High-risk low birth weight neonates admitted to NICUs require prolonged care, which is expensive. Kangaroo care (KC) involves skin-to-skin contact between a family member and the newborn, frequent and exclusive (or nearly exclusive) breastfeeding, and early discharge from the hospital. It has many benefits, with decreased mortality, decreased morbidity, better bonding, early discharge, and rapid establishment of birth weight being the foremost among them.
We studied the association of KC duration with reduced hospital stay and reduced mortality and morbidity, as well as factors governing delivery of KC.
Data were collected from the charts of neonates <2 kg who were admitted to the NICU from January 2012 until June 2014. The data included sociodemographic variables, the clinical profile of neonates including treatment, details of KC, and important outcomes such as mortality, weight gain, antibiotic usage, and ventilator care. Descriptive statistics were used to report on the study population profile, and t tests and regression were used to explore associations.
A total of 106 neonates were included (68 boys, 38 girls). KC was provided to 52 (49.1%) neonates. Three (2.8%) neonates were term, 49 (46.2) were late preterm, 34 (32.1%) were moderate preterm, 16 (15.1%) were very preterm, and 2 (1.9%) were extremely preterm. A significant proportion required a cesarean delivery (n = 45 [42.5%]). About one-half of the neonates (n = 51) required ventilator support, and most neonates (n = 69) required continuous positive airway pressure support. The mean ± SD birth weight of the neonates was 1538.07 ± 337.88 g. KC was provided for a mean of 13.92 ± 21.67 hours. The mean duration of KC was significantly greater for neonates who gained weight compared with those who experienced weight loss (20.92 ± 27.89 hours vs 6.38 ± 6.38 hours; P = .016). The mean duration of KC was significantly greater for neonates who did not require antibiotics versus those who required antibiotics (17.73 ± 24.68 hours vs 4.23 ± 3.39 hours; P = .002). The mean number of KC hours per day was 2.86 ± 1.89. Linear regression revealed that mother’s age was the only significant predictor of KC hours per day (P = .074). There was no significant difference between mean KC duration for neonates who required ventilator support versus those who did not require it.
The few hours of KC given per day suggest that this intervention with proven benefits is not being used optimally. Qualitative research is warranted to determine the barriers for this lacuna.
- Copyright © 2015 by the American Academy of Pediatrics