Kangaroo Mother Care Unit Research Articles

Launching continuous kangaroo mother care through participatory action research in Iran

BackgroundThis study describes the launching of a unit for continuous kangaroo mother care (KMC) in a teaching hospital (Taleghani) in Iran.MethodsWe used a participatory three-stage action research approach to establish a unit for continuous KMC: design (needs identification and planning for change); implementation (and reflection); and evaluation (and institutionalization). As part of the design and implementation stages, individual and focus group interviews were conducted with mothers, physicians, nurses, other healthcare personnel and policy makers. The evaluation was done by means of a standardized tool specifically developed for monitoring progress with the implementation of KMC.ResultsFour themes relating to potential barriers to implementation emerged from the analysis of the staff interviews, namely barriers associated with the mother, the father, the physician and the health system. Mothers’ experiences of barriers were grouped into five themes: personal discomfort, fear, healthcare provider attitudes and actions, infrastructure constraints and family matters. An implementation progress score of 27.05 out of 30 was achieved, indicating that the continuous KMC unit was on the path to institutionalization. Some of the gaps identified related to policies on resource allocation, the discharge and follow-up system, and the transportation of infants in the KMC position.ConclusionThe study findings indicated that participatory action research is a suitable method for studying the establishment of a continuous KMC unit. When action research is practiced, there is a prospect of turning knowledge into action in the real world.

The H-HOPE behavioral intervention plus Kangaroo Mother Care increases mother-preterm infant responsivity in Malawi: a prospective cohort comparison

BackgroundEarly behavioral intervention to promote development is recommended as the standard of care for preterm infants, yet is not provided in Malawi. One such intervention is H-HOPE (Hospital to Home: Optimizing the Premature Infant’s Environment). In US studies, H-HOPE increased mother-preterm infant responsivity at 6-weeks corrected age (CA). Kangaroo Mother Care (KMC) improves infant survival and is the standard of care for preterm infants in Malawi. This is the first study to examine whether H-HOPE is feasible and promotes mother-preterm infant responsivity in Malawi, and the first to examine the impact of H-HOPE when KMC is the standard of care.MethodThis pilot was conducted in a KMC unit using a prospective cohort comparison design. Because the unit is an open room without privacy, random assignment would have led to contamination of the control cohort. H-HOPE includes participatory guidance for mothers and Massage + , a 15 min multisensory session provided by mothers twice daily. H-HOPE began when infants were clinically stable and at least 32 weeks postmenstrual age. Mothers participated if they were physically stable and willing to return for follow-up. Mother-preterm infant dyads were video-recorded during a play session at 6-weeks CA. Responsivity was measured using the Dyadic Mutuality Code (DMC).ResultsThe final sample included 60 H-HOPE + KMC and 59 KMC only mother-preterm infant dyads. Controlling for significant maternal and infant characteristics, the H-HOPE + KMC dyads were over 11 times more likely to have higher responsivity than those in the KMC only dyads (AOR = 11.51, CI = 4.56, 29.04). The only other factor related to higher responsivity was vaginal vs. Caesarian delivery (AOR = 5.44, CI = .096, 30.96).ConclusionThis study demonstrated that H-HOPE can be provided in Malawi. Mother-infant dyads receiving both H-HOPE and KMC had higher responsivity at 6-weeks CA than those receiving KMC only. H-HOPE was taught by nurses in this study, however the nursing shortage in Malawi makes H-HOPE delivery by nurses challenging. Training patient attendants in the KMC unit is a cost-effective alternative. H-HOPE as the standard of care offers benefits to preterm infants and mothers that KMC alone does not provide.

"Breastfeeding at Night Is Awesome" Mothers' Intentions of Continuation of Breastfeeding Extreme and Very Preterm Babies upon Discharge from a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa.

Kangaroo mother care (KMC) is effective in increasing mothers' initiation and maintenance of breastfeeding (BF) for extreme and very preterm (VLBW) infants. Although South Africa has implemented KMC for more than two decades, little is known about mothers' perspectives on KMC. The purpose of this study was to describe the BF intentions and practices of mothers of VLBW infants at home following discharge and assess the role long stay in KMC has on their decision to BF beyond discharge. This qualitative study was conducted at the KMC unit of a tertiary hospital in Pretoria, South Africa. Focus group interviews were conducted with 38 mothers of VLBW infants who had transitioned from neonatal intensive care (NICU) to KMC. We analysed transcripts following the five steps for qualitative thematic data analysis. Mothers were knowledgeable of the importance and value of BF preterm infants and conceded that breast milk has advantages over formula. Mothers had positive feelings toward BF their preterm infants. The stay in KMC increased the direct BF of their preterm infants, mothers' BF efficacy, and had a positive influence on mothers' intentions to continue BF following discharge and to exclusively breastfeed for six months. Their BF intentions, efficacy, and practices were influenced by the skilful BF counselling, training, and support they received from the nursing staff. High intention to BF among these mothers is suggestive of their knowledge and confidence in BF for their VLBW infants. It is important that nursing staff in NICU and KMC appreciate the significant role they play in mothers' readiness and confidence to breastfeed beyond discharge.

Acceptability of the Kangaroo Mother Care at the University Hospital of Treichville in Côte d'Ivoire.

Kangaroo Mother Care (KMC) is a low-tech, highimpact intervention for preterm and low-birth-weight newborns. In 2019, Côte d'Ivoire opened its first KMC unit. We wanted to determine KMC's acceptability in Côte d'Ivoire after a year. This qualitative study used semi-structured interviews in September 2020 at the Teaching Hospital of Treichville's first KMC unit. Mothers of preterm and low birth weight babies who received KMC were studied. Deductive (TFA-driven) framework analysis was performed. Coded using Nvivo 12. KMC was acceptable overall. Mothers knew KMC's goal and benefits, including self-confidence and breastfeeding benefits. Most women reported that the method was easy to implement and were confident in implementing KMC at the unit or in the household, even though some of them found KMC not aligned with their cultural values. Some mothers, especially housewives and self-employed, highlighted the benefits of KMC, but they must have given up. Our study highlighted the need to increase KMC awareness, advocacy, education, and training for pregnant women and the community to reduce preterm and low birth weight infant mortality and morbidity.

Care For Small Babies: A DOH Policy-in-waiting

Care For Small Babies: A DOH Policy-in-waiting

A Review of Very-Low-Birth-Weight Infants Admitted to the Kangaroo Mother Care Unit in Johannesburg, South Africa

BackgroundKangaroo Mother Care (KMC) is a widely implemented intervention developed as an alternative form of care in low- and middle-income countries (LMICs) for neonates. The implementation of KMC has significantly reduced morbidity and mortality in very-low-birth-weight infants (VLBWIs).AimTo describe the maternal and neonatal characteristics and clinical outcomes in VLBWIs who received KMC at a tertiary hospital.MethodsThis is a retrospective descriptive study of 981 VLBWIs admitted at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) over a six-year period (January 1, 2014, to December 31, 2019).ResultsThe mean gestational age of infants admitted to the unit was 29.6 weeks (standard deviation (SD): 2.4), with a mean birth weight of 1185 g (SD: 205.6). The average duration of admission in the neonatal unit was 37 days. The mean rate of weight gain was 37.6 g/kg/day (SD: 57.6). The majority of infants were breastfed (61.4%). In our study, the prevalences of the complications of prematurity were as follows: respiratory distress syndrome (RDS), 84.2%; late-onset sepsis (LOS), 26.1%; and retinopathy of prematurity (ROP), 10.6%. The mortality rate was 3.1%. Maternal comorbidities include human immunodeficiency virus (HIV) (26.4%), syphilis (2.9%) and gestational hypertension (33.7%). The antenatal clinic attendance rate was good (84.7%).ConclusionKMC is a cost-effective alternative to conventional care for VLBWIs in limited-resource countries, with evidence of increased weight gain, less rates of complications of prematurity and low overall mortality. The provision of KMC facilities is urgently required in LMICs.

Survival of Premature Babies with the Revolutionary Kangaroo Mother Care Technique at a Tertiary Care Center, Sindh, Pakistan

Background: Kangaroo mother care (KMC) is a resource-limited method for low-birth-weight babies that seeks to mitigate mortality rates by thermoregulation, breastfeeding assistance, and early hospital discharge. Methods: This study was carried out at GIMS hospital Khairpur Kangaroo Mother Care Unit at PAQSJIMS between August 2019 to September 2020. A total of hundred mothers and their infants were enrolled in the study. A non-probability convenience sampling technique was employed. A Questionnaire filled with the permission of admitted mother and primary data collected as per proforma i.e. date of admission, mother name, address, age, parity, gravida, date of delivery, place of delivery, Type of delivery, gestation at birth (weeks), birth weight, gender, Date of KMS admission, weight at KMC, discharge date of KMC, weight of Discharge KMC, status at the time of discharge and cause of death (if any). All mothers used KMC kits and the infant weight at admission and discharge were documented. Results: The average age (Figure 1) of mothers was recorded as 31.69 (20-40 years). The babies weight at the time of KMC unit admission was recorded as 0.7 – 1.8 grams and after 3-4 weeks admission the babies survived and gained weight recorded at time of discharge was 0.8 to 2.2 grams which showed that all mothers used kits properly, and all babies survived. Conclusions: All mothers were pleased to operate KMC kits. KMC is a very innovative technique to save the lives of premature newborns. This therapy emphasizes mothers for continuous skin-to-skin touch with infants, as well as wrapping the child in a warm blanket. The availability of space facilities and capacity building for health workers are therefore the fundamental requirements that must be funded by international aid agencies in order to scale up the initiative in these environments. Keywords: Neonatal survival, KMC, care, breastfeeding.

The outcome of newborns admitted to kangaroo mother care units at regional hospitals in KwaZulu‑Natal, South Africa

Background. Kangaroo mother care (KMC) is a common modality of care for low birthweight and preterm newborns, with good long-term outcomes at low cost. However, little is known about the short-term outcomes of babies during their stay in a KMC unit. Objective. To describe the profile and outcome of newborn babies admitted to KMC units. Method. A retrospective chart review was undertaken of babies admitted to the KMC units of two Durban hospitals over a two-year period. All babies with birthweights below 2 000 g admitted to the KMC units for the first time during this period were included. Poor outcome was defined as a death in the KMC unit or need for readmission to the neonatal nursery. Result. Two hundred and twenty-four newborns were included in the study. The median maternal age was 25 years. The newborns had a median gestational age of 32 weeks, median birthweight of 1 500 g, median KMC unit admission weight of 1 600 g, and median age on admission to the KMC units of 9.5 days. Twenty-six percent of babies had a poor outcome, including seven deaths. Significant factors associated with a poor outcome included a birth or admission weight to KMC units below 1 500 g, HIV-negative mothers; and abnormal temperature or blood glucose levels. Conclusion. Seventy-four percent of babies admitted to KMC were discharged home after an uneventful stay. Poor outcomes were associated with a birth or KMC admission weight below 1 500 g and an abnormal temperature or blood glucose level while admitted to the KMC unit

Implementation Barriers for Practicing Continuous Kangaroo Mother Care from the Perspective of Neonatologists and Nurses.

Introduction: Kangaroo mother care (KMC), as a complement to incubator care, is one of the ten recommendations of the World Health Organization (WHO) for the care of preterm infants. The KMC stabilizes the heart rate, improves oxygen saturation, makes weight gain better, and reduces crying in the infant. In order to launch KMC unit, the barriers for implementing this type of care should be recognized. Methods: This qualitative research was conducted using a focus group discussion and individual semi-structured interview with nurses, doctors, executive and management staff of a neonatal unit of a third level teaching hospital in Tabriz, northwest Iran. The participants were selected using purposeful sampling. Content analysis was used for analyzing data. Data were analyzed by MAXQDA 10 software. Results: After analyzing data, four main themes were extracted including mother-related barriers, father-related barriers, physician- related barriers, and system-related barriers. Conclusion: Based on the findings of the research, it seems that in order to facilitate practicing continuous KMC, much emphasis should be placed on training the parents and health care providers. Furthermore, in some cases, reforming the payment system for physicians, providing an instruction for performing continuous KMC, and continuous assessment of hospitals annually are necessary.

Evaluating Maternal Discharge Readiness in Kangaroo Mother Care

To develop and apply a tool for measuring hospital discharge readiness of mothers practicing continuous kangaroo mother care (KMC) in a tertiary setting. A 22-item questionnaire was adapted from an existing tool. After a pilot (n=20), the survey was administered to 200 mothers in the KMC unit, Kalafong Hospital, South Africa from 2017-2018. Two items which asked participants how confident and ready they felt overall were used to categorize women as 'ready' or 'less ready' for discharge. Most women (n=168, 88.0%) were categorized as ready for discharge. The mean (SD) score for all 22 questions was 9.4 (0.7). Women categorized as 'less ready' scored lower overall (mean difference: 1.3) and within all four questionnaire categories compared to women who were discharge ready (P<0.05). Although most women in this study reported high levels of discharge readiness, further research is needed to see if results are comparable across settings.

Tube Feeding Practices and Transition to Breastfeeding Experiences of Mothers of Preterm Infants at a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa.

To receive human milk, most preterm infants initially receive the mothers’ expressed milk through a nasogastric tube. However, breast milk feeding the preterm infant and making the transition to direct breast-feeding come with significant challenges. The study explored and described the experiences of mothers of preterm infants regarding initiation and expressing breast milk, tube feeding practices, and transition to breastfeeding during the infants’ stay in a kangaroo care unit (KMC) of an academic hospital in South Africa. Using a qualitative design, focus group interviews were conducted with 38 mothers of preterm infants after discharge from the neonatal intensive care unit (NICU). We analyzed transcripts following the 5 steps for qualitative thematic data analysis. Tube feeding and breastfeeding preterm infants was challenging and exhausting for the mothers. Many described their experiences of initiating expression and sustaining milk supply as negative. They had constant concerns about their ability to produce adequate milk volumes to feed their infants. They had immense dislike of expressing, which they described as physically exhausting, stressful, and painful. Those who had initiated breastfeeding were highly motivated to breastfeed their preterm infants. They described breastfeeding as a positive bonding experience that they derived pleasure from. The mothers’ dislike of expressing was overshadowed by their emotional obligation toward their preterm infants. Although the KMC unit promotes breastfeeding, mothers encountered problems and struggled to initiate expression and sustain milk production. Mothers of extreme and very preterm infants need support to continue with milk expression during the long NICU and KMC stay.

Report on Activities of the Kangaroo Mother Care Unit

Report on Activities of the Kangaroo Mother Care Unit

Proportion of mothers practicing kangaroo mother care at home and factors influencing the practices following hospital discharge, South Wollo, Ethiopia

BackgroundLow birth weight continues to be a significant public health problem globally. Kangaroo Mother Care (KMC) comprises of early and continuous skin-to-skin contact between mother and baby as well as exclusive breastfeeding. More interest has been given to initiate KMC at the health facility for low birth weight babies born at home but, there has been trace evidence to support initiation of KMC at home. Thus, this study was aimed to estimate the proportion of mothers who continued to practice kangaroo mother care at home and identify factors influencing this practice following hospital discharge. MethodsIt was a cross-sectional study of 190 mothers with their low birth weight babies who were discharged from KMC unit at Dessie referral and Akesta hospitals and counseled about KMC to practice at home. In the first week following hospital discharge, the data collectors visited the mothers to interview her about KMC practices and the factors influencing it and analyzed by SPSS V.25.0. Crude odds ratio and adjusted odds ratio were performed to test the association between dependent and independent variables. ResultThe proportion of mothers who practice KMC at home was 89(46.8%). Multivariate logistic regression showed that support from husband (AOR = 4.4, 95% CI = 1.8–10.4), support from health extension works(HEW)(AOR = 3.4, 95% CI = 1.6–7.2), availability of helper (AOR = 4.5, 95% CI = 1.9–4.10) and mothers explained the important of KMC (AOR = 2.3,95% CI = 1.1–4.9) were statistically associated with KMC practices at home. ConclusionThis study concludes that support comes from husband, health extension workers and family. Understanding of mothers about the importance of KMC was found to be one of the significant enhancing factors to implement KMC at home.

Acceptance of kangaroo mother care by mothers of premature babies

Background: Kangaroo Mother Care (KMC) is a low-cost method of care for premature infants in areas with inadequate incubators and/or power outages. Assessing mothers' acceptance of KMC will help in the scale-up of interventions. Aims: To investigate factors that influence the acceptance of KMC in the care of premature babies at University Teaching Hospital, Lusaka, Zambia. Methods: This was a cross-sectional analytical design using a mixed approach, conducted at the University Teaching Hospital in Zambia. A total of 60 mothers and 5 key informants made up the participants. Findings: Overall, 60% of women found KMC acceptable and were able to practise continuously, in spite of not having prior knowledge of KMC. The longest-serving key informant at the KMC unit had served for 2 years, and 3 of the 5 informants had not received any training on KMC. Conclusions: Mothers accepted KMC after they were given information and education through good communication.

Breastfeeding Characteristics of Late-Preterm Infants in a Kangaroo Mother Care Unit.

To describe the breastfeeding characteristics of late-preterm infants (LPIs) in a kangaroo mother care (KMC) unit. In a 20-bed KMC unit, the breastfeeding of 73 purposively-selected LPIs' (mean gestational age: 34.8 weeks) was observed once-off, using the Preterm Infant Breastfeeding Behavior Scale. Participants' mean age was 9.5 days, mean number of days in the unit was 3.1 days, and mean number of days breastfeeding was 7.5 on observation. Only 13.7% of participants were directly breastfeeding without supplementary naso- or orogastric feeding/cup-feeding and 86.3% received supplementary cup-feeding of expressed breast milk. Most participants did not exhibit obvious rooting (83.5%) and although most latched-on (97.3%), those who did, latched shallowly (93%). The mean longest sucking burst was 18.8 (standard deviation: 10.5) and approximately half the participants swallowed repeatedly (53.4%). The mean breastfeeding session duration was 17.8 minutes, but most participants breastfed for less than 10 minutes (76.7%). No statistically significant differences in breastfeeding characteristics were detected between participants of different chronological ages. A general trend toward more mature behaviors in participants' breastfeeding for more days was present for many breastfeeding characteristics. More infants exhibited the most mature behavior for each breastfeeding characteristic when the environment was quiet, rather than noisy and disturbing, except for depth of latching (quiet: 0%, disturbance: 15.2%). LPIs in this sample presented with subtle breastfeeding difficulties, highlighting their need for breastfeeding support. Further research is required to examine the effect of KMC on breastfeeding in LPIs.

Primary Health Care Follow-Up Visits: Investigation Of Care Continuity Of Preterm Newborns From A Kangaroo-Mother Care Unit

INTRODUCTION: The kangaroo-mother care method is an approach adopted in Brazil as a public police, which has helped in the reduction of neonatal mortality rate. Premature birth and its vulnerabilities can trigger, especially in mothers, feelings of fear and insecurity related to taking care of newborns.&#x0D; OBJECTIVE: Investigate care continuity of preterm newborns from a kangaroo-mother care method unit in primary health care facilities.&#x0D; METHODS: It was a transversal study performed with 43 mothers of preterm newborns who were hospitalized in the rooming-in care unit of a kangaroo-mother care method unit of a Brazilian public maternity school. Data collection was carried out through a questionnaire, which was used to interview mothers between September 2015 and February 2016.&#x0D; RESULTS: It was found a relationship between sociodemographic status and risk of premature birth, and the following variables: age, education, marital status, and family income. Regarding findings from the follow-up home visits in primary health care, most of the participants were still breastfeeding and using the kangaroo position. However, 60.5% of the interviewed mothers reported not receiving home visits from health professionals of primary health care facilities.&#x0D; CONCLUSION: It is essential the support of health professionals and the participation of mothers and families to improve, through health education, quality of life promotion for newborns from kangaroo care approach.

Kangaroo Mother Care: A review of mothers׳ experiences at Bwaila hospital and Zomba Central hospital (Malawi)

BackgroundKangaroo Mother Care is an intervention that can help reduce neonatal mortality rate in Malawi but it has not been rolled out to all health facilities. Understanding the mothers׳ experience would help strategise when scaling-up this intervention. Objectiveto review experiences of mothers Kangaroo Mother Care at two hospitals of Bwaila and Zomba. Designquantitative, descriptive using open interviews. Settingtwo central hospitals in Malawi. Participants113 mothers that were in the Kangaroo Mother Care unit and those that had come for follow-up two weeks after discharge before the study took place. Findingsmothers had high level of knowledge about the significant benefits of Kangaroo Mother Care but 84% were not aware of the services prior to their hospitalisation. 18.6% (n=19) were not counselled prior to KMC practice. Mothers preferred KMC to incubator care. There were factors affecting compliance and continuation of KMC, which were lack of support, culture, lack of assistance with skin-to-skin contact, multiple roles of the mother and stigma. Key conclusionsmothers had a positive attitude towards KMC once fully aware of its benefits. Implications for practicethere is need for awareness campaigns on KMC services, provision of counselling, support and assistance which can help motivate mothers and their families to comply with the guidelines of KMC services.

Cost and effectiveness analysis of Kangaroo mother care and conventional care method in low birth weight neonates in Tabriz 2010-2011

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.

Towards Better Care for Preterm Infants in Bamako, Mali

Objective: The objective of this study was to assess the feasibility, acceptability and outcome of Kangaroo Mother Care (KMC) on low birth weight (LBW) infants, including morbidity and mortality related to prematurity. Methods: A longitudinal study of preterm infants in KMC at the Gabriel Toure University Hospital (CHU), Bamako, Mali. Data collected in the KMC unit using hospital and ambulatory records. Data entered withEpiInfo and analyzed with SPSS12.0. Results: Mortality in preterm infants was very high (41.4%) before admission to the KMC unit. More than a third (30.7%) of the 480 surviving LBW infants during the study period were admitted to the KMC unit. The mean age of mothers was 25 years, with an average of three antenatal visits per mother. Deliveries had taken place mainly in community and district health centers. The mean gestational age at birth was 32.5 weeks for a mean birth weight of 1355 g. All babies and families admitted met the KMC eligibility criteria. The mean age at admission in the KMC unit was 9 days, with a mean weight of 1432 g, a mean height of 41 cm, and a mean head circumference of 29 cm. Somatic growth was satisfactory with a mean weight gain of 19 g per day during admission. The mean age of entry into the outpatient KMC program was 9.16 days (range: 2-32 days). The overall mortality of preterm infants admitted to the KMC program was 7.91%. Mortality among the preterm infants who remained in the neonatal unit was 51.1%. The KMC deaths occurred mostly between discharge from the KMC unit and 40 weeks of gestational age. The most common difficulties recorded after discharge were non-compliance with periodic visits, the occurrence of gastrointestinal, infectious or neurological complications, and failure to grow. Conclusions: The KMC program has been accepted by all mothers and families. Infants admitted to KMC showed a satisfactory growth. The overall mortality was lower among preterm infants in KMC unit compared to those cared in the neonatal unit. Keywords: Low birth weight, Kangaroo Mother Care, low income countries, Preterm Infants, prematurity, KMC Unit, public health, skin-to-skin contact, Neonatal Care, High-Risk Preterm Infants

Fatores que influenciam o desmame no recém-nascido prematuro

OBJETIVO: verificar os principais fatores que influenciam o desmame em prematuros nascidos em maternidade pública da cidade de São Paulo. MÉTODO: estudaram-se 89 prematuros de baixo peso acompanhados em ambulatório, no período de agosto de 2006 a maio de 2007. Esses prematuros foram divididos em dois grupos conforme a presença de desmame parcial (introdução de complemento lácteo por mamadeira) ou desmame total (interrupção do aleitamento materno). Foram estudadas variáveis maternas e das crianças, obtidas por meio de entrevista com a mãe e consulta a prontuários. Na análise estatística, utilizaram-se os testes t (Student) e de correlação (Spearman). Adotou-se o nível de significância de 5%. RESULTADOS: a média de idade para o desmame parcial foi de 1,41 meses. Mães que realizaram ordenha durante a internação, ou que iniciaram ou retornaram ao trabalho, introduziram mamadeira mais tardiamente. Quanto menor o peso ao nascer e a idade gestacional, mais tardia a introdução da mamadeira. Quanto menor a idade de introdução da chupeta, mais precoce o desmame parcial. A média de idade para o desmame total foi de 2,93 meses. Mães que internaram na enfermaria canguru, ou que iniciaram ou voltaram ao trabalho, interromperam o aleitamento materno mais tardiamente. CONSIDERAÇÕES FINAIS: os achados do presente trabalho apontam para a importância de fatores controláveis pela equipe de saúde na prevenção do desmame precoce em prematuros, como ordenha, metodologia canguru e orientação para o não uso de chupetas. Fatores não controláveis como peso ao nascer e trabalho materno, mostraram-se indicativos de maior permanência do aleitamento materno.