Effect of Kangaroo Mother Care and Prone Position on Feeding Intolerance, Physiological Parameters, and Comfort among Preterm Neonates

Abstract

Background: Preterm neonates have an increased vulnerability to feeding intolerance problem and distress in Neonatal Intensive care unit, and they considered the most common significant donators to neonates' growth retardation. therefore, it is pivotal for neonatology nurses to detect this condition as early as possible and find effective intervention for confronting this problem to enhance neonates' outcomes. Kangaroo Mother Care and prone positions are therapeutic nursing modalities that may be effective for the protection from feeding intolerance and improve neonates' comfort in NICU. This study aimed to investigate the effect of kangaroo mother care and prone position on gastrointestinal intolerance, physiological parameters, and comfort in preterm neonates. A quasiexperimental research design was conducted to this study. Setting: This study was conducted in Neonatal Intensive Care Unit (NICU) at Alexandria University Children's Hospital (AUCH) at Smouha in Alexandria. Sampling: A convenience sample of 60 preterm neonates more than 130000 gm. hospitalized in NICU from March 2020 to March 2021.Four tools were used to collect the necessary data for this study: Tool1: Preterm Neonates' Characteristics and Their Mothers Assessment Record, Tool II: feeding intolerance and NEC risk-scoring tool, Tool III: feeding intolerance assessment sheet and Tool IV: COMFORT neo scale. Results: statistically significant differences were found between the 1st day and 3 rd day concerning feeding intolerance parameters in the study group regarding the means of the abdominal circumference (P=0.000), the frequency of vomiting episodes (P=0.000), the frequency of defecation (P==<.001) and daily weight gain (P=.003). Additionally, improvement in the neonates' gastric residual volumes among both groups of study with no statistically significant differences were found. KMC and prone positions recorded more stability in physiological parameters than control group in the study. Fortunately, intervention group exhibited high significant comfort levels on three days of study in comparison with control group (P= 0.000). It is concluded that KMC and prone positions may reduce preterm neonates' gastric residual volume, frequency of vomiting episodes, and abdominal circumferences while increasing their daily weight gain and frequency of defecation. This study advised NICU nurses to emphasize the value of applying KMC and prone positions as a safe non-invasive intervention for preterm neonates.

Effect of Kangaroo Mother Care Discharge Guide Program on Mothers and Preterm Neonates Outcomes

“…Increasing temperatures, particularly for LBW and premature neonates with a tendency to hypothermia is beneficial and improves the treatment outcomes. With heat loss, the metabolic rate and oxygen demand rise, which causes physiological and metabolic instability, homeostatic issues, an aggravation of apnea, and impaired weight gain (Badr, Mabrouk and El-Shater, 2022). This confirms that KMC is one of the cost-effective therapies which are a simple yet effective way to reduce many complications, especially in LBW neonates.…”

“…KMC is defined as a method of holding a small nappy neonate in skin-to skin contact, prone and upright on the mother's chest. The neonate is enclosed in maternal clothing in order to maintain temperature stability (Badr, Mabrouk &El-Shater, 2022 andBadiee, Faramarzi &MiriZadeh, 2014). According to WHO, KMC is defined as early, continuous and prolonged skin-to-skin contact between mother and baby, frequent and exclusive breastfeeding and early discharge from hospital with the father or parents acting as kangaroo care providers (Cañadas, Perales, Martínez, Casado-Belmonte and Carreño, 2022).…”

The impact of an educational intervention on neonatal intensive care unit nurses’ knowledge, attitudes, and perceptions of parental participation in kangaroo mother care

“…Its implementation and the resulting high level of outcomes may result in decreasing the mortality rates by around 40% [ 5 ]. Neonatal health problems associated with low-birth weight neonates, such as sepsis, can be prevented by KMC and breastfeeding, as the literature confirms [ 6 , 7 ]. Moreover, in the previously mentioned locations, such as South Asia, KMC has been widely studied and confirmed to bring about huge health developments.…”