Effect Of Kangaroo Mother Care Research Articles

The Effect of Kangaroo Mother Care on the Morbidity and Mortality of Low Birth Weight Babies Admitted in Gov. Celestino Gallares Memorial Hospital

The Effect of Kangaroo Mother Care on the Morbidity and Mortality of Low Birth Weight Babies Admitted in Gov. Celestino Gallares Memorial Hospital

Positive Effects of Kangaroo Mother Care on Long-Term Breastfeeding Rates, Growth, and Neurodevelopment in Preterm Infants.

Background and Objectives: Kangaroo mother care (KMC) benefits preterm infants' health through increasing breastfeeding, but the longitudinal effects of KMC remain unknown. This study investigates the impact of KMC on breastfeeding and health outcomes in Chinese preterm infants. Methods: A longitudinal randomized controlled study was conducted with 79 preterm infant-mother dyads. The KMC group (n = 36) was provided 2.5 hours/day KMC during the neonatal intensive care unit (NICU) hospitalization, while the control group (n = 43) received standard care. Infant's feeding regimens and physical growth were documented daily at NICU. Physical growth and Neonatal Behavioral Neurological Assessment were measured at 40 weeks, 3 months, and 6 months of corrected age (CA). Breastfeeding outcomes were documented at 6 months of CA. Results: Compared with the control group, KMC infants received higher mothers' milk proportion during hospitalization (B = 0.16, confidence interval [CI] = [0.11-0.21]) and less feeding intolerance at discharge (odds ratio [OR] = 0.11, CI = [0.02-0.43]); and higher exclusive breastfeeding proportion (OR = 14.6, CI = [3.5-60.9]) at 6 months CA. KMC infants also had significant increased body weight and body length at hospital discharge; and more increases of body weight, body length, and head circumference in follow-ups. The neurobehavioral score was also higher in the KMC group compared to the control group over time. Conclusions: Longitudinal KMC effects are significant in promoting preterm infants' breastfeeding outcomes, growth, and neurodevelopment. Early initiation of KMC practice is highly recommended to the parent-infant population in Chinese NICUs to promote breastfeeding and developmental outcomes.

Kangaroo father care: A pilot feasibility study of physiologic, biologic, and psychosocial measures to capture the effects of father-infant and mother-infant skin-to-skin contact in the Neonatal Intensive Care Unit.

Robust literature supports the positive effects of kangaroo mother care (KMC) on infant physiologic stability and parent-infant bonding in the Neonatal Intensive Care Unit (NICU). Comparatively little is known about kangaroo father care (KFC) in the NICU, and KFC implementation has been limited. Our pilot feasibility study objective was to examine KFC effects on premature infants and fathers as compared to KMC. Parents of preterm NICU infants independently completed a 90-min Kangaroo Care (KC) session on consecutive days. Infant heart rate variability (HRV) and apnea/periodicity measures were compared (pre-KC to KC; KFC to KMC). Additionally, we assessed the feasibility of administering three psychosocial questionnaires to fathers and mothers in the NICU and after discharge. Ten preterm infants completed 20 KC sessions (334/7 -374/7 weeks post-menstrual age). Results demonstrated similar infant physiologic responses between KMC and KFC, including significant differences in measures of HRV (p<.05) between KC and non-KC periods. Eighty-eight percentage of questionnaires administered were completed, supporting the utilization of these instruments in future research of this population. If confirmed, these preliminary results identify an opportunity to objectively assess KFC effects, supporting the development of empirically based KFC programs benefitting NICU families.

Pain Relief in Late Preterm Neonates: A Comparative Study of Kangaroo Mother Care, Oral Dextrose 50%, and Supine Nesting Position.

Objective:The objectrve is to compare the analgesic effect of Kangaroo Mother Care (KMC), oral dextrose 50% (D50) and supine nesting position in late preterm neonates (34 week to <37 week Gestation Age) while doing heel prick for blood glucose monitoring. Materials and Methods:Babies were randomized into three groups; KMC, D50 and supine nesting. Premature infant pain profile (PIPP) score was used to measure pain severity following heel prick. Total crying time was also compared.Results:Data of 149 eligible babies were analyzed; significant difference was noted in total PIPP scores (mean; SD) across groups; KMC (8.42 [1.99]), D50 (8.76 [1.84]) and nesting (13.08 [1.70]) (P < 0.001). Post hoc analysis revealed comparable scores among KMC and D50 groups (P = 0.638), significantly less than nesting group (P < 0.001). Significant difference in crying time (median; interquartile range) was also noted amongst three groups (P < 0.001).Conclusion:The analgesic effect of KMC and oral D50 is comparable and found to be superior to supine nesting position in reducing pain of heel prick.

The Effect of Kangaroo Mother Care Intervention on the Newborns Health Outcome Delivers at Sulaymaniyah Maternity Teaching Hospital

Background and Objectives: Kangaroo mother care is an intervention for all newborns but especially for premature and low birth weight infants. The method involves babies being carried, usually by the mother, with skin-to-skin contact. It is the most achievable way for decreasing neonatal morbidity and mortality and is practical, inexpensive especially for developing countries. This study intended to assess the effect of kangaroo mother care on the newborns’ health outcome at Sulaymaniyah Maternity Teaching Hospital in Sulaymani-yah, Kurdistan Region, Iraq. Methods: A quasi-experimental, pre-post intervention study was conducted in the Neona-tal Intensive Care Unit and Baby Friend Unit of the hospital. One hundred newborn-mother pairs participated in the Kangaroo mother care procedure. The newborns were physiologically monitored before, in the middle and after the procedure. Result: The highest mean of newborn temperature was 37 ̊C after Kangaroo mother care in the visit three and the lowest mean temperature was 36.1 ̊C before Kangaroo mother care. There were statistically significant differences between the before, middle and after-procedure measurements in temperature, heart rate and respiratory rate (p-value &lt;0.05) on all three visits, while there was no significant difference between the means of the oxy-gen saturation at all three visits (p-value was more than the standard alpha 0.05 F-test=0.961). There was a highly significant association between oxygen saturation and newborn birth weight and gestational age. Individual vital signs abnormalities were often corrected during the Kangaroo mother care sessions. Newborns involved in the procedure showed steady and statistically significant improvement in vital physiological parameters during three sessions on all three days. Conclusion: Majority of babies who received Kangaroo mother care showed significant im-provement in vital physiological parameters on all three days without using special equip-ment showing that this strategy can offer improved care to newborn infants. These find-ings support wider implementation of this strategy.

The effects of kangaroo mother care and music listening on physiological parameters, oxygen saturation, crying, awake state and sleep in infants in NICU

Objective Kangaroo mother care and musical stimulation are recommended nursing interventions in the NICU. However, there is little research on the combination of kangaroo care with musical stimulation and their relationship with the health condition of infants. The aim of the study was to compare the parameters of the physiological state and behavior of infants during kangaroo mother care as well as kangaroo mother care and musical stimulation. Study design The study included 100 infants, with corrected gestational ages of 35 weeks, with an average body weight of 2704 g. During kangaroo care the child was supported by their parent, then musical stimulation was added to kangaroo care. Measurements were made in an incubator after the 1st and the 15th minute of each intervention. Results Neonatal parameters differed in the incubator and during each intervention. During kangaroo care and kangaroo care and musical stimulation, heart rate (p < .0001), respiration rate (p < .0001), crying (p < .0001) and awake state (p < .0001) decreased, oxygen saturation levels (p < .0001) and the number of children who fell asleep (p < .0001) increased. During kangaroo care and musical stimulation significantly fewer children were awake (p = .0003) and more fell asleep (p < .0001) than after kangaroo care alone (p < .0001). Conclusions This study suggests that kangaroo care and kangaroo care and musical stimulation can be used to stabilize the physiological functions of infants. Kangaroo care and musical stimulation can be one of the most effective nursing interventions in the neonatal intensive care unit for the care of infants.

Effect of kangaroo mother care in terms of hospital stay among preterm infants in a tertiary health care center

Background: Hypothermia, infections and ineffective breastfeeding are some of the commonest cause of deaths among premature and low birth weight infants. Kangaroo mother care is a well-known intervention to address the issues related to preterm births, such as hypothermia, infection and prolonged hospitalisation.Methods: This study was carried out in a tertiary care centre in Bengaluru on all preterm neonates of birth weight less than 2500 grams with stable hemodynamic conditions over a period of 18 months. Gestational age assessed by the new Ballard's score, within 24 hours of life and anthropometry details of the neonate were recorded at 24 hours of life by the single observer. Kangaroo mother care was given for a minimum of one hour at a stretch per day and the effect on the preterm neonate in terms of hospital stay was assessed.Results: Kangaroo mother care has positive effects on the infants growth, neurodevelopmental outcome, reduction in the morbidities associated with preterm infants, and breastfeeding practices in mothers of preterm neonates.Conclusions: The study promotes awareness of KMC on preterm neonates considering all the benefits and positive effects of KMC on the infant as well as baby, and to the family and nation amongst the health care personnel as well as the society.

The Effect of Kangaroo Mother Care, Provided in the Early Postpartum Period, on the Breastfeeding Self-Efficacy Level of Mothers and the Perceived Insufficient Milk Supply: Erratum.

The Effect of Kangaroo Mother Care, Provided in the Early Postpartum Period, on the Breastfeeding Self-Efficacy Level of Mothers and the Perceived Insufficient Milk Supply: Erratum.

Effect of kangaroo mother care in preterm versus term intra uterine growth restriction neonates

Background: Low Birth Weight newborns are either Preterm or IUGR. These both have different morbidities and outcomes. KMC is an effective intervention for LBW infants. Here authors study the effectiveness of KMC in preterm babies and full term IUGR babies.Methods: Prospective, Observational, comparative study in which 50 Preterm AGA and 50 Term IUGR included which are hemodynamically stable. effective KMC given and their daily weight gain were observed.Results: Term IUGR having average birthweight is 2083.7±177.9 gm and discharge weight 2179.4±183.8 and preterm AGA are having average birthweight 1972.9±198.9gm and weight on discharge 1962.2±201.0. IUGR term newborns had mean weight loss for 0.90±1.05 days with mean weight loss of 17.94±28.8 grams with average weight loss of 0.9% followed by mean weight gain of 26.6±14.2 grams per day for mean 4.36±0.74 days. Preterm AGA shows weight loss for 3.54±1.5 days with mean weight loss of 98.06±80.83 grams and average 5.4% followed by mean weight gain of 20.4±8.9 grams 4.22±0.97 per day for mean 4.36±0.74 days. With average hospital stay of 5.26±1.2 and 7.76±1.51 days respectively for Term IUGR and Preterm AGA.Conclusions: KMC helps in decreasing the morbidities, achieving physiological weight gain and early discharge in both IUGR term and preterm AGA new-borns but maintaining their physiological pattern of weight gain.

Effect of kangaroo mother care on the growth and morbidity pattern of low birth weight infants: a hospital based cross sectional study

Background: Kangaroo mother care provides Low birth weight babies with warmth, protection from infection and increases the success of breast feeding. Babies who had received KMC care were found to have better neurologic outcome. The aim of the study is to compare the outcome of Kangaroo mother care and conventional method of care among Low birth weight babies in terms of growth and reduction of morbidities such as length of hospital stay, hypothermia and hypoglycemia.Methods: This cross-sectional study included 48 neonates with a birth weight of &lt;2000 grams. Out of them 24 babies received KMC and the other 24 babies were given conventional care with a radiant warmer. The weight gain, length of hospital stay, occurrence of hypothermia and hypoglycaemia were monitored for all babies till discharge.Results: Babies who received KMC had a better weight gain (21.11±2.8 grams/day) versus (15.61±2.6 grams/day) those who received conventional care, and this was found to be statistically significant (p=0.001). Kangaroo mother care provided a statistically significant reduction in the risk of having hypothermia (p=0.03) and hypoglycemia (p=0.04). The babies who received Kangaroo mother care had a shorter length of hospital stay and this was found to be statistically significant (p=0.03).Conclusions: Kangaroo mother care improved the growth and reduced the problems of low birth weight babies such as hypothermia, hypoglycaemia and prolonged hospital stay. Hence, it should be recommended in the care of all these high-risk neonates.

Kangaroo Mother Care –Differences and Quantitative Benefits in Different Subgroups of Low Birth Weight Babies

Objectives: To determine the effectiveness of Kangaroo Mother Care in subgroups of LBW babies-Preterm AGA, Preterm SGA and Term SGA, To assess any differences in benefits of KMC in relation to duration in the subgroups, To assess weight gain difference in NICU and at home at first follow up visit and up to 40 weeks of follow up to Preterm AGA, Preterm SGA and till gain of 2500g in Term SGA babies. Study design: Prospective observational study. Setting: NICU in a large teaching institute, department of pediatrics, Mahatma Gandhi Memorial Hospital, North Telangana. Subjects and Methods: 240 neonates with birth weight &lt;2500g, hemodynamically stable. Intervention: The subjects are classified into three subgroups-based on gestational age (by new Ballard’s score) and by weight (Lubchenco’ s charts) into Preterm Appropriate for gestational age (PT AGA) (102), Preterm Small for Gestational Age (PT SGA) (88) and Term Small for Gestational age (T SGA) (50). Further categorized into &lt;=32 wks,33-34wks,35- 36wks,&gt;=37wks.KMC was given to all subgroups at hospital and home with mean duration of 9+2hrs at hospital and 5+2hrs at home. Outcome Measures: Growth measured by average daily weight gain, mean weight gain, (weight was measured by electronic weighing scale (seca), head circumference (measured by non-stretchable and non-metallic tape) and total length (measured by infant meter) in follow up to 40 weeks of corrected gestational age in Preterm and up to gain of 2500g in Term SGA were assessed with KMC. Results: Better weight gain was noticed in all the 3 subgroups of LBW neonates with KMC at hospital and home. In spite of lower duration of KMC at home PT AGA (33-34 weeks) subgroup has the highest weight gain (24.5+5.5g/day, p=0.003), highest head circumference gain (0.70+0.5cm/week, p=0.002), highest length gain (0.90+0.6cm/week, p &lt;0.008). The time taken to reach full feeds and the time to reach initiation of direct breastfeeds were comparable in all subgroups but attained much earlier in PT AGA (33-34wks) and PT AGA (35-36wks). Duration of hospital stay is least in PT AGA with mean of 12.68 ± 6.37 days.KMC significantly reduced the incidence of apnea in all subgroups of LBW babies. All babies were on exclusive breastfeeds at the end of the study (98%). Conclusion: We conclude by this present study that KMC improves growth in all sub groups of LBW infants. KMC has significantly reduced the incidence of co mortifies like apnea, hypothermia, hypoglycemia in all the subgroups of LBW babies. KMC is cost effective, easily accessible and acceptable not only to mothers but also by majority of the family members

Operationalising kangaroo Mother care before stabilisation amongst low birth Weight Neonates in Africa (OMWaNA): protocol for a randomised controlled trial to examine mortality impact in Uganda

BackgroundThere are 2.5 million neonatal deaths each year; the majority occur within 48 h of birth, before stabilisation. Evidence from 11 trials shows that kangaroo mother care (KMC) significantly reduces mortality in stabilised neonates; however, data on its effect among neonates before stabilisation are lacking. The OMWaNA trial aims to determine the effect of initiating KMC before stabilisation on mortality within seven days relative to standard care. Secondary objectives include exploring pathways for the intervention’s effects and assessing incremental costs and cost-effectiveness between arms.MethodsWe will conduct a four-centre, open-label, individually randomised, superiority trial in Uganda with two parallel groups: an intervention arm allocated to receive KMC and a control arm receiving standard care. We will enrol 2188 neonates (1094 per arm) for whom the indication for KMC is ‘uncertain’, defined as receiving ≥ 1 therapy (e.g. oxygen). Admitted singleton, twin and triplet neonates (triplet if demise before admission of ≥ 1 baby) weighing ≥ 700–≤ 2000 g and aged ≥ 1–< 48 h are eligible. Treatment allocation is random in a 1:1 ratio between groups, stratified by weight and recruitment site. The primary outcome is mortality within seven days. Secondary outcomes include mortality within 28 days, hypothermia prevalence at 24 h, time from randomisation to stabilisation or death, admission duration, time from randomisation to exclusive breastmilk feeding, readmission frequency, daily weight gain, infant–caregiver attachment and women’s wellbeing at 28 days. Primary analyses will be by intention-to-treat. Quantitative and qualitative data will be integrated in a process evaluation. Cost data will be collected and used in economic modelling.DiscussionThe OMWaNA trial aims to assess the effectiveness of KMC in reducing mortality among neonates before stabilisation, a vulnerable population for whom its benefits are uncertain. The trial will improve understanding of pathways underlying the intervention’s effects and will be among the first to rigorously compare the incremental cost and cost-effectiveness of KMC relative to standard care. The findings are expected to have broad applicability to hospitals in sub-Saharan Africa and southern Asia, where three-quarters of global newborn deaths occur, as well as important policy and programme implications.Trial registrationClinicalTrials.gov, NCT02811432. Registered on 23 June 2016.

A study on breastfeeding initiation in low birth weight and very low birth weight babies and their developmental outcome with special reference to kangaroo mother 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.

Effects of kangaroo mother care on anxiety and parenting stress in premature mothers

Objective To investigate the application effect of kangaroo mother care on anxiety and parenting stress in premature mothers during hospitalization. Methods From January to December 2018, 230 premature mothers were admitted to the neonatal intensive care unit of Ningxia Medical University General Hospital.They were randomly divided into the intervention group(n=114) and the control group(n=116). The premature infants in control group only implemented routine developmental support care.The premature infants in the intervention group was on the basis of routine developmental support care, 2 hours per day of kangaroo mother care was performed from the 2nd day incharge to discharge.Parental Stress Scale: Neonatal Intensive Care Unit and Parenting Stress Index-Short Form was performed using the 2nd day and the 14th day of hospitalization, and the two groups of premature mothers were evaluated for anxiety and parenting stress. Results There were no significant differences in the scores of PSS: NICU((3.65±0.91) vs (3.63±0.91)) and PSI-SF((90.32±8.95) vs (90.12±7.17))(both P>0.05) between the two groups on the 2nd day of hospitalization (before intervention). On the 14th day of hospitalization (after intervention), the total scores ((2.57±0.80) vs (3.47±0.93))and each dimension scores of PSS: NICU in the intervention group were lower than those in the control group (first part (2.41±0.78) vs (3.81±0.73), second part (2.61±0.71) vs (3.14±0.83), third part (2.75±0.86) vs (3.57±1.06), fourth part(2.49±0.80) vs (3.35±0.94))(P<0.01). In addition, the total score of PSI-SF((79.09±8.02) vs (89.46±8.74)), parenting Distress((32.32±9.48) vs (37.15±9.67)), Parent-Child Dysfunctional Interaction((24.26±5.07) vs (27.34±5.26)), and Difficult Child scores((22.51±4.88) vs (24.97±5.05)) in the intervention group were lower than those in the control group(P<0.01). Conclusion Kangaroo mother care can reduce the anxiety of premature mothers during hospitalization and help relieve the parenting stress of premature mothers. Key words: Kangaroo mother care; Premature infant; Anxiety; Parenting stress

The Effect of Kangaroo Mother Care, Provided in the Early Postpartum Period, on the Breastfeeding Self-Efficacy Level of Mothers and the Perceived Insufficient Milk Supply.

The aim of this study was to determine the effect of kangaroo mother care, provided in the early postpartum period, on the breastfeeding self-efficacy level and the perceived insufficient milk supply. This study was conducted as the quasi-experimental design. The population of the study consisted of the mothers and their infants, to whom they gave birth in a university hospitals located in either eastern or western Turkey, between December 2016 and June 2017. In this study, mothers and their infants were randomly assigned to the experimental group (kangaroo mother care, n = 30) and the control group (n = 30). This study included 2500 to 4000 g birth weight infants who had no serious health problems and no sucking problems. The Introductory Information Form, the Breastfeeding Self-Efficacy Scale, and the Perception of Insufficient Milk Questionnaire were used to collect the data. In this study, kangaroo mother care was provided as a nursing intervention for the mothers in the experimental group twice a day until they were discharged. Any other application was not performed in the control group's mothers apart from the routine application. Ethical principles were adhered in all stages of the study. The breastfeeding self-efficacy mean score (65.50 ± 3.95) of the mothers who performed kangaroo mother care was higher than the mean score of the mothers who did not perform kangaroo mother care (55.50 ± 7.00) (P < .001). In addition, mothers in the experimental group (46.60 ± 3.40) perceived their milk more sufficiently than mothers in the control group (30.17 ± 11.37) (P < .001). In the study, a statistically significant correlation was determined between breastfeeding self-efficacy levels of mothers in the experimental group and the perceived insufficient milk supply (P < .05). In the study, kangaroo mother care increased breastfeeding self-efficacy perception of the mothers and reduced the perceived insufficient milk supply. This shows that kangaroo mother care can potentially have an important effect on breastfeeding perceptions.

The Effect of Kangaroo Mother Care in Increasing Body Weight and Temperature in Premature Infants: Meta-Analysis

Background: Preterm birth is the leading cause of death in toddlers by 7.5% - 12.5% in various regions of the world. Premature is one of the causes of low birth weight and is a factor that increases the risk of hypothermia. Kangaroo Mother Care is a powerful and easy-to-use method for improving the long-term health and well-being of premature babies. This study aimed to estimate the average effect of Kangaroo Mother Care therapy on increasing body weight and temperature of premature infants. Subjects and Method: This was a meta-analysis and a systematic. The articles used were obtained from PubMed, Science Direct and Google Scholar. The inclusion criteria used were full text articles with the Randomized Control Trial (RCT) design, the study subjects were premature infants, the treatment provided was Kangaroo Mother Care with a comparison of conventional care, weight and temperature assessment of premature infants using stan­dard scales and thermometers, articles publish­ed in English. The PICO research problems are as follows. Population= prema­ture babies. Intervention= Kangaroo Mother Care. Com­pa­rison= Conven­tional Method Care. Out­come= weight and temperature of premature infants. This study used the effect size (Standardized Mean Difference). Meta analysis was performed using RevMan 5.3 with a Random Effect Model. Results: A total of 15 articles conducted a meta-analysis review of this study. The meta-analysis of 11 articles showed that Kangaroo Mother Care increased weight gain in prema­ture infants compared to conventional method care (Standardized Mean Difference= 0.54; 95% CI= 0.17 to 0.92; p= 0.004). Meta analysis on 4 articles showed that Kangaroo Mother Care increased the temperature in preterm infants higher than the conventional method of care, statistically not significant (Standardized Mean Difference = 0.48; 95% CI= -0.23 to 1.19; p=0.190). Conclusion: Kangaroo Mother Care is effective in increasing body weight and temperature in premature infants Keywords: Kangaroo care, skin-to-skin contact, weight, temperature, preterm infant Correspondence: Ines Ratni Pravitasari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: inesratnip@gmail.com. Mobile: +6285­649507909. Journal of Maternal and Child Health (2020), 05(05): 563-578 https://doi.org/10.26911/thejmch.2020.05.05.10.

Comparing the effect of kangaroo mother care and field massage on serum bilirubin level of term neonates with hyperbilirubinemia under phototherapy in the neonatal ward.

Background:Several factors contribute to the effectiveness of phototherapy. The aim of this study was to compare the effect of kangaroo mother care (KMC) and field massage on bilirubin level of term neonates with hyperbilirubinemia under phototherapy in the neonatal ward.Methods:This double-blind clinical trial was performed on 90 term neonates aged 48 hours with hyperbilirubinemia, hospitalized in Fereydunkenar Hospital during 2018-2019. The infants were randomly divided into 3 groups of massage with phototherapy, KMC with phototherapy and control (received conventional phototherapy without KMC and massage). The massage group used field technique for three 15-minutes in 3 days and the KMC group received KMC for five 30 minutes in 3 days as well. In three groups, the serum bilirubin levels were compared at baseline, 24, 48, 72 hours after the onset and at the end of phototherapy. Moreover, the mean duration of phototherapy and hospitalization was compared during the treatment.Results:Serum bilirubin levels at baseline in the control, field massage and KMC groups were (17±1.38, 17.01±1.46 and 16.97±1.27mg/dl) and at the end of phototherapy were (6.97±0.47, 5.56±0.48 and 5.91±0.52 mg/dl) respectively. There was a significant difference between the intervention and control groups (p<0.001). The mean duration of phototherapy and hospitalization had no significant difference between two intervention groups (p>0.001), but it was significantly higher in control group than intervention groups (p<0.001).Conclusion:The use of massage or KMC with phototherapy, compared to the phototherapy alone, can reduce the bilirubin level, phototherapy duration and hospital stay.

Community-based Randomized Controlled Trial Evaluating Effect of Kangaroo Mother Care on Neonatal and Infant Outcomes

In this randomized controlled trial, 8402 babies weighing 1500–2250 g at home within 72 h of birth, if not already initiated in kangaroo mother care, irrespective of place of birth, who were stable and feeding were enrolled. Intervention group comprised of 4480 babies initiated on community-initiated kangaroo mother care (KMC) and 3922 were assigned to the control group. Mothers and infants in the intervention group were visited at home to support KMC and breast feeding. The control group received routine care. Primary outcomes were mortality between enrolment and 180 days. 81.4% occurred at a health facility and 36.2% had initiated breastfeeding within 1 h of birth, and infants were enrolled at an average of about 30 hours of age. From enrolment to 28 days, 73 infants died in 4423 periods of 28 days in the intervention group and 90 deaths in 3859 periods of 28 days in the control group (hazard ratio [HR] 0.70, 95% CI 0.51–0.96; p=0.027). From enrolment to 180 days, 158 infants died in 3965 periods of 180 days in the intervention group and 184 infants died in 3514 periods of 180 days in the control group (HR 0.75, 0.60–0.93; p=0.010). The risk ratios for death were almost the same as the HRs (28-day mortality 0.71, 95% CI 0.52–0.97; p=0.032; 180-day mortality 0.76, 0.60–0.95; p=0.017). The authors concluded that community-initiated kangaroo mother care substantially improves newborn baby and infant survival.

Effects of kangaroo mother care during cesarean section on neonatal health parameters of late preterm newborns within "golden hour"

Objective To evaluate the effects of kangaroo mother care (KMC) during cesarean section on neonatal health parameters in the golden hour of late preterm infants. Methods A total of 120 singleton pregnant women undergoing preterm cesarean section (34-36+6 gestational weeks) from January 1 to December 31, 2018 in Jiaxing Women and Children's Hospital Affiliated to Wenzhou Medical University were prospectively enrolled and divided into two groups (observation and control groups) with 60 cases in each by random number table method. During cesarean section, the both groups received the thorough drying immediately and delayed cord clamping, in addition, the observation group adopted KMC, while the control group received routine maternal and infant care. Several parameters including changes in body temperature, crying, respiration, oxygen saturation and other vital signs, as well as the incidence of hypothermia, transfer to the Department of Neonatology and the success rate of early breastfeeding initiation during the golden hour were compared between the two groups. Satisfaction of obstetricians, pediatricians, the pregnant women and their families to KMC and routine maternal and infant care were compared. Two-independent sample t test and Chi-square test were used as statistical methods. Results In total, 113 cases (58 in the observation group and 55 in the control group) were finally analyzed. The body temperature of the late preterm infants at 5 and 10 min after birth in the observation group was higher than that in the control group (36.5 vs 36.0 ℃, 36.4 vs 35.8 ℃, t=11.756 and 7.512, both P 0.05). The observation group had a lower incidence of hypothermia [0% (0/58) vs 15% (8/55), χ2=9.079, P<0.001] and a higher success rate of early breastfeeding initiation [86% (50/58) vs 58% (32/55), χ2=11.137, P<0.001] than the control group. The satisfaction scores of obstetricians (19.3±1.1 vs 13.4±1.9, t=20.517), pediatricians (18.2±1.8 vs 12.6±2.1, t=15.382), gravidas (19.6±0.4 vs 13.6±1.6, t=27.723) and their family members (18.2±0.9 vs 15.3±1.1, t=11.535) were all higher in the observation group than those in the control group (all P<0.001). Conclusions KMC during cesarean section can improve the body temperature of late premature infants in the golden hour, reduce the occurrence of hypothermia, facilitate early initiation of breastfeeding and improve the satisfaction of doctors and patients on health care. Key words: Cesarean section; Maternal-child nursing; Neonatal nursing; Feasibility studies; Infant, premature

A prospective study on feasibility, acceptability and outcome of kangaroo mother care in low birth weight babies

Background: Low Birth Weight (LBW) continues as an important social health problem. About 20 million LBW babies are born each year worldwide. In India 8 million (40%) LBW babies are born each year. LBW preterm babies are associated with high neonatal/infant mortality and morbidity. Kangaroo Mother Care is an alternative approach for providing thermal care and improving survival of LBW infants which is effective and affordable. The present study was undertaken to study feasibility, acceptability and outcome of KMC in LBW babies. Aims and Objectives: To study feasibility, acceptability and outcome of KMC in LBW babies with an objective to determine the effect of kangaroo mother care on vital parameters like temperature, respiratory rate, heart rate and oxygen saturation; and to denote the establishment of breastfeeding and weight gain in LBW babies and their duration of hospital stay. Methodology: A hospital based prospective observational study conducted over a period of one year from September 2017 to August 2018, at SNCU, SVRRGGH, Tirupati. The study subjects are 210 babies. Results: In the present study, it was observed that there was a significant increase in axillary temperature, decrease in respiratory rate, decrease in heart rate and increase in oxygen saturation observed after KMC which were physiologically favorable. Higher proportion of neonates achieved transition from expressed breast milk consumption to direct breastfeeding during hospital stay. The study showed significant mean weight gain of 20.2 g/day during hospital KMC. Neonates were discharged early as they met our discharge criteria with mean age being 14.3 days. The maternal acceptance of KMC was good. All the mothers providing KMC were satisfied with the training and care. During follow up, it was observed that neonates were all exclusively breastfed; and the velocity of weight gain was satisfactory (153.6 g/week). The response of the family and/or the father was supportive and encouraging. Conclusion: The present study concluded that practice of KMC promotes breastfeeding, shorten hospital stay without compromising survival, growth and development; and would humanize the practice of neonatology. It is superior alternative to conventional method of care in institutions with limited resources. It is definitely feasible, acceptable to mothers at tertiary care hospital and can be continued at home in the Indian setup.