Kangaroo Mother Care Differences and Quantitative Benefits in Different Subgroups of Low Birth Weight Babies

Abstract

Jyostna Arelly and Sudhakar Ajmera

Objectives: To determine the effectiveness of Kangaroo Mother Care in subgroups of LBW babies-Preterm AGA, Preterm SGA and Term SGA, To assess any differences in benefits of KMC in relation to duration in the subgroups, To assess weight gain difference in NICU and at home at first follow up visit and up to 40 weeks of follow up to Preterm AGA, Preterm SGA and till gain of 2500g in Term SGA babies.

Study design: Prospective observational study.

Setting: NICU in a large teaching institute, department of pediatrics, Mahatma Gandhi Memorial Hospital, North Telangana.

Subjects and Methods: 240 neonates with birth weight <2500g, hemodynamically stable.

Intervention: The subjects are classified into three subgroups-based on gestational age (by new Ballard’s score) and by weight (Lubchenco’ s charts) into Preterm Appropriate for gestational age (PT AGA) (102), Preterm Small for Gestational Age (PT SGA) (88) and Term Small for Gestational age (T SGA) (50). Further categorized into =37wks.KMC was given to all subgroups at hospital and home with mean duration of 9+2hrs at hospital and 5+2hrs at home.

Outcome Measures: Growth measured by average daily weight gain, mean weight gain, (weight was measured by electronic weighing scale (seca), head circumference (measured by non-stretchable and non-metallic tape) and total length (measured by infant meter) in follow up to 40 weeks of corrected gestational age in Preterm and up to gain of 2500g in Term SGA were assessed with KMC.

Results: Better weight gain was noticed in all the 3 subgroups of LBW neonates with KMC at hospital and home. In spite of lower duration of KMC at home PT AGA (33-34 weeks) subgroup has the highest weight gain (24.5+5.5g/day, p=0.003), highest head circumference gain (0.70+0.5cm/week, p=0.002), highest length gain (0.90+0.6cm/week, p <0.008). The time taken to reach full feeds and the time to reach initiation of direct breastfeeds were comparable in all subgroups but attained much earlier in PT AGA (33-34wks) and PT AGA (35-36wks). Duration of hospital stay is least in PT AGA with mean of 12.68 ± 6.37 days.KMC significantly reduced the incidence of apnea in all subgroups of LBW babies. All babies were on exclusive breastfeeds at the end of the study (98%).

Conclusion: We conclude by this present study that KMC improves growth in all sub groups of LBW infants. KMC has significantly reduced the incidence of co mortifies like apnea, hypothermia, hypoglycemia in all the subgroups of LBW babies. KMC is cost effective, easily accessible and acceptable not only to mothers but also by majority of the family members.

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