). Average age of initiating KMC was 6 days (ranging from 1 to 13 days of age). Mean duration of providing KMC was 6 hours and 50 minutes. More than two third (74.4%) patients came for follow up. During each follow up, an increasing trend was observed regarding weight gain and mean weight gain was 15.9+1.2 g/ kg/day. Conclusion: Kangaroo mother care was provided to most of the eligible patients and persistent weight gain was observed among all KMC candidates after discharge.

Maternal and Fetal Outcome of COVID-19 Infection among Pregnant Women.

Background and Objectives: Pregnant women face an increased risk of experiencing negative consequences due to COVID-19 infection. Our study aimed to identify outcomes for both mothers and fetuses associated with COVID-19 during each trimester, as well as to identify post-COVID symptoms in this population. Materials and Methods: Among the total population, 14 females were infected during the first trimester, 25 during the second, and 66 during the third trimester. Weekly follow-ups were conducted until delivery. Seventy-five females (71.4%; 95% CI:26.9-115.9%) were admitted to the hospital secondary to COVID-19 infection. Maternal hospitalization was independently associated with COVID-19 severity (adjusted odds ratio (aOR) = 3.9; 95% CI: 1.6-9.2 at p = 0.002 relative to the reference group (mild infection)) and the presence of dyspnea at initial assessment (aOR = 6.9; 95% CI: 1.7-28.2 at p = 0.007 relative to nondyspneic patients). Results: The duration of hospitalization (mean ± SD) was higher in the third trimester than the first and second trimesters (10.1 ± 0.8 vs. 4.0 ± 1.2 days and 10.1 ± 0.8 vs. 6.2 ± 1.4 days, respectively, at p < 0.05). The number of maternal deaths in the third trimester was higher than in the first and second trimesters (16 (24.2%) vs. no deaths and 16 (24.2%) vs. 1 (4%) deaths, respectively, at p < 0.05). In terms of fetal outcomes, a good fetal condition was more likely if the mother was infected during the first trimester (92.9%) than the second (80%) or third trimesters (66.7%), but the difference was not significant. The percentage of preterm deliveries was insignificantly higher in the second trimester (16%) than the first (7.1%) and third (4.5%) trimesters. Conclusions: The most common post-COVID symptoms included persistent loss of smell, dry eyes, post-partum depression, knee pain, and myalgia. Post-COVID symptoms were more prevalent in patients infected during the third trimester. The adverse outcomes of COVID-19 infection for both mother and fetus were more severe in cases where the infection occurred during the third trimester compared to the second and first trimesters. Therefore, it is crucial to adhere to precautionary measures against COVID-19, prioritize vaccination, and provide comprehensive care for pregnant mothers.

Association Between a Mother's Cervical Cancer Screening and Child's Human Papillomavirus (HPV) Vaccination Status.

To investigate the association between maternal cervical cancer (CC) screening status and child human papillomavirus (HPV) vaccination uptake. To understand if child sex or social deprivation index (SDI) modify this association. We used a national cohort of children linked to at least one parent using electronic health record (EHR) data from a network of community health centers across the United States. We used SDI scores and child sex as moderating variables. We performed the analysis (1) for the whole sample (with SDI and child sex added as covariates), (2) stratified by SDI quartile (with child sex added as a covariate), and (3) stratified by SDI quartile and child sex, to examine whether associations vary by SDI quartile and by child sex. N = 52,919 linked mother-child pairs. Mother's receipt of CC screening was positively associated with the linked child's odds of receiving HPV vaccination [adjusted odds ratio (AOR) 1.39, 95% confidence interval (CI) 1.32, 1.47]. Neither sex or SDI modified this association. There were no significant differences in odds of HPV vaccination in children between SDI quartiles or between male and female children. An effective way to improve rates of HPV vaccination among children and adolescents may be to target attention towards increasing CC screening rates among mothers. Further, focusing resources and efforts on CC screenings and care of both mothers and their children may be more worthwhile than isolated efforts targeting HPV vaccination for children and adolescents.

Maternal experiences and preference of maternity services in Singapore: A descriptive qualitative study

ProblemLittle is known about mothers’ experiences and preferences for maternity services in Singapore. A more nuanced understanding would identify areas for improvement in perinatal care, reducing the burden on healthcare providers in supporting maternity services. BackgroundExpecting mothers are typically referred to hospital-based antenatal and postnatal services in Singapore. In recent years, Singapore has made maternity services available in primary care community settings called polyclinics, to improve accessibility of such services. AimTo explore the experiences and preferences of Singaporean mothers in receiving maternity services in acute hospitals and polyclinics. MethodsA descriptive qualitative study design was adopted, and data were collected from September to October 2023. In total, 13 mothers were recruited from a maternity care hospital in Singapore. Individual semi-structured audio-recorded interviews were conducted, and data were analysed using thematic analysis. FindingsThree themes were identified: (1) Considerations when seeking maternity care, (2) Differing preferences and satisfaction levels, (3) Hopes for better perinatal care for mothers and babies. DiscussionMost mothers preferred seeking hospital-based antenatal care and were more inclined to do postnatal follow-ups in polyclinics. Factors like accessibility, cost and perceived expertise of healthcare providers influenced the decision-making. Maternal satisfaction with care services also fluctuated based on interpersonal factors and whether their informational needs were met. ConclusionOverall, mothers’ perceptions of maternity services were positive. Findings suggest the possibility of further expanding maternity services in community settings to increase professional support for mothers. Future research is needed to ascertain these findings in non-English speaking and non-subsidized settings.

Effects of kangaroo mother care combined with nurse-assisted mindfulness training for reducing stress among mothers of preterm infants hospitalized in the NICU: a randomized controlled trial

BackgroundKangaroo mother care (KMC) can have a positive effect on the mental well-being of a mother. However, there are specific challenges associated with the process that may contribute to increased anxiety for the mother. By integrating nurse-assisted mindfulness training alongside KMC guidance, nurses may effectively alleviate maternal stress to a greater extent.MethodsA single-centre randomized controlled trial was conducted to investigate the effects of KMC combined with nurse-assisted mindfulness training. The study included preterm infants with a gestational age of less than 32 weeks or a birth weight of less than 1500 g and their mothers, who were randomly divided into two groups. The intervention group consisted of mothers who received KMC combined with nurse-assisted mindfulness training for 14 days. The control group comprised mothers who received only KMC for 14 days. Data from both groups were collected and compared for analysis.ResultsForty-seven infants and their mothers were included in the intervention group, whereas 44 pairs were included in the control group. After the intervention, the parental stressor scale scores for the neonatal intensive care unit (PSS: NICU) (3), PSS: NICU (4), and Hospital Anxiety and Depression Scale (HADS) scores for the intervention group were lower than those for the control group, whereas the Five Facet Mindfulness Questionnaire (FFMQ) (1), FFMQ (4), and FFMQ (5) scores for the intervention group were higher. The degree of change in the PSS: NICU and HADS scores was inversely correlated with the degree of change in the FFMQ score. The breast milk feed rate and weight gain rate were greater in the intervention group than in the control group. No adverse reactions were observed in either group.ConclusionsKangaroo mother care combined with nurse-assisted mindfulness training is an acceptable, feasible, and effective procedure for reducing anxiety in mothers of preterm infants in the NICU, with potential benefits for the short-term prognosis of these infants.Trial registrationChinese Clinical Trial Registry, ChiCTR1900023697, registered on June 8, 2019, retrospectively registered.

Promotive and Preventive Programs for Health Workers and Mothers on Newborn Umbilical Cord Care to Prevent Infection During the Neonatal Period

Umbilical cord infections can be prevented by caring for the umbilical cordproperly. The data regarding proper and correct umbilical cord care of newborn babiesby mothers in North Sumatra Province is limited. Hence, this community serviceaimed to determine the proportion of knowledge in umbilical cord care for newbornbabies using the open-dry cord care method. Thew community service project washeld on August 24, 2023, in Pematang Siantar City, North Sumatra Province. In thisactivity, we provided counseling on the open-dry cord care method for umbilical cordcare by presentation and discussion using modules, posters, and leaflets. We used apre-test and post-test questionnaire to assess the knowledge level of health workersand mothers. Participant demographic data and results are presented in the form ofproportion data. This counseling was attended by 150 participants consisting of 52health workers and 98 mothers. Before the counseling, 39 health workers and 93mothers did not know how to take care of the umbilical cord properly. After thecounseling, the knowledge of umbilical cord care using the open-dry cord methodincreased by 15.4% for health workers and 24.5% for mothers. Based on the results,over 80% of participants were found to have had a satisfactory level of knowledgeabout umbilical cord care after the counseling session. This community serviceprogram should be conducted regularly to further enhance the knowledge of healthworkers and mothers on proper umbilical cord care.

Exploring marital safety: three South African wives living with HIV in nonmutual monogamous marriage

For wives who have been sexually monogamous, their being infected with HIV disrupts the cultural assumption of sexual safety in marriage. This phenomenological interview study shows how three married South African women, who were diagnosed with HIV and had reported being monogamous, experienced gendered distress while contemplating the failures of married coupledom in offering safety and familial stability. Constructionist thematic analysis showed three themes to represent changes in the marital unit. The first theme, HIV as Demarcation of Enduring Disruption, pointed to infection as the harbinger of distressing relational dynamics. The second theme, Feeling Controlled, reflected domains in which the wives felt trapped: restricted freedoms and obligatory intimacy. The third theme, Relational Deterioration, showed meanings about infidelity, fights or arguments, and distress about partner disengagement. Highlighted in this analysis is that, for two women, male control and disempowerment after having been infected with HIV added to their experiences of feeling trapped because they felt pressured into regressing into subservient spousal roles. They were required to retreat into household, mothering, and child care duties. The study’s practice implication is that, to address the aftermath of the discovery of HIV infection in heterosexual married couples, wherein sexual monogamy remains the unquestioned norm, health psychology and clinical interventions should incorporate a gendered approach in counselling formulation.

A critical review of neonatal parent support programme in United Kingdom: the effect of kangaroo mother care in NHS.

It has become critically important to provide a thorough understanding of the effects of the Kangaroo mother care (KMC) phenomenon on infants in the neonatal stage within the United Kingdom (UK). The current body of knowledge suggests numerous research publications globally, but the UK has yet to scale up its KMC practice. This study provides a critical review of the subject for a more nuanced understanding of the subject effect and to identify the current stage of KMC research in the UK. The findings were consistent with the body of knowledge on KMC with slight variations. Specifically, the UK has limited primary study in KMC. Randomized clinical trials (RCT) in KMC are minimal hence the UK is dependent on MedTech like an infant incubator which is a potential threat to KMC scale-up. Breastfeeding figures in the UK suggest depleting practice of KMC. The National and local policies captured KMC components but have impacted morbidity and mortality indices. It also showed three areas of divergence in practice and standardization. To enhance UK national and local policies uniformized guidelines and standardization of postnatal follow-up and community-based supervision are necessary.

Clinical decision-making during childbirth in health facilities from the perspectives of labouring women, relatives, and health care providers: A scoping review

ProblemFor health care providers to ensure appropriate decision-making in clinical settings during childbirth, facilitators and barriers must be identified. BackgroundWomen who experience a sense of control by participating in the decision-making process, are more likely to have a positive birth experience. However, decision-making may involve hierarchies of close observation and control. AimThe aim of the scoping review was to map and summarise existing literature on the process of clinical decision-making during childbirth from the perspective of labouring women, relatives and health care providers. MethodsWe carried out a scoping review in line with Joanna Briggs Institute scoping review methodology. The search identified studies in Scandinavian or English languages from 2010 - Jan 2023 comprising evidence at different levels of the pyramid, resulting in 18.227 hits. Following the PRISMA checklist, the final inclusion comprised 62 papers. FindingsFour main categories summarized the importance of the following factors: 1) Woman-caregiver relationship, with sub-categories The importance of communication and Midwifery care, 2) Consent and legal issues, 3) Organization, with sub-categories Medicalization, Working atmosphere, and Complexity, and 4) Decision-making tools and models, with sub-categories Shared decision-making, and Other tools and models for decision-making. ConclusionBalancing intuition and expertise of caregivers with evidence-based practices, is crucial to ensure women's participation in decision-making. Furthermore, a trusting relationship between the mother, partner, and health care provider is of utmost importance. Shared decision-making, which appeared to be the primary model for clinical decision-making regardless context, requires reflective practice and is a communication strategy.

The experiences of older migrant mothers and grandmothers with intergenerational solidarity in their transnational families

AbstractThe role of grandparents in providing support to their migrant adult children is well researched within the intergenerational cross‐border solidarity literature. Studies highlight the gendered care roles assumed by ‘left behind’ grandparents, usually women, who provide hands‐on caregiving to their young grandchildren. However, there is limited research on the supportive economic roles of older migrant women who help ‘left behind’ families navigate economically unpredictable circumstances through remittance transfers. This article makes a contribution by exploring the economic roles of older mothers and grandmothers who participate in the international labour market as paid care workers to support their families ‘back home.’ It draws on ethnographic research with Romanian women in their late 50s and 60s in Italy. Insight is gained into the experiences with transnational care and mobility of older mothers and grandmothers. More specifically, how expectations and demands for intergenerational solidarity in their families conditions women's migration projects, including its temporalities and the distribution of economic risks and responsibilities within the transnational family.

Lactation-focused audio relaxation versus standard care for mothers of very preterm infants (the EXPRESS randomised clinical trial).

Mothers of very premature newborns often have low milk supply. Systematic review has shown increased milk quantity with relaxation interventions. We hypothesised that a self-directed audio relaxation and lactation-specific visualisation would increase milk quantity after a very premature birth. Unmasked, randomised, controlled trial, recruiting 132 participants in four United Kingdom neonatal units. Eligible women had given birth to one or two infants between 23+0 and 31+6 weeks of gestation. The intervention was a 12-min voice recording including breathing exercises, muscle relaxation and lactation-specific visualisation. Primary outcome was the highest 24-h breastmilk weight expressed on any of day 4, day 14 or day 21 after birth. Mean birth gestation was 27.8 weeks (SD 2.4), with 26% of participants giving birth under 26 weeks (34/132). Adjusted mean difference in primary outcome was 73.9 g (95% CI -61.7 to 209.5, p = 0.28). Spielberger State-Trait Anxiety Index adjusted mean difference was -1.9 (-8.2 to 4.3, p = 0.54). The majority of relaxation group participants felt the intervention was relaxing (32/42, 76%). There was no beneficial effect of this relaxation intervention on milk quantity. Mothers of very premature infants may value relaxation interventions but they are unlikely to have a large effect on milk quantity. This randomised trial did not show a beneficial effect of a self-directed audio relaxation and visualisation on mothers' own milk quantity expressed after very preterm birth. Mothers of very and extremely preterm infants may value relaxation interventions, but they are unlikely to have a large effect on milk quantity. Prior systematic review of mixed populations has shown an increase in mothers' own milk quantity with relaxation interventions. Combining this study with existing meta-analysis could result in a new hypothesis that the lower the gestation at birth, the smaller the impact of relaxation on milk quantity.

Factors Associated with Newborn’s Survival: A Cross-Sectional Study at two Districts of Bihar

Family Participatory Care (FPC) is a relatively new concept adopted in SNCUs in India. Its effect on survival outcomes of sick newborns has not been studied much. As such newborn mortality studies are rare due to their large sample scale requirement. This is one of the few studies which have been conducted using primary data on this subject in India. In our study, we have found similar causes of death among newborns as published by renowned studies. Study findings highlighted that FPC may reduce newborn mortality by reducing the length of stay at the facility, newborn growth, and survival outcome of sick neonates, especially Kangaroo mother care and exclusive breastfeeding are key components of FPC, and help in reducing newborn deaths. Objectives: Family Participatory Care (FPC), a cost-effective innovation implemented in Special Newborn Care Units (SNCUs) where vulnerable newborns are treated, is a well-established concept akin to Family Centered Care (FCC) in developed nations. The study aims to assess the impact of FPC on the survival rates of sick neonates in SNCUs. The study explored the factors associated with the care of sick neonates after discharge from SNCU that adapted FPC and that did not adapt FPC. Methods: A multistage random sampling method was used to examine sick neonates and newborns discharged from Special Newborn Care Units (SNCUs) in selected districts of Bihar namely Nalanda SNCU with Family Participatory Care (FPC) and Vaishali SNCU without FPC. Findings: The study found a notable variance in the rate of newborn mortality between the district implementing Family Participatory Care and the district that did not implement FPC, with the former experiencing nearly double the rate of newborn deaths. 11 key factors (maternal, household, family support, newborn health-related) attributing towards newborn survival status were identified in this study. Novelty: Family Participatory Care (FPC) is a relatively new concept in India, and this is one of the few studies that have been conducted on this subject. Keywords: Neonatal death, Family Participatory Care, Newborn Survival, Newborn Care, Family participation in Newborn care

Evaluating Access to Health Care in Mothers and Caregivers of Children under Five Years of Age in Rural Communities of Yucatán, Mexico.

Populations in rural communities have more limited access to health care and attention than urban populations. The present study aimed to evaluate barriers to access to health care in mothers and caregivers of children under five years of age, twelve months after an educational intervention. The study was carried out from February to September 2022, and 472 mothers from eight communities in the state of Yucatán, in the southeast of the United Mexican States, participated. A comparative analysis was carried out on help-seeking times, obstacles to reaching it, and illnesses in children. The results revealed that the main barriers to access to care were long times to decide to seek help, lack of financial resources to pay for the transfer to another health unit, lack of someone to accompany the mother or caregiver when the child needed be transferred, and lack of transportation for the transfer. Disease knowledge remained at different levels in the eight communities; the significant differences occurred in four communities, one specifically for heart defects. It was concluded that, in the rural populations studied, there are barriers to access to health care which have to do with neglected social determinants, such as those related to conditions of gender, income, social support network, and the health system. Access to health care must be universal, so public health interventions should be aimed at reducing the barriers that prevent the population from demanding and using services in a timely manner.

Perinatal continuity of care for mothers with depressive symptoms: perspectives of mothers and clinicians.

Mothers with mild to moderate depression in pregnancy are at risk of developing postpartum depression. Midwife-led continuity of care may support maternal mental health throughout the perinatal period. Research is needed to better understand how continuity of care may support mothers experiencing depression in pregnancy. This study aimed to investigate the perspectives of mothers with mild to moderate depression and clinicians regarding continuity of care in the perinatal period. Fourteen mothers and clinicians participated in individual interviews or a focus group. Analysis was conducted using inductive reflexive thematic analysis with a constructivist orientation. From the perspectives of mothers and clinicians, continuity of care during the antenatal period benefitted mothers' mental health by providing connection and rapport, information about pregnancy and referral options, and reassurance about whether pregnancy symptoms were normal. The experience of seeing multiple clinicians was noted by mothers to increase distress while participants discussed the value of extending continuity of care into the postpartum period, including having someone familiar checking in on them. The importance of having a second opinion and not always relying on a single provider during pregnancy was highlighted by some mothers and clinicians. Mothers also described how multiple modes of communication with a midwife can be helpful, including the ease and accessibility of text or email. Mothers and clinicians perceived benefits of continuity of care for maternal mental health. Offering midwife-led continuity of care to mothers with mild to moderate depression during the perinatal period is recommended.

Maternal Care of Preterm Infants after Discharge from the Neonatal Intensive Care Unit: A Rapid Review

Abstract The maternal care of infants poses a unique challenge for mothers, especially after discharge from the hospital. This review focused on the literature on maternal care of preterm infants at home after discharge from the hospital’s Neonatal Intensive Care Unit (NICU). A comprehensive literature search was conducted using keywords relevant to the topic. PubMed and EBSCO essential databases were searched for studies published between 2017 and 2023 (six years). Out of the 2903 retrieved studies, 7 were eligible and included in the review. The quality of available evidence was assessed using the Johns Hopkins Nursing Evidence Appraisal Tool (JHNEAT) and the Critical Appraisal Skills Programme (CASP) checklist. This review found that exclusive breastfeeding rates for preterm infants at home varied from 27% to 76% (Pooled prevalence of 48%) in data extracted from the studies conducted in Ethiopia (Africa), Brazil (South America), USA (North America), Denmark, and Italy (Europe). The practice of kangaroo mother care (KMC) for temperature regulation ranged from 41% to 83% (Pooled prevalence of 63%) in data extracted from studies conducted in Ethiopia (Africa) and Denmark (Europe). The review concluded that the care provided by mothers at home after discharge from the NICU was inadequate. Maternal and child health services providers should develop social media platforms to educate and encourage mothers to sustain exclusive breastfeeding and KMC practices after leaving the NICU.

Predictors of effective kangaroo mother care, exclusive breastfeeding, and skin-to-skin contact among low birthweight newborns in Amhara, Ethiopia.

Globally, 20% of all newborns are born with low birth weight (LBW). There is, therefore, an urgent need to expedite the delivery of high-impact, evidenced-based, and low-cost interventions such as kangaroo mother care (KMC (defined as continuous skin-to-skin care) and exclusive breastfeeding for this vulnerable group. A multinational World Health Organization (WHO)-supported consortium created and tested the impact of locally-specific and globally-informed phases of KMC care on KMC uptake/scale-up across multiple sites. Here we report on the study of KMC predictors that is nested within Amhara's KMC implementation trial in Amhara, Ethiopia. We used multivariate logistic regression phases to identify diverse predictors of KMC, skin-to-skin contact, and exclusive breastfeeding at hospital discharge and day 28 of life. We analysed data from 860 LBW newborns. At day 28, implementation period (adjusted odds ratio (aOR) = 3.2-5.0), hospital facility (aOR = 3.0-4.6), and having multiple births (aOR = 0.31) were the strongest predictors of effective KMC. Meanwhile, previous death of a newborn, type of health facility where delivery occurred, and previous LBW delivery were predictors of effective KMC at both time points. No single factor predicted KMC, skin-to-skin contact, and exclusive breastfeeding at all time points and across all implementation periods. Having multiple births was a negative predictor for skin-to-skin contact, while the implementation period and having older fathers (>29 years) were strong positive predictors for exclusive breastfeeding at both discharge and day 28. Mothers with a previous history of neonatal death and current skin-to-skin-care uptake strongly predicted exclusive breastfeeding uptake at both time points. At discharge, however, having a history of preterm birth and neonatal death strongly predicted exclusive breastfeeding uptake, while multiple current births, current very LBW newborns, and the use of standard binders decreased the likelihood of exclusive breastfeeding. To achieve the effective KMC coverage target of ≥80% in Ethiopia, KMC scale-up phases may have to consider the key predictors of KMC, EBF, and SSC to effectively target beneficiaries.