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There are more than 200 publications on KMC or skin to skin contact, which prove the beneficial effect of KMC. The various outcome variables studied include:

  • Mortality
    Four published randomized controlled trials (RCT) comparing KMC with conventional care have been conducted in low-income countries1-4. The results showed no difference in survival between the two groups. Although the evidence shows that KMC does not necessarily improve survival, it does not increase mortality. Since KMC is usually initiated after stabilization and most of the neonatal mortality has already occurred by then, KMC is unlikely to affect the neonatal mortality. There are no studies evaluating the use of KMC as the primary and initial modality in the care of low birth weight infants in the community.
  • Breast-feeding
    Four randomized controlled trails and a cohort study carried out in low-income countries looked at the effect of KMC on breast-feeding1,3,4,5. Three studies found that the method increased the prevalence and duration of breast-feeding. Effects were more dramatic in areas with low breast-feeding rates.
  • Thermal control & metabolism
    Four studies5-8 carried out in low-income countries showed that prolonged skin to skin contact between mother and her preterm/LBW infant provided effective thermal control and was associated with reduced risk of hypothermia.
  • Growth
    In one RCT, no difference in growth was observed at one year of age1. However two subsequent RCTs3,5 have shown that infants cared for by KMC have a slightly better daily weight gain during their hospital stay.
  • Serious morbidity
    Two RCTs have shown a lower rate of serious illness and hospitalization with use of KMC in first year of life1,4. However, there was no effect on mild to moderate infection.
  • Other effects
    KMC helps both infants and parents. Mothers have reported significantly less stress during kangaroo care than when baby is receiving conventional care. They have described a sense of empowerment, confidence and a feeling that they can do something positive for their preterm infants in different settings and cultures. Fathers too said that they feel relaxed, comfortable and contended while providing kangaroo care.
  • Acceptability
    KMC was acceptable to health-care staff, and the presence of mothers in the ward did not seem to be a problem5. Most health workers considered KMC to be beneficial.

References

  1. Charpak N, Ruiz-Pelaez JG, Figueroa de CZ, Charpak Y. A randomized controlled trail of kangaroo mother care: results of follow-up at 1 year of corrected age. Pediatrics. 2001 Nov; 108(5): 1072-9.
  2. Kambarami RA, Chidede O, Kowo DT. Kangaroo care versus incubator care in the management of well preterm infants- a pilot study. Ann Trop Paediatr. 1998 Jun; 18(2): 81-6.
  3. Cattaneo A, Davanzo R, Bergman N, Charpak N. Kangaroo mother care in low income countries. International Network in Kangaroo Mother Care. J Trop Pediatr. 1998 Oct;44(5):279-82.
  4. Sloan NL, Camacho LW, Rojas EP, Stern C. Kangaroo mother method: randomised controlled trial of an alternative method of care for stabalised low-birth weight infants. Maternidad Isidro Ayora Study Team. Lancet. 1994 Sep 17; 334(8925):782-5.
  5. Ramanathan K, Paul VK, Deorari AK, Taneja U, George G. Kangaroo Mother Care in very low birth weight infants. Indian J Pediatr. 2001 Nov;68(11):1019-23.
  6. Chwo MJ, Anderson GC, Good M, Dowling DA, Shiau SH, Chu DM. A randomized controlled trial of early kangaroo care for preterm infants: effects on temperature, weight , behaviour and acuity. J Nurs Res. 2002 Jun;10(2):129-42.
  7. Legault M, Goulet C. Comparison of kangaroo and traditional methods of removing preterm infants from incubators. J Obstet Gynecol Neonatal Nurs. 1995 Jul-Aug;24(6):501-6.
  8. Johanson RB, Spencer SA, Rolfe P, Jones P, Malla DS. Effects of post-delivery care on neonatal body temperature. Acta Paediatr. 1992 Nov;81(11):859-63.

EVIDENCE FOR KMC - EXPERERIENCE FROM INDIA

1: Indian J Pediatr. 2005 Jan;72(1):35-8.

Feasibility of kangaroo mother care in Mumbai.

Kadam S, Binoy S, Kanbur W, Mondkar JA, Fernandez A.
Lokmanya Municipal Medical College and General Hospital, Sion, Mumbai, India.
drsandeepkadam@yahoo.com

OBJECTIVE: The purpose of this study was to determine the feasibility and acceptability of kangaroo care in a tertiary care hospital in India.

METHODS: A randomized controlled trial was performed over one year period in which 89 neonates were randomized into two groups kangaroo mother care (KMC) and conventional method of care (CMC). RESULTS: Forty-four babies were randomized into KMC group and 45 to CMC. There was significant reduction in KMC vs CMC group of hypothermia (10/44 vs 21/45, p-value < 0.01), higher oxygen saturations (95.7 vs 94.8%, p-value < 0.01) and decrease in respiratory rates (36.2 vs 40.7, p-value < 0.01). There were no statistically significant ifferences in the incidence of hyperthermia, sepsis, apnea, onset of breastfeeding and hospital stay in two groups. 79% of mothers felt comfortable during the KMC and 73% felt they would be able to give KMC at home. KMC is feasible, as mothers are already admitted in hospitals and are involved in the care of newborn.

CONCLUSION: KMC is a simple and feasible intervention; acceptable to most mothers admitted in hospitals. There may be benefits in terms of reducing the incidence of hypothermia with no adverse effects of KMC demonstrated in the study. The present study has important implications in the care of LBW infants in the developing countries, where expensive facilities for conventional care may not be available at all place.

PMID: 15684446 [PubMed - in process]

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