Impact of season and discharge weight on complications and growth of Kangaroo Mother Care treated low birthweight infants in Mozambique

Abstract

This study aimed to determine the impact of season and weight at discharge on growth rate and complications in low birthweight infants treated with Kangaroo Mother Care (KMC) in Maputo, Mozambique. The study population included 246 infants of birthweight < 2000 g. Follow‐up until 2400 g was obtained in 64%. There were no seasonal differences in weight gain and the risk of complications of infants treated with KMC in hospital. During the cold season after discharge, the risk of serious complications, including death, was higher (risk ratio 1.96; p= 0:02) and more readmissions occurred (risk ratio 2.77; p= 0:04). We postulate that after discharge mothers are unable to comply with the kangaroo position at all hours of the day and that exposure to low ambient temperatures may explain the more frequent occurrence of complications in the cold season. The weight at discharge did not affect complications or growth rate. We conclude that the current policy to discharge infants when having gained weight on 3 consecutive days, regardless of the actual weight, or whether the weight at birth has been regained, is adequate. In the cold season particularly, more efforts may be needed to ensure compliance with kangaroo position after discharge and to educate mothers on early signs of complications such as bronchopneumonia to encourage timely care seeking. With this method, low birthweight infants can grow adequately.

Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India

“…Our use of a low-reading thermometer and a more inclusive definition of hypothermia (<36.51C), as well as lower ambient winter temperatures in the study area, may explain, in part, the higher rates of hypothermia reported in our study. Lincetto et al 28 found that the risk of complications after discharge of newborns who had been managed in the hospital with KMC was greater in the cold season, which they attributed to exposure to low ambient temperatures. Baby is more relaxed while listening to mother's heartbeat Mothers were advised to practice STSC for as long and as often as possible, but were not given a prescription but rather were given freedom to adapt the practice to their lifestyle No perceived adverse effects…”

Translating research findings into practice – the implementation of kangaroo mother care in Ghana

“…Since the introduction of KMC more than 30 years ago in Bogotá Colombia, different forms of KMC practice have spread across the world. In the 1980s and 1990s, KMC was introduced in African countries such as Ethiopia [5], Mozambique [6], South Africa [7], and Zimbabwe [8,9], mostly in teaching hospitals with no further scale-up to lower levels of care.…”

The relation between early mother–infant skin‐to‐skin contact and later maternal sensitivity in South African mothers of low birth weight infants

“…Studies have shown that compared to newborns who do not have SSC with their mothers, newborns with SSC have more stable temperatures, heart rates, respiratory rates, and gastrointestinal adaptation (Bauer, Sontheimer, Fischer, & Linderkamp, 1996;Cleary, Spinner, Gibson, & Greenspan, 1997;Conde-Agudelo, Diaz-Rossello, & Belizen, 2000;Fohe, Kropf & Avenarius, 2000;Ludington-Hoe, Anderson, Swinth, Thompson, & Hadeed, 2004;Moore, Anderson, & Bergman, 2007). The infants' sleep is more restful (Feldman & Eidelman, 2003;Messmer et al, 1997), they cry less (Christensson et al, 1992;Christensson, Cabrera, Christensson, Uvnas-Moberg, & Winberg, 1995;Ferber & Makhoul, 2004;Michelsson, Christensson, Rothganger, & Winberg, 1996), grow faster (Bergman & Jurisoo, 1994;Lincetto et al, 1998;Rojas et al, 2003), breastfeed longer (Charpak, Ruiz-Pelaez, Figueroa, & Charpak, 2001;Meyer & Anderson, 1999), experience less pain from routine procedures (Gray, Miller, Philipp, & Blass, 2002;Gray, Watt, & Blass, 2000), and go home sooner from the hospital (Cattaneo et al, 1998;Charpak, Ruiz-Pelaez, Figueroa, & Charpak, 1997;Charpak et al, 2001), thereby saving money for hospitals and health systems. Most of the research on the benefits of SSC to infants has been conducted exclusively in the newborn period.…”