Immediate “Kangaroo Mother Care” and Survival of Infants with Low Birth Weight
Study Type: RCT
Method: “Kangaroo mother care” is defined in this article as ‘both continuous skin-to-skin contact of the infant with the chest of the mother (or another caregiver when not possible with the mother) and feeding exclusively with breast milk’. This RCT aimed to determine if commencement of kangaroo mother care prior to stabilisation will lead to an improvement in mortality rate in the immediate 72 hours post birth and at the end of the neonatal period (28 days). The authors recruited 3211 infants, across five hospitals located in Ghana, India, Malawi, Nigeria and Tanzania. Both control and intervention groups were similar in number and demographics. Methodology and study protocol were robust with very little loss to follow up. The nature of the intervention prevented blinding, however the study states that the outcome assessment was conducted by an independent team whose members were not involved in intervention delivery. Thus, assessors were blinded and the primary outcome being mortality, removes measurement bias.
Findings: Researchers found that infants with a birth weight between 1.0 and 1.799 kg, who received immediate kangaroo mother care had lower mortality at 28 days compared with infants who received conventional care with kangaroo mother care initiated after stabilisation. No difference in survival was found between the intervention and control group at 72 hours.
Commentary: Research to date has demonstrated that kangaroo mother care results in a reduction in mortality for infants with a low birth weight (<2.0 kg) when utilised after medical stabilisation. However, the majority of deaths occur prior to stabilisation in the baby’s condition. This study was conducted in a low resource setting in developing nations. It demonstrates that this simple intervention is effective at reducing morality at 28 days. There was no survival difference between the treatment and control group at 72 hours. There may be some confounding elements in extrapolating these results to nations such as Australia, as medical care and population demographics may not reflect developed nations.
Reviewed by Dr Renee Burton