Kangaroo mother care linked to better neonatal outcomes

1. Low birth weight newborns receiving kangaroo mother care (KMC) had 36% lower mortality compared to those receiving conventional care. These neonates also had lower rates of sepsis, hypothermia, hypoglycemia, and hospital readmission.

2. Infants receiving KMC also had lower mean respiratory rates and pain measures. They had higher oxygen saturation, temperature, and head circumference growth, as well as increased rates of exclusive breastfeeding.

Evidence Rating Level: 2 (Good)

Study Rundown: Low birth weight and preterm infants are at increased risk of both short and long term complications, including higher rates of mortality, chronic disease, and developmental delay. Kangaroo mother care (KMC), or early, continuous skin-to-skin contact (SSC) between the neonate and mother, is an effective, low cost, and easily available method shown to have beneficial effects on neonatal health. This systematic review attempts to uncover a more comprehensive understanding of the effects of KMC/SSC on neonatal outcomes. This meta-analysis included 124 studies and showed significant decreases in negative outcomes of low birth weight neonates receiving KMC. Specifically, mortality rates of infants receiving KMC were lower compared with those receiving conventional care. KMC also increased the rates of exclusive breastfeeding, infant temperature, head circumference growth, and oxygen saturation. Risk of neonatal sepsis was lower in KMC infants. Finally, infants receiving KMC had lower respiratory rates, and hospital readmission rates. Infants receiving SSC during painful procedures had lower pain scores compared to those with conventional care. The implications of this study indicate the need to increase the use of KMC in all deliveries, but especially those of low birth weight and preterm infants. While this study indicates clear benefits of SSC and KMC, it is limited by the heterogeneity of the criteria used to describe the 2 methods.

Click to read the study, published today in Pediatrics

Relevant Reading: A randomized, controlled trial of kangaroo mother care: results of follow-up at 1 year of corrected age

Study Author, Dr. Ellen O. Boundy, MS, ScD, talks to 2 Minute Medicine: Harvard R,H, Chan School of Public Health, Department of Epidemiology, Boston, Massachusetts.

“Our study offers a comprehensive summary of the evidence on Kangaroo Mother Care, or skin-to-skin contact between mothers and babies after birth, which we found improved numerous neonatal outcomes.  Integration of this low-cost intervention into routine neonatal care could benefit all newborns, and in particular offers the potential to make a significant impact on outcomes for preterm and low birth weight infants.”

In-Depth [meta-analysis]: A total of 124 randomized trials and observational studies were included, 89% of which were published between 2000 and 2014 and all of which met inclusion criteria, including methodologic strength analyzed by 2 independent reviewers. The definition of KMC included, at a minimum, SSC between parent and child. At latest follow up time among low birth weight infants <2000g, KMC lowered mortality by 36% (95% CI 0.46 to 0.89). Onset of SSC, whether before or after infant stability criteria were met, did not significantly affect outcomes. Exclusive breastfeeding at discharge or full term age was increased by 50% in infants receiving KMC (95% CI 1.26 to 1.78), and at 1-4 month follow up KMC had increased likelihood of exclusive breastfeeding by 39% (95% CI 1.11 to 1.74). KMC was associated with 47% lower risk of infant sepsis (95% CI 0.34 to 0.83). Compared to controls, infants receiving KMC had a respiratory rate of 3 breaths lower (95% CI -5.15 to -1.19) and oxygen saturation 0.9% higher (95% CI 0.35 to 1.45). Head circumference growth among KMC infants was 0.19 cm per week higher than among controls (95% CI 0.01 to 0.37). KMC was also associated with better temperature maintenance: 78% lower risk of hypothermia (95% CI 0.12 to 0.41) and 23% lower risk of hyperthermia (95% CI 0.59 to 1.01). In 2 studies, KMC decreased readmission rates by 58% (95% CI 0.23 to 0.76). Infants receiving SSC during painful procedures had lower pain scores compared to those with conventional care (95% CI -1.09 to -0.16).

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