Mother Care Research Articles

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Effect of kangaroo mother care and white noise on physiological-stress parameters in heel lancing: randomized controlled study

BackgroundNewborns are exposed to varying degrees of stressful interventions due to procedures such as heel lancing used in routine metabolic screenings. It is an examination of the effects of white noise and kangaroo care on some physiological parameters and stress markers (cortisol and glucose-regulated protein 78-GRP78) in heel lancing in newborns.MethodsRandomized controlled study was conducted at a gynecology service of a hospital between January and September 2023. 90 babies were divided into three groups: 30 babies in the Kangaroo Care Group (KCG), 30 babies in the White Music Group (WMG), and 30 babies in the Control Group (CG). All babies were randomly divided into groups. Stress parameters were measured by saliva collection method and physiological parameters by saturation device.ResultsA statistically significant difference was determined between the total crying time, pulse and saturation values ​​according to the groups (p < 0.001; p = 0.001). A statistically significant difference was determined between the mean values ​​of cortisol and GRP78 measurements according to group and time interaction (p < 0.001). KCG was more effective in reducing total crying time and stabilizing pulse, saturation, salivary cortisol, GRP-78 values compared to WNG and CG.ConclusionIt was concluded that white noise and kangaroo care help reduce newborns’ stress in the case of heel lancing.Practical implicationsThe practice of kangaroo care and the use of white noise methods may assist healthcare professionals as supportive methods in stress management during invasive procedures.Trial RegistrationNCT06278441, registered on 19/02/2024.

“… I carry their stories home …”: experiences of nurses and midwives caring for perinatal adolescent mothers in primary health care settings in Rwanda

IntroductionAdolescent mothers require trauma- and violence-informed care during the perinatal period due to trauma histories and ongoing violence as a result of pregnancy. Nurses and midwives play a critical role in caring for adolescent mothers in primary healthcare settings in Rwanda in the perinatal period.PurposeTo explore the experiences of nurses and midwives working with adolescent mothers in selected primary healthcare settings in Rwanda to inform the delivery of trauma- and violence- informed care.MethodsThis study utilized an interpretive description qualitative approach and was conducted in eight primary healthcare settings in Rwanda. Twelve nurses and midwives working in perinatal services and four heads of health centers participated in in-depth individual interviews. Data were analyzed thematically.ResultsThe analysis revealed four main themes and 11 (sub-themes): (a) relational practice (being creative and flexible, “lending them our ears”); (b) individual challenges of providing care to adolescent mothers (lack of knowledge to provide care related to gender-based violence, and gendered experience); (c) factors contributing to workarounds (inflexible guidelines, lack of protocol and procedures, lack of nurses’ and midwives’ in service training, and the physical structure of the perinatal environment); and (d) vicarious trauma (living the feelings, “I carry their stories home,” and hypervigilance in parenting).ConclusionNurses and midwives find caring for adolescent mothers challenging due to their unique needs. These needs require them to be creative, adaptable, and attentive listeners to better understand their challenges. These practitioners face difficulties such as insufficient specific knowledge related to, for example, gender-based violence, inflexible guidelines, and a lack of protocols and training. Additionally, in the perinatal environment attention to the needs of practitioners in those settings is often lacking, and many nurses and midwives report experiencing vicarious trauma. Consequently, there is a pressing need for guidelines and protocols specifically tailored for the care of adolescent mothers. Ongoing trauma- and violence- informed care training and professional education should be provided to enhance the ability of nurses and midwives to care for adolescent mothers and prevent re-traumatization and mitigate vicarious trauma effectively.

Efforts to Improve Postpartum Maternal Behavior through Family-Centered Maternity Care (FCMC) about Postpartum Care Education

The role of parents is inseparable from the participation or cooperation between the mother and the family (husband) and other family members. An obstacle that is still found in the care of postpartum mothers is the assumption that postpartum mothers are sick mothers, their mobilization is inhibited, the type of food is restricted, the provision of colostrum breast milk is inhibited so that the needs of postpartum mothers are prioritized for full rest. The involvement of extended families in the care of babies has so far been misinterpreted, where the care of babies is left to other family members. After efforts to improve the behavior of postpartum mothers through Family Centered Maternity Care (FCMC) education, it is hoped that postpartum mothers can carry out postpartum care by involving the family. Implementation method with demonstration and discussion. The media used are baby phantoms, postpartum care booklets, LCDs, Laptops, and Projectors. The implementation of health education is carried out by visiting the home of postpartum mothers. The result of community service is that 90% of postpartum mothers can do postpartum care with family involvement. As well as from the results of monitoring and evaluation by way of meeting again by conducting home visits (home care) to postpartum mothers using instruments related to postpartum care. Based on the implementation of community service, it can be concluded that there is an increase in the behavior of postpartum mothers in postpartum care.

Impact of Kangaroo Mother Care on Severely Acute Malnourished Infants- A Comparative Hospital-Based Study

Impact of Kangaroo Mother Care on Severely Acute Malnourished Infants- A Comparative Hospital-Based Study

The Value of Emotional Intelligence in Midwifery: Enhancing Care and Outcomes for Mothers and Infants through Sustainable Development Goals and Leadership

Emotional Intelligence (EI), the ability to recognise, understand, and manage emotions in oneself and others, plays a crucial role in the field of midwifery. This article explores the value of EI in midwifery practice, highlighting its impact on maternal and infant outcomes, professional relationships, and job satisfaction among midwives. Through a comprehensive literature review and case studies, the article demonstrates how high levels of EI contribute to effective communication, empathy, and stress management, leading to improved care experiences for mothers and infants. The discussion includes practical strategies for developing EI skills among midwives and recommendations for integrating EI training into midwifery education and professional development programs. The article also connects the value of EI in midwifery to the Sustainable Development Goals (SDGs), emphasising its importance in achieving gender equality, health, and well-being. Furthermore, the role of leadership in fostering a culture of EI within midwifery practice is examined. The findings underscore the importance of EI as a key competency in midwifery, essential for fostering a supportive and responsive care environment aligned with global development goals.

PENGARUH PEMBERIAN SUSU KEDELAI TERHADAP PENINGKATAN PRODUKSI ASI PADA IBU POSTPARTUM

Maternal deaths occur after childbirth in around 60% of cases, and postpartum obstetric care with monitoring eliminates 50% of these deaths. The puerperium is a critical time for mothers. Breast milk is essential for preserving an infant's health and survival. Breastfeeding should begin as soon as possible, ideally in the first 30 to 60 minutes following delivery.The goal of the baby's suction on the mother's nipple is not to extract a large amount of milk. Soy milk or soy beans are commonly available and reasonably priced, and they can facilitate a smoother nursing experience. This study aimed to ascertain whether providing soy milk to postpartum moms could enhance their supply of breast milk. In this work, a case study methodology was combined with descriptive research techniques. Mrs. "D," who is receiving care at Hj. Bunda Halimah Hospital in Batam City, has an enhanced milk production that is measured by using observation sheet with LATCH scores. The results of the study after being given soy milk 2 times in 3 consecutive days with a LATCH score of 9 (good). The conclusion of midwifery care in postpartum mothers by giving soy milk times in 3 consecutive days has an effect on increasing Mrs. D's milk production

Identification of mothers with mental health problems is accidental: perceptions of health care providers on availability, access, and support for maternal mental health care for adolescent mothers in Malawi

BackgroundIntegration of maternal mental health into primary health care is considered a strategy to improve access to mental health support in low- and middle-income countries (LMICs). Health care workers’ (HCWs) and traditional practitioners’ (traditional healers, herbalists, traditional birth attendants, spiritual healers, prophets, and community health volunteers) perceptions of the availability and management of adolescent mothers’ maternal mental health care were explored in rural Malawi. Recognizing and identifying the barriers associated with access to maternal mental health support is essential to improving the mental health of adolescent mothers.MethodsA descriptive qualitative design (DQ) was used to explore HCWs’ and traditional practitioners’ perceptions of maternal mental health services for adolescent mothers. In-depth interviews were conducted with HCWs (n = 6), and three focus group discussions were conducted with 30 community-based traditional practitioners. Participants were purposefully recruited because they provide formal or informal health services to adolescent mothers during the postnatal period at Mitundu Rural Hospital and its catchment area in Lilongwe District, in Malawi. Interviews were analyzed using reflective thematic analysis and inductive thinking.ResultsThematic analysis found four themes to describe access to maternal mental health care for adolescent mothers. Participant perceptions were themed around health system challenges and how cultural background and beliefs influence access to mental health care and support. The themes were: (1) Inadequate staff development; (2) Limited resources (medication and infrastructure); (3) Limited policy and guidelines implementation; and (4) Cultural background and belief influence on help-seeking. HCWs suggested improving pre-service and in-service training to improve mental health assessment of mothers, while traditional practitioners wanted to increase their awareness of mental health issues.ConclusionParticipants emphasized that multifaceted factors influenced access to mental health support. These factors affect the assessment, treatment, and support of adolescent mothers and help-seeking by mothers. Therefore, strengthening the healthcare system and empowering providers with the knowledge and skills to recognize at-risk mothers and provide timely support is essential.

Postpartum Yoga on Fitness Postpartum Mother

Postpartum mothers experience physical and psychological changes, this greatly affects breast milk production and postpartum mother's fitness. Analyzing the effect of using the Postpartum Yoga movement on fitness in postpartum mothers and producing a proper Postpartum Yoga movement and its effective application so as to improve the welfare. quasi-experimental (Quasi Experiment Research) with Pre and Post Test approach with Control Group Design. This study involved a control group and a treatment group, 30 experimental and control groups of 30 respondents. The intervention given to the experimental group was postpartum yoga intervention 2 times for 2 weeks, while in the control group the standard of care for postpartum mothers was postpartum mothers who gave birth normally. The data were tested using the Wilcoxon test and the Mann-Whitney test. Postpartum yoga was effective in improving fitness (p-value 0.02) compared to the control group. Postpartum Yoga as an educational medium for holistic-based midwifery care during pregnancy and the puerperium, and its application is effective in improving fitness in postpartum mothers. It is recommended for postpartum mothers to use the Postpartum Yoga movement as an intervention to increase breast milk production and fitness in postpartum mothers.

Caregiving Ability of Mothers of Children With Cancer: Qualitative Content Analysis.

Childhood cancer confronts the child and the parents with considerable degrees of stress. Because caring for the child is mainly the role of the mother in most families, her ability to take care of the affected child is very important. To explore the caregiving ability of Iranian mothers who have children diagnosed with cancer. In this present study, which was conducted using the Directed Qualitative Content Analysis Method, 11 parents having children diagnosed with cancer and 5 professional caregivers working at the Department of Hematology and Oncology of Mofid Children Hospital in Tehran, Iran, were selected using purposeful sampling method. Data were collected through semistructured interviews. Data analysis was performed simultaneously with data collection using the Directed Content Analysis Approach. Five main categories emerged, namely, care exhaustion, care confusion, spiritual conflict, care competence, and care preparedness that represent the beneficiaries' perception of the caring ability of Iranian mothers of cancer-afflicted children. Study results revealed that the caregiving capacity of mothers nurturing cancer-stricken children can be evaluated across 5 domains, encompassing a spectrum of maternal requirements in child care. Improving these domains can elevate maternal caregiving proficiency, fostering self-care and enhancing care for the ailing child. A program can be developed based on the findings of the present study, in order to improve the caring ability of mothers of cancer-afflicted children, which results in improving the mother's care for her cancer-afflicted child.

Theophylline impact on weaning in oxygen-dependent infants followed in an outpatient Kangaroo Program.

Theophylline was an orally administered xanthine used for treatment of apnea of prematurity and Bronchopulmonary Dysplasia in ambulatory follow-up of Low-Birth-Weight infants (LBWI) with oxygen-dependency in the outpatient Kangaroo Mother Care Program (KMCP). Theophylline's main metabolic product is caffeine; therefore, it was an alternative due to the frequent lack of ambulatory oral caffeine in low and middle-income countries. To assess the effectiveness of oral theophylline in decreasing days with oxygen and to describe frequency of adverse related events. Quasi-experiment before and after withdrawal of theophylline given systematically to LBWI with ambulatory oxygen in two KMCPs. 729 patients were recruited; period 1: 319 infants when theophylline was given routinely and period 2: 410 infants when theophylline was no longer used. The theophylline cohort had less gestational age, less weight at birth, more days in Neonatal Intensive Care Unit, more days of oxygen-dependency at KMCP admission, and more frequencies of Intrauterine Growth Restriction and apneas. After adjusting with propensity score matching, multiple linear regression showed that nutrition was associated with days of oxygen-dependency, but theophylline treatment not. No differences were found in frequencies of readmissions up to 40 weeks, intraventricular hemorrhage or neurodevelopmental problems. Participants in period 2 had more tachycardia episodes. We did not find association between oral theophylline treatment and the reduction of days with ambulatory oxygen. For the current management of oxygen-dependency in LBW infants, the importance of nutrition based on exclusive breast feeding whenever possible, is the challenge.

The effect of kangaroo mother care on weight gain pattern in low birth weight premature babies at a tertiary care hospital

Abstract Background: Premature infants are at high risk of death. They need specialized incubatory care which is very costly and requires skilled workforce and specialized equipment. Kangaroo mother care (KMC) does the same job with no cost and does not require set-up as for incubatory care. It can prevent mortality and morbidity and also promotes bonding between mother and child. Objective: The objective of the study was to study the effect of KMC on weight gain pattern in low birth weight premature babies compared to incubatory care. Materials and Methods: A nonrandomized experimental study was carried out among 200 premature infants. They were divided into two groups of 100 each. Randomization was not done. One group was given KMC. The second group was given incubatory care. The weight of babies in both groups was measured with a digital weighing machine. Both groups were followed till the 9th day with a follow-up frequency of days – 1, 3, 5, 7, and 9. On each follow-up day, weight was recorded. Results: Both groups were comparable for gender, birth weight, and gestational age. In the KMC group, there was significant weight gain on day 2 compared to day 1 and on day 7 compared to day 6. But weight gain on day 3 compared to day 2 and on day 9 compared to day 8 was not significant. In the non-KMC group, there was significant weight gain on day 3 compared to day 2 and on day 9 compared to day 8. From 2nd day to 9th day, each day weight gain in the KMC group was higher compared to the non-KMC group. Conclusion: We conclude that the KMC significantly improved weight gain on a daily basis. The KMC also improved the weight gain compared to that of the non-KMC group. Hence, we recommend to create awareness among the community at all health-care levels and among health-care professionals on the benefits of KMC/the importance of KMC.