Kangaroo mother care (KMC) or the intervention where babies are placed in skin-to-skin contact with their mothers and exclusively breast fed has been recommended worldwide for stable low-birthweight newborns. Stable babies are defined as babies who do not need respiratory support or intravenous fluids and can accept oral feeds. Though previous studies have shown that keeping the baby in contact with the mother improves survival in babies (less than 2 kg weight at birth) when compared to standard hospital care, global data show that barely 5% receive such care. Also, there is no much evidence on kangaroo mother care impact when initiated at homes in India.
To understand this, a team of researchers led by Nita Bhandari, Director at the Centre for Health Research and Development, Society for Applied Studies, New Delhi, carried out a study in Haryana. The results recently published in The Lancet show that kangaroo mother care improved survival by 30% and 25%, in babies till 28 days and six months of age, respectively. The paper adds that such care for all infants with low birthweight could substantially reduce neonatal and infant mortality.
Developing countries
About 97% of the world’s low-weight babies are born in developing countries, and India accounts for about 40% of this, implying an urgent need of effective interventions. Sarmila Mazumder, lead author of the study says, “In developing countries, even today, babies are born at home or even if born in hospitals, are discharged too soon without kangaroo mother care initiation. It is imperative therefore that such care is initiated at home.”
For the study, over 8,000 stable low-birthweight babies weighing less than 2.25 kg, were enrolled from two districts in Haryana, during 2015-2018 and randomly assigned to intervention and control groups. Kangaroo mother care intervention was initiated at home, at an average age of 33 hours and delivered during the first month of life, through home visits. The enrolled babies were followed up at one, three and six months of age.
Multiple benefits
Dr. Mazumder adds that kangaroo mother care benefits are much beyond preventing hypothermia. “The care improves exclusive breast feeding, duration of breast feeding, and also reduces infections. It also promotes growth and development of the child and increases mother child bonding, and also reduces stress in both mother and baby,” she explains.
When asked how long babies need to be kept in such care, Dr. Mazumder explained that in the study, mothers were advised to keep the babies as long as possible, preferably 24 hours in day and night and till 28 days of age. An average of 11 hours of skin-to-skin contact was achieved, and mothers reported giving kangaroo mother care till 27 days of baby’s age. WHO recommends that it be continued till baby attains a weight of 2.5 kg or till babies wriggle out, indicating that they do not need kangaroo mother care any further.
Dr. Mazumder added that an implementation research was also conducted by the same team with the Haryana Government to scale up kangaroo mother care across 16 districts of the state. The paper adds that kangaroo mother care has the potential to prevent thousands of neonatal deaths in our country if 90% coverage can be achieved.
