Randomized Control Trial of Kangaroo Mother Care in Low Birth Weight Babies at a Tertiary Level Hospital

Abstract

Introduction:This study was conducted to compare the effect of Kangaroo Mother Care (KMC) and conventional methods of care on weight gain, occurrence of hypothermia and apnea and duration of hospital stay among Low Birth Weight (LBW) babies. Materials and Methods: It was a randomized control trial conducted at a tertiary level hospital for a period of one year from June 2009 to May 2010. Total 126 stable LBW babies weighing less than 2000 gm and fulfilling inclusion criteria were included in the study. Neonates enrolled for the study were allocated to either KMC or control group using random number table. KMC group was subjected to Kangaroo mother care of at least six hours per day in not more than four sittings. In control group, babies were adequately clothed, covered and kept with their mother and if required were kept under radiant warmer. Recording of temperature in KMC group was done before, during and after KMC. In control group temperature was taken every 4 hours. Weighing of baby was done twice daily on electronic weighing scale. Results: Median daily weight gain (IQR) was 10 (6-20) gm in KMC group as compared to 7 (0-10) gm in control group (p<0.001). Mean weight gain was 12.11±9.04 gm in KMC group as compared to 3.29±15.81 gm in control group (p<0.001). Incidence of hypothermia was more in control group (12.6%) as compared to KMC group (3.1%) (p=0.048). Duration of hospital stay was less in control group as compared to KMC group (p=0.015). Conclusion: LBW babies less than 2000 gm who receive KMC show better weight gain and have less incidence of hypothermia than those who do not receive KMC.

Kangaroo mother care for clinically unstable neonates weighing ≤2000 g: Is it feasible at a hospital in Uganda?

“…The median age at enrolment was 25.3 hours, and neonates received a median duration of KMC ranging from 4.5 to 9.7 hours per day with a slight upward trend over time. This is comparable to findings from several RCTs, which reported me-dian daily durations of ≥4 to 10 hours with mean/median age at enrolment ranging from <1 to 4.7 days [15,[21][22][23][24]28]. Notably, despite nurse counselling, few neonates achieved the target KMC duration of 18 hours per day (two on day 1 and one on day 3).…”

“…Among 17 RCTs (14 enrolled only clinically stable neonates) comparing KMC with conventional care in low birthweight (LBW, <2500g) neonates aged <15 days, there was significant variability in how clinical stability was defined. Six defined this based on therapies [15][16][17][18][19][20], five on 'hemodynamic stability' [13,[21][22][23][24], and three on specific vital sign parameters [25][26][27], while three provided no definition at all [28][29][30]. Hence codifying stability criteria for KMC is critical.…”

Impact of continuous Kangaroo Mother Care initiated immediately after birth (iKMC) on survival of newborns with birth weight between 1.0 to < 1.8 kg: study protocol for a randomized controlled trial

“…A mother-infant pair is not eligible if any of the following is present: (1) the mother is younger than 15 years of age, (2) the mother (or her guardian if the mother is 15-17 years old) is unable or unwilling to provide consent, (3) the mother is unlikely to be able to provide KMC within the first 3 days after birth (e.g., she has eclampsia or shock or has undergone major surgery), (4) the baby is unable to breathe spontaneously within 1 h of birth, (5) triplets or more, (6) the baby has a congenital malformation that interferes with the intervention or the intervention interferes with the required care for the congenital malformation, (7) the place of residence is not a part of the defined study area (the study area has been defined to make 28-day follow-up home visit feasible), or (8) if for any reason the mother-infant pair cannot be enrolled within 2 h of the birth of the infant.…”

“…Preterm infants have fundamental challenges to maintain thermoregulation and become cold very rapidly after birth and to a great extent this can be prevented by SSC. Evidence shows that KMC reduces mortality, possibly by helping maintenance of better thermoregulation, facilitating the earlier initiation of breastfeeding, reducing the risk of nosocomial infection, reducing the risk of apneic attacks, and promoting bonding of the mother-infant dyad [8][9][10][11][12][13][14][15][16][17][18][19].…”

Newborn Health Interventions and Challenges for Implementation in Nepal

“…More than half of all newborn deaths reportedly occur due to perinatal complications ( 29 ), but in the given context, quality intra-partum care services is not being properly delivered ( 27 ). Furthermore, very few tertiary hospitals offer KMC services because of inadequately skilled health care providers and space in those facilities ( 30 , 31 ). Inadequate BEmONC and CEmONC sites in remote districts have resulted in poor coverage of services as well as poor practices in management of complications ( 4 ).…”