Kangaroo Mother Care To Reduce Morbidity and Mortality in Low Birthweight Infants

Latin American Center for Perinatology and Human Development, Pan American Health Organization, World Health Organization, Hospital de Clinicas, piso 16, Casilla de Correo 627, Montevideo, Uruguay.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2003; 3(2):CD002771. DOI: 10.1002/14651858.CD002771
Source: PubMed


Kangaroo mother care (KMC) is an effective and safe alternative to conventional neonatal care in low birthweight (LBW) infants mainly in resource-limited countries. Low birthweight (LBW) (less than 2500 g) is associated with an increased risk of neonatal morbidity and mortality, neurodevelopmental disabilities, and cardiovascular disease at adulthood. Conventional neonatal care of LBW infants is expensive and needs both highly skilled personnel and permanent logistic support. The major component of KMC is skin-to-skin contact (SSC) between a mother and her newborn. The other two components of KMC are frequent and exclusive or nearly exclusive breastfeeding and attempt of early discharge from hospital. Compared with conventional neonatal care, KMC was found to reduce mortality at discharge or 40-41 weeks' postmenstrual age and at latest follow up, severe infection/sepsis, nosocomial infection/sepsis, hypothermia, severe illness, lower respiratory tract disease, and length of hospital stay. Moreover, KMC increased weight, head circumference, and length gain, breastfeeding, mother satisfaction with method of infant care, some measures of maternal-infant attachment, and home environment. There were no differences in neurodevelopmental and neurosensory outcomes at one year of corrected age.

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Available from: José M Belizán, Jan 29, 2014
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    • "However, adverse outcomes in preterm infants remain high. There are several reports of positive impact of non-medical interventions on outcomes following neonatal intensive care (Als et al., 1994, 2012, Conde-Agudelo et al., 2011, Feldman et al., 2002, 2006, 2010, Vickers et al., 2004), although comprehensive assessments of these interventions suggest that they have limited usefulness in resolving problems of long-term outcome (Ohlsson and Jacobs, 2013, Symington and Pinelli, 2006). The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) focuses on providing care of NICU infants tailored to their observed neurobehavioral characteristics (Als et al., 1994). "
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    ABSTRACT: To assess the impact of Family Nurture Intervention (FNI) on cortical function in preterm infants at term age METHODS: FNI is a NICU-based intervention designed to establish emotional connection between mothers and preterm infants. Infants born at 26-34 weeks postmenstrual age (PMA) were divided into two groups, Standard Care (SC, N=49) and FNI (FNI, N=56). Infants had EEG recordings of ~1 hour duration with 124 lead nets between 37 and 44 weeks PMA. Coherence was measured between all pairs of electrodes in 10 frequency bands. Data were summarized both within and between 12 regions during two sleep states (active, quiet) RESULTS: Coherence levels were negatively correlated with PMA age in both groups. As compared to SC infants, FNI infants showed significantly lower levels of EEG coherence (1 to 18 Hz) largely within and between frontal regions. Coherence in FNI infants was decreased in regions where we previously found robust increases in EEG power. Since coherence decreases with age, results suggest that FNI may accelerate brain maturation particularly in frontal brain regions, which have been shown in research by others to be involved in regulation of attention, cognition and emotion regulation; domains deficient in preterm infants. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta paediatrica (Oslo, Norway: 1992). Supplement 03/2015; 104(7). DOI:10.1111/apa.13007
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    • "Within neonatology, FCC has evolved into an extensive spectrum of services and activities incorporating a range of environmental, educational, psycho-social and behavioral characteristics all of which seek to place the family at the heart of care planning [3] [4] [5]. In the last two decades, FCC based interventions have been developed to support the parent–child attachment relationship [6] [7] [8] [9]. There is convincing evidence about the positive effects of Kangaroo Mother Care [9] [10] [11], but studies suggest there are huge differences in the provision of facilities to enable skinto-skin care and parental involvement [12] [13]. "
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    ABSTRACT: Objective To explore mothers' perceptions of Family Centred Care (FCC) in Neonatal Intensive Care Units (NICUs) in England. Design The qualitative experiences of 12 mothers from three NICUs in the UK were elicited using individual interviews. A Thematic Network Analysis was conducted on the transcribed interviews Main Outcome Measures A central global theme supported by a number of organizing themes were developed reflecting the views of the mothers and their experiences of FCC. Results A global theme of ‘Finding my Place’ was identified, supported by six organizing themes: Mothering in Limbo; Deference to the Experts; Anxious Surveillance; Muted Relations, Power Struggles and Consistently Inconsistent. Mothers experienced a state of liminality and were acutely sensitive to power struggles, awkward relationships and inconsistencies in care. To try to maintain their equilibrium and protect their baby they formed deferential relationships with health professionals and remained in a state of anxious surveillance. Conclusions This study illustrates that despite the rhetoric around the practice of FCC in NICU's, there was little in the mother's narratives to support this. It is of the utmost importance to minimise the consequences of the liminal experience, to improve staff-mother interactions and to facilitate mothers' opportunities to be primary caregivers.
    Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives 10/2014; 5(3). DOI:10.1016/j.srhc.2014.06.003 · 1.25 Impact Factor
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    • "However other milestones might be considered. Skin-to-skin contact is the first step in the breastfeeding process, as it promotes breastfeeding behaviour [31] and is positively associated with breastfeeding duration in preterm infants [32]. Another milestone is the nutritive sucking of a fixed number of mls [12], [23], [24], [25], [28], which requires test-weighing in breastfed infants, something that is not used routinely at all NICUs [22]. "
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    ABSTRACT: Background and Aim Many preterm infants are not capable of exclusive breastfeeding from birth. To guide mothers in breastfeeding, it is important to know when preterm infants can initiate breastfeeding and progress. The aim was to analyse postmenstrual age (PMA) at breastfeeding milestones in different preterm gestational age (GA) groups, to describe rates of breastfeeding duration at pre-defined times, as well as analyse factors associated with PMA at the establishment of exclusive breastfeeding. Methods The study was part of a prospective survey of a national Danish cohort of preterm infants based on questionnaires and structured telephone interviews, including 1,221 mothers and their 1,488 preterm infants with GA of 24–36 weeks. Results Of the preterm infants, 99% initiated breastfeeding and 68% were discharged exclusively breastfed. Breastfeeding milestones were generally reached at different PMAs for different GA groups, but preterm infants were able to initiate breastfeeding at early times, with some delay in infants less than GA 32 weeks. Very preterm infants had lowest mean PMA (35.5 weeks) at first complete breastfeed, and moderate preterm infants had lowest mean PMA at the establishment of exclusive breastfeeding (36.4 weeks). Admitting mothers to the NICU together with the infant and minimising the use of a pacifier during breastfeeding transition were associated with 1.6 (95% CI 0.4–2.8) and 1.2 days (95% CI 0.1–2.3) earlier establishment of exclusive breastfeeding respectively. Infants that were small for gestational age were associated with 5.6 days (95% CI 4.1–7.0) later establishment of exclusive breastfeeding. Conclusion Breastfeeding competence is not developed at a fixed PMA, but is influenced by multiple factors in infants, mothers and clinical practice. Admitting mothers together with their infants to the NICU and minimising the use of pacifiers may contribute to earlier establishment of exclusive breastfeeding.
    PLoS ONE 09/2014; 9(9):e108208. DOI:10.1371/journal.pone.0108208 · 3.23 Impact Factor
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