The “kangaroo mother care” method of skin-to-skin contact between a mother and her prematurely born or low birth weight baby reduces the risk of infant mortality by nearly a third, according to new research.
A study published online in BMJ Global Health found that starting kangaroo care within 24 hours of birth and carrying it out for at least eight hours a day is even more effective in reducing mortality and infection.
Although the World Health Organization (WHO) recommends kangaroo care – which normally involves an infant being carried in a sling with skin-to-skin contact – as the standard of care among low birth weight infants after clinical stabilisation, there was no recommendation on the best time to begin it.
Researchers in India reviewed 31 trials that included a total of 15,559 infants. Of these, 27 studies compared the method with conventional care, while four compared early with late initiation of the method.
They found compared with conventional care, the method appeared to reduce the risk of mortality by 32% during birth hospitalisation or by 28 days after birth. It also appeared to reduce the risk of severe infection, such as sepsis, by 15%.
The team found the reduction in mortality was regardless of gestational age or weight of the child at enrolment, time of initiation, and where the method took place, such as hospital or in the community.
Mortality benefits were greater when the method took place at least eight hours per day compared with shorter durations.
The studies that compared early with late-initiated kangaroo mother care showed that early initiation led to a reduction in neonatal mortality of 33% and a probable decreased risk of 15% in clinical sepsis until 28 days.
Although the review had some limitations, the authors said the risk of bias in the included studies was generally low. The review included a comprehensive and systematic search of existing studies, which, they said, meant the certainty of the evidence for the primary outcomes was moderate to high.
They concluded: “Our findings support the practice of kangaroo mother care for preterm and low birth weight infants as soon as possible after birth and for at least eight hours a day.
“Future research should focus on overcoming barriers and facilitators to large-scale implementation of kangaroo mother care in facility and community settings. Data on long-term neurodevelopmental outcomes are also needed.
Sivanandan S, Sankar MJ. Kangaroo mother care for preterm or low birth weight infants: a systematic review and meta-analysis. BMJ Global Health. June 2023. doi:10.1136/bmjgh-2022-010728
Leave a Reply