Immediate “Kangaroo Mother Care” and Survival of Infants With Low Birth Weight

Arya, Sugandha; Naburi, Helga; Kawaza, Kondwani; Newton, Suzanne; Anyabolu, Chineme Henry; Bergman, Nils; Rao, Sandhya; Mittal, Parul; Assenga, Evelyne; Gadama, Luis; Larsen-Reindorf, Roderick; Kuti, Oluwafemi; Linnér, Agnes; Yoshida, Shiko; Chopra, Neha; Ngarina, Matilda; Msusa, Ausbert Thoko; Boakye-Yiadom, Adwoa Pokuaa; Kuti, Bankole Peter; Morgan, Beverly C.; Minckas, Nicole; Suri, Jyotsna; Moshiro, Robert; Samuel, Samuel; Wireko-Brobby, Naana; Rettedal, Siren; Jaiswal, Harsh Vardhan; Sankar, Mari Jeeva; Nyanor,; Tiwary, Hiresh; Anand, Prabha; Manu, Alexander; Nagpal, Kamal; Ansong, Daniel; Saini, Lalit Mohan; Aggarwal, Kailash Chandra; Wadhwa, Neelam; Bahl, Rachna; Westrup, Björn; Adejuyigbe, E A; Plange‐Rhule, Gyikua; Dube, Queen; Chellani, Harish; Massawe, Augustine

doi:10.1097/01.aoa.0000796200.17421.fe

Cited by 16 publications

(49 citation statements)

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“…While a Cochrane review (2016) showed that KMC initiated after clinical stabilization reduces mortality by 40% [6], evidence of the effect of initiating KMC immediately after birth without waiting for babies to become stable was unavailable until recently. This research question was addressed by a multicountry, randomized, controlled trial (iKMC study) co-ordinated by WHO [14]. This trial was conducted in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania.…”

Section: Kangaroo Mother Care and Low-birth-weight Newbornsmentioning

confidence: 99%

“…In the iKMC study, the median daily duration of skin-to-skin contact in the neonatal intensive care unit was 16.9 h (interquartile range, 13.0 to 19.7) in the MNCU and 1.5 h (interquartile range, 0.3 to 3.3) in the conventional NICU [14].…”

Section: Prolonged Continuous Effective Kmcmentioning

confidence: 99%

“…Babies can be put to the breast earlier for non-nutritive sucking (NNS), which helps babies to develop reflexes faster and improves milk output of the mother by stimulating prolactin reflex. In the iKMC study, breast-milk feeding was initiated within the first 24 h after birth in 58.5% of infants in the MNCU and in 45.5% of infants in the conventional NICU; full breast-feeding occurred within 7 d in 78.4% infants in MNCU vs. 69.0% of infants in conventional NICU [14].…”

Section: Higher Breast-milk Feeding Ratesmentioning

confidence: 99%

“…Neonatal deaths in the first 28 d of life occurred in 191 of 1596 infants in the intervention group (12.0%) and in 249 of 1587 infants in the control group (15.7%) [relative risk of death, 0.75; 95% confidence interval (CI), 0.64 to 0.89; p = 0.001], i.e. 25% less risk of mortality in MNCU as compared to NICU [14]. This implies that 1,50,000 neonatal deaths can be prevented globally if this model of care is adopted.…”

Section: Outcomes In Mncumentioning

confidence: 99%

“…Besides India, other countries which participated in iKMC study were Ghana, Nigeria, Malawi, and Tanzania [14]. Most of these sites had experience similar to that of India.…”

Section: Experience From Other Countriesmentioning

confidence: 99%

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Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

et al. 2022

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While a Cochrane review (2016) showed that kangaroo mother care (KMC) initiated after clinical stabilization reduces mortality by 40%, evidence of the effect of initiating KMC immediately after birth without waiting for babies to become stable was unavailable until recently. This research gap was addressed by a multicountry, randomized, controlled trial co-ordinated by WHO. This trial was conducted in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania. Implementation of this trial led to development of the “mother–newborn care unit (MNCU).” Mother–newborn care unit or mother–newborn intensive care unit (M–NICU) is a facility where sick and small newborns are cared with their mothers 24 × 7 with all facilities of level II newborn care and provision for postnatal care to mothers. The mother is not a mere visitor, but she has her bed inside the special newborn care unit (SNCU)/newborn intensive care unit (NICU) and as a resident of MNCU, becomes an active caregiver and is involved in continuum of neonatal care. The study results show that intervention babies in MNCU had 25% less mortality at 28 d of life, 35% less incidence of hypothermia, and 18% less suspected sepsis as compared to control babies cared in conventional NICU. World Health Organization is in the process of reviewing the current recommendations on care of preterm or LBW newborns considering new evidence that has become available. However, it would require national policy change to permit mother and surrogate in SNCU/NICU 24 × 7, making the concept of zero-separation a reality.

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Section: Kangaroo Mother Care and Low-birth-weight Newbornsmentioning

confidence: 99%

Section: Prolonged Continuous Effective Kmcmentioning

confidence: 99%

Section: Higher Breast-milk Feeding Ratesmentioning

confidence: 99%

Section: Outcomes In Mncumentioning

confidence: 99%

“…Besides India, other countries which participated in iKMC study were Ghana, Nigeria, Malawi, and Tanzania [14]. Most of these sites had experience similar to that of India.…”

Section: Experience From Other Countriesmentioning

confidence: 99%

See 3 more Smart Citations

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

et al. 2022

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Systematic Review of Kangaroo Care Duration's Impact in Neonatal Intensive Care Units on Infant–Maternal Health

et al. 2022

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Kangaroo care (KC), skin-to-skin contact between neonates and caregivers, is encouraged in neonatal intensive care units (NICUs) to support health benefits such as improved weight, growth, and maternal-infant attachment while reducing incidence of sepsis and neonate pain. However, the optimal duration and frequency of KC time to maximize health outcomes is unknown. Given parents’ time stressors, identifying optimal KC time is critical. A literature review was undertaken via querying the PubMed® database from January 1, 1995 to May 28, 2021 regarding KC and NICUs with 442 results. Eleven studies met eligibility criteria of (1) comparative KC between neonates and adult caregivers in NICUs as a randomized controlled trial, (2) peer-reviewed articles in English (3) study subjects ≥5, (4) health outcomes and (5) kangaroo care sessions >1. Further study of KC duration and frequency as related to health outcome dose-response relationships would help determine how much KC time is needed to improve health.

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Breastfeeding support for mothers of low birth weight infants using mother-to-mother peers in rural western Kenya - a feasibility study

Dickinson

Achieng

K’Oloo

et al. 2023

Preprint

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The majority of the 2.4 million neonates (infants<28 days) who died in 2020 were born weighing <2500g i.e. low birth weight (LBW). In Africa, approximately 1 in 10 neonates are LBW. The majority of those who survive beyond the neonatal period are undernourished, have neuro-developmental impairment, or die before their second birthday. Unaddressed feeding difficulties contribute significantly to these adverse outcomes. This study assessed the feasibility and acceptability of using trained mother-to-mother peers (peer-mothers) to deliver breastfeeding support to mothers of LBW infants in healthcare facilities in rural Kenya.A mixed methods approach was employed, using structured observations, and pre- and post-intervention semi-structured interviews, with mothers, healthcare providers and peer-mothers. Six trained peer-mothers delivered the interventions to the mother-LBW infant pairs across eight healthcare facilities in Homa Bay County. Descriptive statistics were used to analyse the quantitative data and thematic analysis for the qualitative data.From September-November 2021, 23 mothers and 26 LBW infants were recruited and received the intervention. All infants were born in a hospital, the median age of the infants was 1 day (Interquartile range, IQR 1,3), birth weight 2100g (IQR 1900, 2260) and recorded gestation 34 weeks (IQR 34,36). Although all mothers looked well, 4 (17%) showed no signs of bonding with their infant. One infant was too weak to suckle and was referred to healthcare providers. Key themes were challenges with infant feeding decision-making among mothers of LBW infants, community misconceptions of recommended infant feeding practices for LBW infants, and the integral role of peer-mothers in maternity units.Facility-based, breastfeeding peer support for LBW infants was feasible and acceptable in the context of resource constraints. It could improve uptake of appropriate infant feeding practices among these vulnerable infants and enhance their post-discharge survival and growth outcomes. This strategy warrants further evaluation in a larger study.

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Immediate “Kangaroo Mother Care” and Survival of Infants With Low Birth Weight

Cited by 16 publications

References 0 publications

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

Mother-Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns

Systematic Review of Kangaroo Care Duration's Impact in Neonatal Intensive Care Units on Infant–Maternal Health

Breastfeeding support for mothers of low birth weight infants using mother-to-mother peers in rural western Kenya - a feasibility study

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