Background: Kangaroo Mother Care (KMC) is the standard of care for stable low birth weight infants. Provision of KMC to intubated preterm infants may also be beneficial, but strong evidence is still lacking. Objective: To determine the effectiveness of KMC in decreasing mortality among intubated preterm neonates. Study Design: This is a non-blinded, parallel, non-inferiority randomized controlled trial. Methodology: All intubated, preterm admissions, 28-36 weeks gestation, weighing 600-2000 grams, with respiratory distress were included. They were randomized to the intervention group who received KMC for 2-4 hours daily while intubated and the control group who received care inside an incubator. Participants’ physiologic status – before, during, and after the intervention – was recorded. The primary outcome was mortality. Secondary outcomes included comorbidities, days intubated, and hospital stay. Results: There was a total of 32 patients. The risk of dying in the KMC group (n=16) was significantly reduced by 78% (RR 0.22; 95% CI 0.06 - 0.87 p=0.009). The KMC patients were also less likely to have hypothermia, nosocomial pneumonia, NEC, and late-onset neonatal sepsis (p<0.05). The KMC group had higher blood sugar levels (110 vs. 58, p=0.001) and required fewer days of intubation (3.5 vs.1.5 days, p<0.000) compared to the control group. There was no difference in the duration of the hospital stay. Conclusion KMC is effective in decreasing mortality among intubated preterm neonates. Other comorbidities and days of intubation were also reduced.
Kangaroo-Mother Care Method ; Infant Mortality

Objective: To determine the effectiveness of Kangaroo Mother Care (KMC) in increasing the rate of weight gain and decreasing hypothermia, apnea, and sepsis rate, and shorten hospital stay among low-birth-weight infants. Methods: Very low birth weight (VLBW) infants (≤1500 grams) were randomized to either the KMC or conventional care group. KMC provided skin-to-skin contact at least 6 hours per day while the conventional group received the usual care in the newborn intensive care unit (NICU). Daily weight measurements and weekly measurements of length, head, and chest circumference were recorded until discharge. Occurrence of hypothermia, apnea, sepsis, and length of stay was noted. Results: KMC group had a higher mean weight gain per day (p=0.0102). There was no difference in the length, head, and chest circumference between the two groups. Sepsis and apnea rates were not significant between the two groups. Significantly more neonates experience hypothermia in the control group (p<0.0069). Conclusion KMC is effective in increasing the weight per day compared with the control group. KMC protects the neonates against hypothermia. There is not enough evidence to show a difference in the incidence of sepsis, apnea, and the length of hospital stay between the two groups.
Kangaroo-Mother Care Method ; Infant, Low Birth Weight ; Weight Gain

Background: The Neonatal Intensive Care Unit (NICU) admission at the Philippine General Hospital (PGH) exceeds total bed capacity. Decreasing admissions to the NICU would prevent overcrowding of patients, improve patient care, reduce hospital stay, and reduce predisposition to hospital-acquired infections. Objective: To determine the effect of continuous versus intermittent Kangaroo Mother Care (KMC) on weight gain and duration of hospital stay among low birth weight (LBW) neonates weighing 1,800 - 2,220 grams. Methods: Forty-six (46) stable LBW were randomized to either continuous (≥12 hours in the maternity ward) or intermittent (≤6 hours in the NICU step-down unit) KMC groups. Daily weight and weekly length, head and chest circumference until discharge, and duration of hospital stay were measured. Data were analyzed using the Mann-Whitney U-test and Fisher's exact test. Results: Infants in continuous KMC had an average weight gain of 50 grams/day (p=0.509) and had an average duration of hospital stay of 3 days (p=0.218). Results were not statistically different from intermittent KMC. Conclusion There was no evidence to show that weight gain and duration of hospital stay among infants in continuous KMC were significantly different from those in the intermittent KMC group.
Kangaroo-Mother Care Method ; Infant, Low Birth Weight

Background: One of the World Health Organization (WHO) nutrition target by 2025 is 50% exclusive breastfeeding rate among infants until age 6 months. Kangaroo mother care (KMC) known to increase breastfeeding rates, especially in preterm and low birth weight (LBW) infants. Objectives: This study determined the effect of KMC to the rate of exclusive breastfeeding among preterm and LBW infants at 6 months of age. Methods: Conducted searches in MEDLINE and CENTRAL databases, likewise hand searched local publications December 1996 until June 2018. Included several randomized controlled trials and prospective observational studies comparing KMC and conventional care among preterm and LBW infants. The primary outcome was exclusive breastfeeding of infants at six months of age. Two authors independently assessed trial quality and extracted data the statistical analysis applied using Review Manager version 5.3. Results: Identified nine eligible trials involving 1,202 neonates. All studies had low-to-moderate risk of bias. KMC significantly noted to increase the likelihood of exclusive breastfeeding by 1.9 times at birth up to 6 months (OR 1.93 [1.18,3.17], p=0.009). Conclusion KMC can increase exclusive breastfeeding among preterm and LBW infants from birth up to 6 months of age.
Kangaroo-Mother Care Method ; Breast Feeding ; Infant, Low Birth Weight

Background: Kangaroo Mother Care (KMC) has facilitated infant growth and decreased morbidities and hospital stay. Adding touch therapy (TT) may potentiate the KMC benefits. Objective: To compare the effectiveness of KMC+TT versus KMC alone in improving anthropometric and physiologic parameters and decreasing morbidities and hospital stay in low birth weight (LBW) infants. Methods: Stable LBW infants (<2000 g) admitted in the KMC ward were randomized to either intervention (KMC+TT) or control (KMC only) group. The KMC+TT group underwent thrice daily touch therapy sessions until discharge. Results: A total of 50 infants were included in the study. Baseline characteristics between the two groups were comparable. There was a significant increase in weight gain (grams/kg/day) in the KMC+TT group compared to KMC only. Physiologic parameters like heart rate, respiratory rate, and temperature were significantly better in the KMC+TT group. More infants in the KMC only group were transferred to NICU care, while more KMC+TT infants went home against advice. Hospital stay was similar between the two groups. Conclusion Touch therapy added to KMC is more effective than KMC alone in improving weight gain and physiologic parameters. It is associated with lower morbidities, although it did not affect the hospital stay.
Kangaroo-Mother Care Method ; Infant, Low Birth Weight

Objective: To compare outcomes of low-birth-weight neonates delivered before and after implementation of intermittent kangaroo mother care (KMC) in terms of duration of hospital stay, mortality rate, and clinical outcome. Methods: This is a retrospective analytical study that included all neonates delivered in a tertiary government hospital with birth weight of less than 2000 grams before and after intermittent KMC implementation from January 2015 to December 2016. Chart review was done for demographics, mortality profile, and length of hospital stay. Chi-square test and Student’s t-test were used to compare mortality rate and length of hospital stay, and odds ratio was used for mortality outcome. Results: A total of 677 low birth weight newborns were reviewed and of these, 276 (79.8%) neonates in group 1 (Pre-intermittent KMC implementation), and 263 (79.4%) neonates in group 2 (Post-intermittent KMC implementation) fulfilled the inclusion criteria. The duration of hospital stay of neonates enrolled in KMC was significantly shorter (p ≤ 0.05). In Groups 1 and 2, 93–94% of neonates were discharged improved with a 5–6% mortality of almost equal distribution. There was no significant difference in mortality between groups 1 and 2 (OR 1.19, 95% CI 0.59, 2.42). Conclusion There was no significant difference in mortality rate and cause of death pre- and post-intermittent KMC implementation. However, the length of hospital stay among the LBW neonates discharged improved was significantly shortened.
Kangaroo-Mother Care Method ; Infant, Low Birth Weight ; Length of Stay

PURPOSE: A National survey was conducted to assess neonatal intensive care nurses' practice, barriers, knowledge, and belief regarding Kangaroo Care (KC). METHODS: A descriptive survey was conducted. Kangaroo care questionares were sent to nurses in all hospitals in Korea whose were identified as providing neonatal intensive care services(N=263). Descriptive statistics were used to summarized the data. RESULTS: Among 67 neonatal care units, 61.1% adapted KC in their practice. About 60% of nurses in the KC providing hospital actually practiced KC. Major barrier of practicing KC were infant safety concerns, as well as work load of nurses. Respondants who had practiced KC were more knowledgable and were more positive in their belief regarding KC. CONCLUSION: The findings suggest that in order to overcome barriers of practicing KC, educational programs are recommended designed for nurses. In addition, development of KC practice guideline is necessary to facilicate successful and safe KC.
Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Kangaroo-Mother Care Method ; Korea ; Macropodidae ; Practice Patterns, Nurses'

PURPOSE: This study was intended to standardize the Kangaroo care protocol for fathers, and to determine the effect of fathers' Kangaroo care experience on paternal attachment.METHODS: The data was collected from February to April, 2013. The study subjects were 34 fathers (17 experimental group subjects, 17 control group subjects) of premature babies, bornatatertiaryhospitalinSeoul, who agreed to participate. The standardized Kangaroo care protocol, which consisted of at least three 60-minutes sessions during the hospitalization period in a neonatal intensive care unit, was carried out with the experimental group. The data was analyzed by a χ2-test and Mann-Whitney U test.RESULTS: The results were as follows: 1) There were no between-group differences in the general characteristics of babies and their fathers. 2) The Kangaroo care fathers showed higher scores of paternal attachment than the control group (Z=-3.657, p=0.008).CONCLUSION: Fathers who attended the Kangaroo care sessions showed stronger paternal attachment than those who did not. Therefore, use of a Kangaroo care program for fathers of premature babies at neonatal intensive care units is recommended.
Fathers ; Hospitalization ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Kangaroo-Mother Care Method ; Macropodidae

PURPOSE: This study was conducted to investigate nursing students' knowledge and beliefs about Kangaroo care (KC). METHODS: A cross-sectional descriptive design was used. Undergraduate students enrolled in departments of nursing (n=322) from three universities in D city participated. Knowledge and beliefs about KC were measured using the Kangaroo Care Questionnaire (KCQ). RESULTS: The overall level of nursing students' knowledge about KC was very low with a mean score of 6.9 out of 17. The mean score for nursing students' beliefs about KC was 87.4 out of 100, indicating relatively positive beliefs. The students who had both education and exposure to KC had higher scores for knowledge and more positive beliefs about KC compared to students with no experience or exposure to KC. There was a positive correlation between knowledge and beliefs about KC (r=.371, p<.001). CONCLUSION: The results suggest that there is a need to develop educational programs for nursing students in order to increase their knowledge and develop positive beliefs about KC.
Education ; Humans ; Infant, Newborn ; Infant, Premature ; Kangaroo-Mother Care Method ; Macropodidae* ; Nursing* ; Students, Nursing*

OBJECTIVE: To explore the effect of breastfeeding promotion strategies on neonatal clinical outcomes of preterm infants during hospitalization in the neonatal intensive care unit (NICU). METHODS: We developed breastfeeding promotion strategies, including the establishment of a multidisciplinary breastfeeding steering team, breastfeeding support of families and society, family-integrated care, kangaroo mother care, donor human milk bank, and so on. Preterm infants meeting the inclusion standard, less than 32 weeks gestational age, who were admitted to NICU from November 2015 to February 2017 were enrolled, and the eligible infants were divided into two groups (control group and intervention group) before and after policy implementation. The data of preterm infants including breastfeeding related outcomes (time to initiation of enteral feeding, time to initiation of breastfeeding, time to achieve full breastfeeding, time to achieve full enteral feeding and rate of breastfeeding), growth (extrauterine growth restriction) and complications were compared between the two groups. RESULTS: One hundred and twenty-three preterm infants were enrolled, including 61 in the control group and 62 in the intervention group. There were no significant differences in gender, gestational age, birth weight, intrauterine growth retardation (IUGR) and admission disease status between the two groups (P>0.05). Compared with the control group, there were significantly earlier time to initiation of enteral feeding [15.37 (10.00, 22.13) h vs. 20.25 (12.88, 26.33) h, P<0.01], time to achieve full breastfeeding [91.00 (69.75, 103.00) h vs. 94.00 (80.37, 118.75) h, P=0.04], and time to achieve full enteral feeding [12 (11, 15) d vs. 14 (12, 18) d, P<0.01] in the intervention group. Otherwise, there were no significant differences in time to initiation of breastfeeding, hospital stay, extrauterine growth restriction (EUGR) occurance rate of weight, the rate of breastfeeding, motality, and the incidence of complications including feeding intolerance, neonatal necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) (P>0.05). CONCLUSION The breastfeeding promotion strategie was a quality improvement of ordinary breastfeeding protocol. It had significantly reduced time to initiation of enteral feeding, time to achieve full breastfeeding and time to achieve full enteral feeding for preterm infants in NICU. Further research is needed to confirm whether the strategies can improve the breastfeeding rate and reduce the occurrence of the complications, such as NEC, BPD, and ROP.
Breast Feeding ; Enterocolitis, Necrotizing ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Kangaroo-Mother Care Method