Intermittent kangaroo mother care and the practice of breastfeeding late preterm infants: results from four hospitals in different provinces of China

Abstract

Background: China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. Methods: Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the "KMC group", those who did not were enrolled in the "No KMC group". Basic maternal sociodemographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. Results: Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 h before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR = 2.15 (95% CI 1.53, 3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR = 1.61 (95% CI 1.15, 2.25)), be exclusive breast milk feeding at follow-up (OR = 2.55 (95% CI 1.81, 3.61)), and use breastfeeding method at follow-up (OR = 2.09 (95% CI 1.44, 3.02)).

Effectiveness of Kangaroo Mother Care by Role-Playing Method on Mother’s Resilience and Breastfeeding Self-Efficacy in Neonatal Intensive Care Unit, a Randomized Controlled Trial

“…Consistent with the present study, Yilmaz et al state that KMC is effective in promoting breastfeeding self-e cacy and they recommend that KMC to participate mothers in care of their infants and create a sense of empowerment in them and consequently help better development of infants [22]. Our study results are consistent with previous evidence from published literature that frequent skin-to skin contact between mother and infant is crucial to the successful transition to direct breastfeeding in preterm infants [6, 23,31] and initiation of exclusive breastfeeding in healthy full-term infants [22,23] One of the notable limitations of the present study was the small sample size of the participants in the study. Therefore, it is recommended to conduct similar studies in the coming years in different communities, and with larger sample size.…”

“…In this regard, the study of Zhang et al Showed mothers in the intervention group (KMC) reported more frequency and quality of breastfeeding than the control group. Therefore, it can be said that kangaroo care has signi cantly improved the number and quality of breastfeeding in mothers of premature infants [23]. Which is consistent with the present study, but in the present study, the mean score of breastfeeding self-e cacy was better in the control group (routine care with manual training) and the role-playing group A possible reason for this difference could be a difference in how is taught KMC.…”

“…Following these chemical happenings, the body can increase the mother's sense of calm, vitality, and pain tolerance, and reduces the mother's stress, anxiety, and worry [18]. Although there are many studies in these areas, few studies have examined the effects of kangaroo care on mothers of infants, especially mothers of preterm infants admitted to the neonatal intensive care unit [7,16,19] 2019) have reported that kangaroo care increases mothers' con dence in caring for their babies [21][22][23]. These studies also revealed that mothers needed less help with breastfeeding and reported more breastfeeding self-e cacy [22].…”

Maternal Experience of Intermittent Kangaroo Mother Care for Late Preterm Infants: A Mixed-Methods Study in Four Postnatal Wards in China

“…Late preterm infants are at a higher risk of mortality and morbidity than term infants (8) and have lower rates of breastfeeding (9). KMC could bring potential bene ts to late preterm newborns and their mothers including improved breastfeeding rates and better maternal recovery from birth-related fatigue (6,(10)(11)(12)(13)(14). The challenges of introducing, initiating and continuing kangaroo mother care on postnatal wards could differ from those faced on neonatal units with early preterm newborns.…”

“…In this study, we used a concurrent mixed-methods approach including quantitative maternal questionnaires and qualitative semi-structured interviews. Detailed information on our approach to quantitative and qualitative data collection has been described in other publications (5,6). The focus of the current analysis differs from our previously published papers which focused on breastfeeding and barriers and facilitators for KMC adoption.…”