Skin-to-skin Research Articles

Determinants of Kangaroo Mother Care among low-birth-weight infants in low resource settings.

Kangaroo Mother Care involves direct contact between a baby's bare skin and a caregiver, typically the mother. It has many benefits for both baby and caregiver and is often used to regulate body temperature, promote breastfeeding, enhance growth, and bonding. This study aims to explore factors associated with Kangaroo Mother Care uptake in low-resource countries for babies born with low-birth-weight. Demographic and Health Survey data from 34 low- and middle- income countries were analyzed. Cross-sectional data of 57,223 children were pooled and analyzed. Hierarchical multivariable analysis was performed to determine the factors associated with skin-to-skin contact. Statistical significance was set to 5%. The prevalence of Kangaroo Mother Care ranged from 11.04% to 84.36%; highest in Benin (84.36%), Tajikistan (80.88%), and Uganda (80.86%) and lowest in Burundi (11.04%), Bangladesh (16.58%), and Pakistan (19.24%). Higher odds of Kangaroo Mother Care were estimated among low-birth-weight infants who were put to breast immediately, had low-birth-weight (≥1.5kg), born through normal delivery, born at health facility, those whose mothers were exposed to media, had high antenatal care visits, had formal education, and in the younger age bracket. Also, women living in communities with high illiteracy, countries in the lower-middle income region had higher odds of Kangaroo Mother Care. Women domiciled in Europe and Central Asia, Sub-Saharan Africa, Latin America and The Caribbeans, and East Asia and Pacific had lower odds of Kangaroo Mother Care. This study found a low uptake of Kangaroo Mother Care in countries with limited resources, which is a concerning issue that requires urgent attention. Increasing awareness, education, and support for mothers and families to practice Kangaroo Mother Care, as well as training healthcare practitioners, can lead to better outcomes for newborns and reduce neonatal death.

Comparison of Infrared Thermometer with Digital Thermometer in Neonates During Delivery Room Care

Objective To compare an infrared thermometer (IRT) at the forehead with a Digital thermometer (DT) at the axillary site in neonates in the delivery room. Methods Temperature was assessed simultaneously in 65 neonates born at ≥34 weeks in the delivery room with IRT at the forehead site and DT at the axillary site at 1 and 5 min of age. Immediately after delayed cord clamping, skin-to-skin contact (SSC) was given for vaginal-born neonates, and a radiant warmer was used for cesarean-born neonates. Results In a total of 130 paired measurements, the intraclass correlation coefficient (ICC) between the IRT and the DT was good, ICC = 0.859, P < 0.001; the bias (SD) was –0.16(0.42)°C in Bland-Altman analysis. The correlation between IRT and DT during SSC was ICC = 0.881, P < .001, and the bias (SD) was –0.14(0.33)°C; and for neonates cared under radiant warmer, the ICC was 0.846, P < .001 with bias (SD) of –0.17(0.47)°C. Conclusion Temperature assessed by IRT at the forehead site shows good reliability with DT at the axillary site in neonates for thermal management in the delivery room.

XIII International Conference on Kangaroo Mother Care - Different opinions, experiences and related KMC issues: Good practices, stabilisation concept, nutrition and basic respiratory support.

This study aimed to summarise the views and experiences of the participants in the workshop of the XIII International Conference on Kangaroo Mother Care (KMC). The results of the discussions held during the workshop of the XIII International Conference on KMC were summarised. There were 152 participants from 47 countries. Four main KMC topics were discussed: good practices, immediate implementation, nutrition and basic ventilation. Several agreements were reached, namely that professional societies and governments should develop official recommendations to promote KMC as standard care for preterm and low birth weight infants and that parents should be involved as active caregivers in neonatal care units. Moreover, the criteria for referring community-born infants to KMC require standardisation. Important inequalities in resource availability among high-, middle- and low-income countries were recognised for all topics. Specific needs were identified for parenteral nutrition and fortifiers, nasal continuous positive airway pressure (nCPAP) and oxygen blenders, which are rarely available in low- and middle-income countries. Immediate implementation of KMC was discussed as a new concept. Its benefits were recognised, but its application has some variability. Adequate preterm care requires a basic neonatal package, including KMC, nCPAP, immediate management protocols and adequate nutrition and feeding strategies. The differences in resources among high-, middle- and low-income countries highlight the wide disparities in neonatal care according to the place of birth.

Kangaroo Mother Care in Improving Thermoregulation of Premature Babies During the COVID-19 Pandemic: A Case Report

Premature babies lose four times more heat than those with sufficient birth weight. Moreover, their body temperature regulation center does not function properly. This study aimed to investigate Kangaroo Mother Care's effect in increasing premature babies' thermoregulation during the COVID-19 pandemic at Hospital A in Malang City, Indonesia. This study was a case report with data from follow-up checks on premature babies discharged from the hospital. The Kangaroo Mother Care method, carried out by the mother, increased the thermoregulation of premature babies' temperature by 0.2ᴼC compared to the father. It was because women have a slightly higher body temperature than men. The comfortable body temperature for women was 2.5ᴼC higher than for men. Men had a lower body mass of fat, so it took an average longer time for metabolism. The Kangaroo Mother Care procedure, especially when done by the mother, can increase the body temperature of premature babies by conduction.

Postnatal Kangaroo mother care practice at home and comparison of improvement in vital parameters in low-birth-weight babies in-home setup and non-teaching hospital setup in rural coal mines area Jharkhand, India: A community-based observational study.

Low birth weight (LBW) newborns especially those <2000 g are more prone to hypothermia due to which other physiological parameters gets deteriorated in the 1st week of life. The objective of this observational study was to continue Kangaroo mother care practice at home and to ascertain whether KMC was effective in improving the vital parameters of LBW babies when it is given at home in a rural coal mines area, in Jharkhand, India. This study was a community-based prospective observational study, done over three years from November 2019 to November 2022. In this study, we included 156 pairs of both mothers and LBW babies (weight 1500 g to <2000 g). After discharge from the hospital on day 3, KMC was continued at home on day 4, day 5, and day 6. Data of four physiological parameters, namely, temperature, oxygen saturation, respiratory rate, and heart rate were collected before and after KMC and analyzed. Among 400 newborns, 156 LBW babies (39.0%) who were given KMC at home showed similar but statistically significant improvement of vital parameters, especially in temperature and oxygen saturation (P < 0.0001) compared to the same babies 156 (39.0%) given KMC in the hospital (P < 0.001). Kangaroo mother care, which was continued at home, has a significant role in the Improvement of vital parameters, especially concerning temperature and oxygen saturation. If the babies in the weight range of 1500 g to <2000 g are healthy, well-breast-fed, and have no other risk factors, they can be discharged early and managed at home by delivering supportive care and nursing care along with Kangaroo mother care with continuous follow-up.

Research prioritisation on prevention and management of preterm birth in low and middle-income countries (LMICs) with a special focus on Bangladesh using the Child Health and Nutrition Research Initiative (CHNRI) method.

Fifteen million babies are born preterm globally each year, with 81% occurring in low- and middle-income countries (LMICs). Preterm birth complications are the leading cause of newborn deaths and significantly impact health, quality of life, and costs of health services. Improving outcomes for newborns and their families requires prioritising research for developing practical, scalable solutions, especially in low-resource settings such as Bangladesh. We aimed to identify research priorities related to preventing and managing preterm birth in LMICs for 2021-2030, with a special focus on Bangladesh. We adopted the Child Health and Nutrition Research Initiative (CHNRI) method to set research priorities for preventing and managing preterm birth. Seventy-six experts submitted 490 research questions online, which we collated into 95 unique questions and sent for scoring to all experts. A hundred and nine experts scored the questions using five pre-selected criteria: answerability, effectiveness, deliverability, maximum potential for burden reduction, and effect on equity. We calculated weighted and unweighted research priority scores and average expert agreement to generate a list of top-ranked research questions for LMICs and Bangladesh. Health systems and policy research dominated the top 20 identified priorities for LMICs, such as understanding and improving uptake of the facility and community-based Kangaroo Mother Care (KMC), promoting breastfeeding, improving referral and transport networks, evaluating the impact of the use of skilled attendants, quality improvement activities, and exploring barriers to antenatal steroid use. Several of the top 20 questions also focused on screening high-risk women or the general population of women, understanding the causes of preterm birth, or managing preterm babies with illnesses (jaundice, sepsis and retinopathy of prematurity). There was a high overlap between research priorities in LMICs and Bangladesh. This exercise, aimed at identifying priorities for preterm birth prevention and management research in LMICs, especially in Bangladesh, found research on improving the care of preterm babies to be more important in reducing the burden of preterm birth and accelerating the attainment of Sustainable Development Goal 3 target of newborn deaths, by 2030.

Breastfeeding needs of mothers of preterm infants in China: a qualitative study informed by the behaviour change wheel

BackgroundAlthough breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiological immaturity of preterm infants, Chinese mothers of preterm infants face unique challenges of maternal-infant separation after birth. Moreover, little is known about Chinese mothers’ specific needs in coping with the difficulties posed by these challenges. This study utilized the Behaviour Change Wheel to investigate the breastfeeding needs of Chinese preterm mothers that may facilitate its practice in the future.MethodA qualitative descriptive design was implemented in Wuhan in 2022. Based on purposeful sampling, 13 preterm mothers were recruited from a NICU in a Grade III Class A hospital in Wuhan, China. Face-to-face semi-structured interviews were conducted to collect data using the interview guide developed by the Theoretical Domains Framework. Theoretical Thematic Analysis was used to review the data in 6 steps to identify themes.ResultsFive major themes emerged: (1) capability: ability to interpret infants’ cues and identify problems, and need for breastfeeding knowledge and skills training; (2) physical opportunity: cleanliness and quietness in household environment, private lactation spaces and breastfeeding tools in workplaces and hospitals; (3) social opportunity: family support, peer support, and authoritative support from healthcare providers; (4) reflective motivation: information on health impacts of breastfeeding; (5) automatic motivation: maternal-infant bonding, free of aversive stimulus.ConclusionPreterm mothers’ needs to enable breastfeeding were diverse, including increasing their capability, physical and social opportunities, and reflective and automatic motivation. People, resources and environments associated with these needs should be engaged together to stablish a conducive structural environment for breastfeeding. The policy change for “zero separation” and implementation of kangaroo care should also be implemented in Chinese neonatal intensive care units. Future studies are needed to design effective interventions according to mothers’ specific needs.

Neonatal Nurses Knowledge, Attitude, and Practice of Kangaroo Care

Neonatal Nurses Knowledge, Attitude, and Practice of Kangaroo Care

Experiences of Xhosa women providing Kangaroo mother care in a tertiary hospital in the Western Cape, South Africa

Kangaroo mother care has been recognized as a credible intervention to improve preterm birth outcomes by the World Health Organization. Kangaroo mother care requires high user engagement and consists of continuous skin-to-skin contact between the mother and infant and exclusive breastfeeding. We conducted a qualitative study of Xhosa women ( n = 10) practicing Kangaroo mother care in a tertiary hospital in the Western Cape, South Africa. All interviews were conducted in isiXhosa, audio-recorded, and transcribed. The transcribed data were analysed using thematic analysis. Four themes emerged: (1) Kangaroo mother care, a beneficial but foreign concept; (2) distress in the Kangaroo mother care ward; (3) the missing umbilical cord: cultural experiences of mothers in the Kangaroo mother care ward; and (4) the Kangaroo mother care village: interpersonal relations in the ward. Our study showed that cultural practices still pose a challenge to fully accepting Kangaroo mother care. We suggest more studies on cultural sensitivity to encourage acceptance of interventions that affect culturally diverse groups.

THE EFFECTIVENESS OF KANGAROO MOTHER CARE (KMC) USING METKA INFANT SLING ON INCREASED TEMPERATURE OF LOW-BIRTH WEIGHT BABIES (LBW)

&lt;p&gt;&lt;strong&gt;Introduction:&lt;/strong&gt; Weight is one indicator of newborn health. Babies born with low weight need serious treatment because in this condition the baby is easily got hypothermic. As much as 40.5 percent of infant deaths in Central Java Province in 2019 were also caused by LBW. Efforts to maintain the baby's body temperature in LBW still need to develop low-cost technology so that hypothermia does not occur.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;&lt;strong&gt;:&lt;/strong&gt; This study aimed to determine the effectiveness of kangaroo mother care (KMC) using a &lt;em&gt;metka&lt;/em&gt; infant sling on the increasing temperature babies. This type of quantitative research was a quasi-experimental method was used a two-group pretest-posttest design. The sampling technique uses purposive sampling. The number of samples in the study was 30 respondents according to the specified criteria. The instrument used was a digital thermometer where the thermometer was only placed in the baby's armpit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; The result of this research showed that there was significant effectiveness in kangaroo mother care (KMC) using &lt;em&gt;metka&lt;/em&gt; infant sling on LBW body temperature p &amp;lt;0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The conclusion was there is the effectiveness of kangaroo mother care with a &lt;em&gt;metka&lt;/em&gt; infant sling on the temperature in LBW. Giving the kangaroo method with the &lt;em&gt;metka&lt;/em&gt; sling is considered very effective in meeting very basic baby needs such as warmth, breast milk, protection from infection, stimulation, safety, and affection.&lt;/p&gt;

Health professional assisted Kangaroo mother care practice in Ethiopian health care facilities: evidence from the 2016 Ethiopian demographic and health survey

BackgroundWorldwide, 15 million children born prematurely every year and over one million of them died because of prematurity caused complications. However, three-fourths of deaths from preterm related complications are preventable by using Kangaroo Mother Care (KMC). The Ethiopian government has been implementing a guideline that declares putting all low birth weight neonates at KMC. The aim of this study was to assess health professionals’ assisted KMC practice and its associated factors among Ethiopian mothers who gave birth at health facilities.MethodologyThis study used the 2016Ethiopian Demographic and Health Survey data (EDHS). The 2016EDHS used a stratified two stage sampling method to select a representative sample using validated questioner. The sample we used in this study after cleaning the children’s data set from the 2016EDHS was 2,960. Logistic regression model was used to assess the association of health professional assisted KMC practice and predictor variables.ResultsMothers who gave birth in health facilities and practiced kangaroo mother care were 1808(62.1%). In the multivariable logistic regression analysis, women from poorest (AOR, (95%CI)), (0.60, (0.43, 0.81)) and poorer (0.62, (0.46, 0.86)) socio-economic status were not practicing KMC.ConclusionsThe coverage of health professional assisted KMC practice was far lower than the expectation for mothers who gave birth in health facilities (100%). Low socio-economic status was associated with not practicing KMC. A further study on why mothers from low wealth index did not practicing KMC while they were in health facilities may be needed.

A quality improvement project to increase breast milk feeding of hospitalized late preterm infants in China

BackgroundThe breastfeeding rates of late preterm infants are lower than both term and extremely preterm infants. To explore the interventions of increasing full breast milk feeding rate of hospitalized late preterm infants on the 7th day after birth (D7) and evaluate the effect of these quality improvement (QI) interventions.MethodsThe full breast milk feeding (amount of enteral breast milk reached 120ml/kg/d on D7) rate of hospitalized late preterm infants during May 2017 and November 2017 was set as the baseline before intervention, and the specific aim of promoting breast milk feeding was put forward. The Pareto Chart was used to analyze the factors that affect breast milk feeding process, as well as the discussion of multidisciplinary experts. Key drivers were constructed, including informational materials and education about breast milk feeding, consultations and support on optimal breast milk initiation, initiating breast milk expression within one hour after birth, accurate measurement and recording of expressed breast milk, stimulating continuous and effective lactation, proper breast pump selection in and out of hospital and sending and preserving of expressed milk to NICU. Control chart was used to monitor the monthly change of full breast milk feeding rate until the aim was achieved and sustained.ResultsThe baseline of full breast milk feeding rate of late preterm infants was 10%, and the aim of QI was to increase the rate to 60% within a two-year period. Control chart dynamically showed the full breast milk feeding rate increased to 80% with the implementation of the interventions, achieved and made the aim of QI sustained.ConclusionQI interventions including breast milk feeding education, early postpartum breast milk pumping, kangaroo care to stimulate breast milk secretion, and convenient way of transporting breast milk to NICU, could significantly improve the full breast milk feeding rate of hospitalized late preterm infants.

Pre-Experimental Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Kangaroo Mother Care among III-year BSc Nursing Students

Background: A pre-experimental study was conducted to assess the effectiveness of structured teaching programme on knowledge regarding Kangaroo mother care among III-year B.Sc. Nursing students in selected Nursing College, Tumkur district, Karnataka. A total sample of 60, III-year B.Sc. (N) students were selected using Simple random sampling technique. The objectives of the study were to assess the knowledge level among III-year BSc. nursing students regarding kangaroo mother care before and after structured teaching programme and to find out the effectiveness of structured teaching programme on knowledge regarding kangaroo mother care among nursing students. The final objective was to determine the association between pre-test level of knowledge and selected demographic variables. Materials and Methods: A one-group pre-test post-test design was used to conduct the study. A sample comprising of 60 students were enrolled using simple random sampling technique. The conceptual framework of the study was based on Ludwig VonBertalanffy’s General System Model. Tools used for data collection were demographic Performa and structured knowledge questionnaire. Results: Data analysis was done using descriptive and inferential statistics. Findings of the study revealed that the mean post-test knowledge score 25.12±2.41was significantly higher than the mean pre-test knowledge score 14.36±3.47 (p&lt;0.01). Paired t value computed at 21.56** was statistically significant at p&lt;0.01. which revealed that, there is significant increase in the mean post-test knowledge score. Significant association at 0.05 level was observed between knowledge with regard to their previous knowledge. Conclusion: The findings of the study confirmed that the structured teaching programme was significantly effective in improving the knowledge on kangaroo mother care amongIII year B.Sc. nursing students.

Effect of Immediate Postpartum Skin-to-Skin Contact Between Mothers and Newborns on Episiotomy Pain: A Randomized Controlled Trial

Objective: To determine the effect of immediate skin-to-skin contact (SSC) between mothers and their newborns on episiotomy pain.Material and Methods: This randomized controlled trial enrolled 60 participants who underwent vaginal delivery. The participants were divided into two groups: an immediate SSC group and a no SSC group (n=30 for each group). SSC was initiated within 10 minutes after birth with a contact duration of at least 30 minutes. Episiotomy pain severity was evaluated using a visual analog scale (VAS) at one hour after birth in both groups. The pain scores were analyzed using the Mann-Whitney U test and the optimum contact time for reducing episiotomy wound pain was evaluated by a receiver operating characteristic (ROC) curve.Results: The median VAS of episiotomy pain at one hour after delivery in the SSC group was statistically significantly lower than the no SSC group (1.9 (0.8-3.1) vs. 3.4 (2-5.2) cm, p-value&lt;0.001). The contact time for optimal pain reduction was at least 30 minutes of SSC.Conclusion: Immediate SSC contact between a mother and her neonate after delivery can effectively reduce episiotomy pain.

The beneficial effect of early and prolonged kangaroo mother care on long-term neuro-developmental outcomes in low birth neonates - A cohort study.

Kangaroo mother care (KMC) has immense short-term benefits, but data on long-term outcomes are scarce. Hence, this study aimed to compare the neurodevelopmental outcomes at 12 months of corrected age (CA) in infants <2000 g receiving early and prolonged KMC to a control group. This was a cohort study that was conducted from January 2017 to November 2018. All neonates<2000 g were eligible for the study. Neonates that received early initiation (<72 h of life) and prolonged KMC comprised the intervention group and were compared to neonates without the intervention. Bayley Scales of Infant and Toddler Development, Third edition (BSID-III) was done at 12 months of CA, and this was analysed using t-test and multi-linear regression analysis. There were 75 neonates in the intervention and 69 in the control group. Baseline characteristics were comparable. We found higher composite scores for cognition (110.38 ± 9.89 vs. 105.44 ± 8.77, p value = 0.023), language (107.51 ± 10.72 vs. 101.05 ± 12.06, p value = 0.014) and adaptive behaviour (87.97 ± 9.97 vs. 80 ± 9.1, p value<0.001) in the early and prolonged KMC group in comparison to the control group. Infants with early and prolonged KMC have better neurodevelopmental outcomes in terms of cognition, language and adaptive behaviour at 12 months of CA.

The effect of postpartum skin-to-skin contact on the pain of the first intramuscular injection to the Newborn: A randomized controlled trial

BackgroundNewborns are exposed to painful interventions during medical procedures. AimThis study was conducted to evaluate the effect of postpartum skin-to-skin contact (SSC) on the pain of the first intramuscular (IM) injection in the newborn. DesignA randomized controlled trial with four measurement points (5 min following pre-intervention, pre-injection and post-injection, 10 min following post-injection). ParticipantsTerm newborns delivered vaginally. MethodThe women were randomly divided into control (n = 30) and experimental (n = 30) groups. SSC was performed to the experimental group 5 min before and after injection while the control group did not receive SSC. The pain response of newborns was evaluated by Neonatal Infant Pain Scale (NIPS), crying time, oxygen saturation (SpO2) and heart rate (HR). ResultsPre- and post-injection NIPS scores of the newborns in the experimental group were significantly lower than the control group (p < 0.01). The crying time of the newborns in the experimental group at 5 min after the injection was found to be significantly lower than the control group (p < 0.01). The newborns in the experimental group had significantly higher SpO2 at 5 min before and after the injection compared to the control group (p < 0.05). The mean HR of the newborns in the experimental group at 5 min before and after, and at 10 min after the injection was found to be significantly lower than that of the control group (p < 0.05). ConclusionIt has been determined that performing SSC to newborns is an effective method in reducing the pain of the first IM injection.

Learning Curve of Multiport Robotic Cholecystectomy: A Cumulative Sum Analysis.

To establish the learning curve of multiport robotic cholecystectomy (MRC). A retrospective analysis of patients undergoing MRC was performed. A cumulative sum analysis helped define the learning curve through the evaluation of skin-to-skin (STS) time and postoperative complications rate. Direct comparison of variables was conducted between the phases. Two hundred forty-five MRC cases were included. Average STS and console times were 50.6 and 29.9 minutes, respectively. Cumulative sum analysis established 3 phases with inflection points at cases 84th and 134th. A significant decrease in STS time was observed between the phases. Middle and late phases encompassed patients with higher comorbidities. Two conversions to open were recorded in the early phase. Postoperative complication rates were comparable among the early (2.5%), middle (6.8%), and late (5.6%) phases (P = 0.482). A steady decrease in STS time was observed across the 3 different phases established at the 84th and 134th patients.

Development and evaluation of a kangaroo mother care implementation model in South Ethiopia.

To develop a model for increasing the coverage of kangaroo mother care (KMC), which involved ≥8 h of skin-to-skin contact per day and exclusive breastfeeding, for small babies with birth weight < 2000 g in South Ethiopia. A mixed methods study was conducted between June 2017 and January 2019 at four hospitals and their catchment areas. Iterative cycles of implementation, program learning and evaluation were used to optimise KMC implementation models. The study explored the community-facility continuum of care and assessed the proportion of neonates with a birth weight less than 2000 g receiving effective KMC. Three KMC implementation models were tested with Model 2 being the final version. This model included enhanced identification of home births, improved referral linkages, immediate skin-to-skin care initiation in facilities and early contact after discharge. These improvements resulted in 86% coverage of effective facility-based KMC initiation for eligible babies. The coverage was 81.5% at discharge and 57.5% 7 days after discharge. The mean age of babies at KMC initiation was 8.2 days (SD = 5.7). The study found that the KMC implementation model was feasible and can lead to substantial population-level KMC coverage for small babies.

Kangaroo Mother Care in Improving Thermoregulation of Premature Babies During the COVID-19 Pandemic: A Case Report

Premature babies lose four times more heat than those with sufficient birth weight. Moreover, their body temperature regulation center does not function properly. This study aimed to investigate Kangaroo Mother Care's effect in increasing premature babies' thermoregulation during the COVID-19 pandemic at Hospital A in Malang City, Indonesia. This study was a case report with data from follow-up checks on premature babies discharged from the hospital. The Kangaroo Mother Care method, carried out by the mother, increased the thermoregulation of premature babies' temperature by 0.2ᴼC compared to the father. It was because women have a slightly higher body temperature than men. The comfortable body temperature for women was 2.5ᴼC higher than for men. Men had a lower body mass of fat, so it took an average longer time for metabolism. The Kangaroo Mother Care procedure, especially when done by the mother, can increase the body temperature of premature babies by conduction.

The Relationship Between the Duration of Kangaroo Mother Care and Edinburgh Postnatal Depression Scale Outcomes in Mothers with Preterm Infants

The Relationship Between the Duration of Kangaroo Mother Care and Edinburgh Postnatal Depression Scale Outcomes in Mothers with Preterm Infants