The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies

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Abstract

Background Kangaroo mother care is a comprehensive intervention given for all newborns especially for premature and low birthweight infants. It is the most feasible and preferred intervention for decreasing neonatal morbidity and mortality. Even though time to initiating breastfeeding has been examined by randomized controlled trials, varying findings have been reported. Therefore, the main objective of this meta-analysis was to estimate the pooled mean time to initiate breastfeeding among preterm and low birthweight infants. Methods The authors searched for randomized controlled trial studies conducted on the effects of kangaroo mother care on the time to breastfeeding initiation among preterm and low birthweight infants. Published articles were identified through a computerized search of electronic databases that includes MEDLINE via PubMed, EMBASE, CINAHL and CENTRAL. The search terms were kangaroo mother care or (skin to skin), or conventional care, newborns, preterm infants, low birthweight infants and randomized controlled trial. A total of 467 eligible titles were identified and eight studies met the inclusion criteria. The extracted data were entered and analyzed using Cochrane Review Manager-5-3 software. Heterogeneity across studies was evaluated by Chi2 test and inconsistency index (I2). Publication bias was assessed using a funnel plot. The random effect model was applied to estimate the pooled mean time to initiate breastfeeding with 95% confidence interval. Results In this meta-analysis, the overall pooled mean time to initiate breastfeeding was 2.6 days (95% CI 1.23, 3.96). Preterm and low birthweight infants receiving kangaroo mother care intervention initiated breastfeeding 2 days 14 h 24 min earlier than conventional care of radiant warmer/incubator method. Conclusions Kangaroo mother care promotes early initiation of breastfeeding as compared to conventional care method. Therefore, health facilities need to implement the kangaroo mother care for preterm and low birthweight infants. Electronic supplementary material The online version of this article (10.1186/s13006-019-0206-0) contains supplementary material, which is available to authorized users.

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Most cited references 26

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A randomized, controlled trial of kangaroo mother care: results of follow-up at 1 year of corrected age.

Y Charpak, N Charpak, J R Peláez … (2001)

To assess the effectiveness and safety of Kangaroo Mother Care (KMC) for infants of low birth weight. An open, randomized, controlled trial of a Colombian social security referral hospital was conducted. A total of 1084 consecutive infants who were born at

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Community-based kangaroo mother care to prevent neonatal and infant mortality: a randomized, controlled cluster trial.

S Mitra, Beverly Winikoff, Ubaider Rob … (2008)

We adapted kangaroo mother care for immediate postnatal community-based application in rural Bangladesh, where the incidence of home delivery, low birth weight, and neonatal and infant mortality is high and neonatal intensive care is unavailable. This trial tested whether community-based kangaroo mother care reduces the overall neonatal mortality rate by 27.5%, infant mortality rate by 25%, and low birth weight neonatal mortality rate by 30%. Half of 42 unions in 2 Bangladesh divisions with the highest infant mortality rates were randomly assigned to community-based kangaroo mother care, and half were not. One village per union was randomly selected proportionate to union population size. A baseline survey of 39,888 eligible consenting women collected sociodemographic information. Community-based workers were taught to teach community-based kangaroo mother care to all expectant and postpartum women in the intervention villages. A total of 4165 live births were identified and enrolled. Newborns were followed for 30 to 45 days and infants were followed quarterly through their first birthday to record infant care, feeding, growth, health, and vital status. Forty percent overall and approximately 65% of newborns who died were not weighed at birth, and missing birth weight was differential by study group. There was no difference in overall neonatal mortality rate or infant mortality rate. Except for care seeking, community-based kangaroo mother care behaviors were more common in the intervention than control group, but implementation was weak compared with the pilot study. The extensive missing birth weight and its potential bias render the evidence insufficient to justify implementing community-based kangaroo mother care. Additional experimental research ensuring baseline comparability of mortality, adequate kangaroo mother care implementation, and birth weight assessment is necessary to clarify the effect of community-based kangaroo mother care on survival.

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Effect of very early skin to skin contact on success at breastfeeding and preventing early hypothermia in neonates

Amit Gupta, Anjoo Bhatnagar, Smita Srivastava … (2014)

Birth and immediate postpartum period pose many challenges for the newborn. The neonatal mortality rates are high in India, whereas the breastfeeding rates are still low. Hence, need exists for a simple and easily applicable intervention, which may counter these challenges.