Document Type : Original article
Author
pediatrician-sub specialist of pediatric infectious diseases-MPH-Medical assistant professor-Iran Ministry of health and medical education-Mashhad medical university, Mashhad, Iran
Abstract
Background: Approximately 20 million low-birth-weight infants are annually born worldwide. Prematurity and low birth weight are significantly linked to infant mortality rates. Neonates in neonatal intensive care units are often separated from their mothers, leading to a lack of parental involvement in care, which poses numerous risks and threats.Kangaroo mother care has been identified as an alternative method that can mitigate these risks.
Methods: This semi-experimental clinical trial examined the effects of independent variables (kangaroo mother care and incubator care) on dependent variables (body temperature, weight gain, exclusive breastfeeding, and physiological measures) in 130 low birth weight infants admitted to the neonatal intensive care unit at Tehran Imam Hussein Hospital during 2019-2020.
Results: This study observed an increase in maternal presence at the hospital. There were no significant differences between the two groups of mothers in terms of quantitative variables such as maternal age, number of pregnancies, and length of maternal hospital stay post-delivery. The average duration of kangaroo mother care was 12 ± 8.7 days, No differences were found between the two groups in variables such as gestational age, Apgar score, and weight and height at birth, at stability, and at discharge.
Conclusion: This study demonstrated that kangaroo mother care reduces mortality, promotes exclusive breastfeeding, enhances emotional bonding between parents and neonates, reduces sepsis and patent ductus arteriosus, and shortens the duration of antibiotic use. This study supports the development of guidelines for educational programs to incorporate this alternative care method in neonatal intensive care units.
Keywords
- Technical Working Group on Essential Newborn Care (1994 : Trieste, Italy)& World Health Organization. Maternal and Newborn Health / Safe Motherhood Unit. (1996). Essential newborn care : report of a technical working group (Trieste, 25-29 April 1994). World Health Organization. Link
- Ashworth A. Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. Eur J Clin Nutr. 1998 Jan;52 Suppl 1:S34-41; discussion S41-2. PMID:
- Rey ES, Martinez HG. Manejo racional del niño prematuro. In: Universidad Nacional, Curso de Medicina Fetal, Bogotá, Universidad Nacional, 1983. Link
- World Health Organization. Maternal Health and Safe Motherhood Programme & Meeting of Technical Working Group on Thermal Control of the Newborn (1992 : Geneva, Switzerland). (1993). Thermal control of the newborn: a practical guide. World Health Organization. Link
- Shiau SH, Anderson GC. Randomized controlled trial of kangaroo care with fullterm infants: effects on maternal anxiety, breastmilk maturation, breast engorgement, and breast-feeding status. Paper presented at the International Breastfeeding Conference, Australia’s Breastfeeding Association, Sydney, October 23-25, 2020. Link
- Cattaneo A, Davanzo R, Uxa F, Tamburlini G. Recommendations for the implementation of Kangaroo Mother Care for low birthweight infants. International Network on Kangaroo Mother Care. Acta Paediatr. 1998 Apr;87(4):440-5. doi:1080/08035259850157066.
- Cattaneo A, et al. Kangaroo mother care in low-income countries. Journal of Tropical Pediatrics, 1998, 44:279-282. Link
- Anderson GC. Current knowledge about skin-to-skin (kangaroo) care for preterm infants. J Perinatol. 1991 Sep;11(3):216-26. PMID:
- Charpak N, Ruiz-Peláez JG, Figueroa de Calume Z. Current knowledge of Kangaroo Mother Intervention. Curr Opin Pediatr. 1996 Apr;8(2):108-12. doi:1097/00008480-199604000-00004. PMID: 8723803.
- Ludington-Hoe SM, Swinth JY. Developmental aspects of kangaroo care. J Obstet Gynecol Neonatal Nurs. 1996 Oct;25(8):691-703. doi:1111/j.1552-6909.1996.tb01483.x. PMID: 8912220.
- Bergman NJ, Jürisoo LA. The 'kangaroo-method' for treating low birth weight babies in a developing country. Trop Doct. 1994 Apr;24(2):57-60. doi:1177/004947559402400205. PMID: 8009615.
- Lincetto O, Nazir AI, Cattaneo A. Kangaroo mother care with limited resources. J Trop Pediatr. 2000 Oct;46(5):293-5. doi: 1093/tropej/46.5.293. PMID: 11077939.
- Charpak N, Ruiz-Peláez JG, Figueroa de C Z, Charpak Y. Kangaroo mother versus traditional care for newborn infants </=2000 grams: a randomized, controlled trial. Pediatrics. 1997 Oct;100(4):682-8. doi:1542/peds.100.4.682. PMID: 9310525.
- Cattaneo A, Davanzo R, Worku B, Surjono A, Echeverria M, Bedri A, Haksari E, Osorno L, Gudetta B, Setyowireni D, Quintero S, Tamburlini G. Kangaroo mother care for low birthweight infants: a randomized controlled trial in different settings. Acta Paediatr. 1998 Sep;87(9):976-85. doi:1080/080352598750031653. PMID: 9764894.
- Charpak N, et al. Kangaroo-mother programme: an alternative way of caring for low birth weight infants? One year mortality in a two-cohort study. Pediatrics, 1994, 94:804-810. PMid:7970993
- Schmidt E, Wittreich G. Care of the abnormal newborn: a random controlled trial study of the “kangaroo method” of care of low birth weight newborns. In: Consensus Conference on Appropriate Technology Following Birth, Trieste, 7-11 October 1986. WHO Regional Office for Europe.
- Hurst NM, Valentine CJ, Renfro L, Burns P, Ferlic L. Skin-to-skin holding in the neonatal intensive care unit influences maternal milk volume. J Perinatol. 1997 May-Jun;17(3):213-7. PMID:
- Kambarami RA, Chidede O, Kowo DT. Kangaroo care versus incubator care in the management of well preterm infants: a pilot study. Annals of Tropical Pediatrics, 1998, 18:81-86.PMid:9924567
- Acolet D, Sleath K, Whitelaw A. Oxygenation, heart rate and temperature in very low birth weight infants during skin-to-skin contact with their mothers. Acta Paediatrica Scandinavica, 1989, 78: 189-193. PMid:2929342
- de Leeuw R, et al. Physiologic effects of kangaroo care in very small preterm infants. Biology of the Neonate, 1991, 59:149-155. PMid:2054424
- Fischer C, et al. Cardiorespiratory stability of premature boys and girls during kangaroo care. Early Human Development, 2020, 52:145-153. PMid:9783816
- Affonso DD, Wahlberg V, Persson B. Exploration of mothers' reactions to the kangaroo method of prematurity care. Neonatal Netw. 1989 Jun;7(6):43-51. PMID:
- Affonso D, Bosque E, Wahlberg V, Brady JP. Reconciliation and healing for mothers through skin-to-skin contact provided in an American tertiary level intensive care nursery. Neonatal Netw. 1993 Apr;12(3):25-32. PMID:
- Legault M, Goulet C. Comparison of kangaroo and traditional methods of removing preterm infants from incubators. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2021, 24:501-506. PMid:7562132
)