Skip to main content

Advertisement

SpringerLink
Log in

The effect of kangaroo ward care in comparison with “intermediate intensive care” on the growth velocity in preterm infant with birth weight <1100 g: randomized control trial

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Kangaroo mother care (KMC) reduces neonatal mortality, neonatal sepsis and improves growth outcome in preterm infants. In this study, we compared the efficacy of “baby care in kangaroo ward (KWC)” with “baby care in intermediate intensive care (IIC)” in stable preterm infants (birth weight <1100 g) for improving the growth velocity till term corrected age. One hundred and forty-one infants were randomized to KWC (n = 71) or IIC (n = 70) once the infant reached a weight of 1150 g. Infants in the KWC group were shifted to the KWC immediately after randomization and those in the IIC group were given care in the IIC till they attained a weight of 1250 g and then shifted to the KWC. The average weight gains as well as weight, length, and head circumference at term corrected age were comparable in both the groups. There was significant reduction in IIC stay post randomization and increase in weight gain before discharge in the KWC group. There was a significant increase in incidence of apnea in the IIC group.

Conclusion: Early KWC is equally efficacious as IIC in improving the growth outcomes of stable preterm (birth weight <1100 g) infants at term gestational age. Clinical trial registration: Clinical trial registry of India CTRI/2014/05/004625

What is known:

• Kangaroo mother care (KMC) reduces neonatal mortality, neonatal sepsis and improves growth outcome in VLBW infants.

What is new:

• Baby care by mother can be given safely in kangaroo ward from a weight of 1150 g in stable preterm infants without any adverse effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

CPAP:

Continuous positive airway pressure

EBM:

Expressed breast milk

ELBW:

Extremely low birth weight

FCC:

Family-centered care

IVH:

Intraventricular hemorrhage

IIC:

Intermediate intensive care

KMC:

Kangaroo mother care

KWC:

Kangaroo ward care

LBW:

Low birth weight

NEC:

Necrotizing enterocolitis

PDA:

Patent ductus arteriosus

PVL:

Periventricular leukomalacia

ROP:

Retinopathy of prematurity

SSC:

Skin-to-skin contact

SD:

Standard deviation

VLBW:

very low birth weight

References

  1. Ali SM, Sharma J, Sharma R, Alam S (2009) Kangaroo mother care as compared to conventional care for low birth weight babies. Dicle Med J 36:155–160

    Google Scholar 

  2. Bastani F, Abadi TA, Haghani H (2015) Effect of family-centered care on improving parental satisfaction and reducing readmission among premature infants: a randomized controlled trial. J Clin Diagn Res JCDR 9:SC04–SC08. doi:10.7860/JCDR/2015/10356.5444

    PubMed  Google Scholar 

  3. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T (1978) Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 187:1–7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, Sankar MJ, Sankar JM, Blencowe H, Rizvi A, Chou VB, Walker N, Lancet Newborn Interventions Review Group, Lancet Every Newborn Study Group (2014) Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet Lond Engl 384:347–370. doi:10.1016/S0140-6736(14)60792-3

    Article  Google Scholar 

  5. Bier JA, Ferguson AE, Morales Y, Liebling JA, Archer D, Oh W, Vohr BR (1996) Comparison of skin-to-skin contact with standard contact in low-birth-weight infants who are breast-fed. Arch Pediatr Adolesc Med 150:1265–1269

    Article  CAS  PubMed  Google Scholar 

  6. Boo N-Y, Jamli FM (2007) Short duration of skin-to-skin contact: effects on growth and breastfeeding. J Paediatr Child Health 43:831–836. doi:10.1111/j.1440-1754.2007.01198.x

    Article  PubMed  Google Scholar 

  7. Cattaneo A, Davanzo R, Bergman N, Charpak N (1998) Kangaroo mother care in low-income countries. International Network in Kangaroo Mother Care J Trop Pediatr 44:279–282

    CAS  PubMed  Google Scholar 

  8. Charpak N, Ruiz-Peláez JG, Charpak Y (1994) Rey-Martinez kangaroo mother program: an alternative way of caring for low birth weight infants? One year mortality in a two cohort study. Pediatrics 94:804–810

    CAS  PubMed  Google Scholar 

  9. Charpak N, Ruiz-Peláez JG, Figueroa de CZ, Charpak Y (1997) Kangaroo mother versus traditional care for newborn infants </=2000 grams: a randomized, controlled trial. Pediatrics 100:682–688

    Article  CAS  PubMed  Google Scholar 

  10. Conde-Agudelo A, Díaz-Rossello JL (2014) Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 4:CD002771. doi:10.1002/14651858.CD002771.pub3

    PubMed  Google Scholar 

  11. Early Treatment For Retinopathy Of Prematurity Cooperative Group null (2003) Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol Chic Ill 1960(121):1684–1694. doi:10.1001/archopht.121.12.1684

    Google Scholar 

  12. Gathwala G, Singh B, Balhara B (2008) KMC facilitates mother baby attachment in low birth weight infants. Indian J Pediatr 75:43–47

    Article  PubMed  Google Scholar 

  13. Gathwala G, Singh B, Singh J (2010) Effect of kangaroo mother care on physical growth, breastfeeding and its acceptability. Trop Dr 40:199–202. doi:10.1258/td.2010.090513

    Article  Google Scholar 

  14. Ghavane S, Murki S, Subramanian S, Gaddam P, Kandraju H, Thumalla S (2012) Kangaroo mother care in kangaroo ward for improving the growth and breastfeeding outcomes when reaching term gestational age in very low birth weight infants. Acta Paediatr Oslo Nor 1992 101:e545–e549. doi:10.1111/apa.12023

    Google Scholar 

  15. Griffin T (2006) Family-centered care in the NICU. J Perinat Neonatal Nurs 20:98–102

    Article  PubMed  Google Scholar 

  16. Jain A, Shah PS (2015) Diagnosis, evaluation, and management of patent ductus arteriosus in preterm neonates. JAMA Pediatr 169:863–872. doi:10.1001/jamapediatrics.2015.0987

    Article  PubMed  Google Scholar 

  17. Kadam S, Binoy S, Kanbur W, Mondkar JA, Fernandez A (2005) Feasibility of kangaroo mother care in Mumbai. Indian J Pediatr 72:35–38

    Article  PubMed  Google Scholar 

  18. Kandraju H, Agrawal S, Geetha K, Sujatha L, Subramanian S, Murki S (2012) Gestational age-specific centile charts for anthropometry at birth for south Indian infants. Indian Pediatr 49:199–202

    Article  PubMed  Google Scholar 

  19. Nagai S, Andrianarimanana D, Rabesandratana N, Yonemoto N, Nakayama T, Mori R (2010) Earlier versus later continuous kangaroo mother care (KMC) for stable low-birth-weight infants: a randomized controlled trial. Acta Paediatr Oslo Nor 1992 99:827–835. doi:10.1111/j.1651-2227.2009.01676.x

    CAS  Google Scholar 

  20. Nagai S, Yonemoto N, Rabesandratana N, Andrianarimanana D, Nakayama T, Mori R (2011) Long-term effects of earlier initiated continuous kangaroo mother care (KMC) for low-birth-weight (LBW) infants in Madagascar. Acta Paediatr Oslo Nor 1992 100:e241–e247. doi:10.1111/j.1651-2227.2011.02372.x

    Google Scholar 

  21. Neu M, Robinson J (2010) Maternal holding of preterm infants during the early weeks after birth and dyad interaction at six months. J Obstet Gynecol Neonatal Nurs JOGNN NAACOG 39:401–414. doi:10.1111/j.1552-6909.2010.01152.x

    Article  Google Scholar 

  22. Papile LA, Burstein J, Burstein R, Koffler H (1978) Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 92:529–534

    Article  CAS  PubMed  Google Scholar 

  23. Ramanathan K, Paul VK, Deorari AK, Taneja U, George G (2001) Kangaroo mother care in very low birth weight infants. Indian J Pediatr 68:1019–1023

    Article  CAS  PubMed  Google Scholar 

  24. Roberts KL, Paynter C, McEwan B (2000) A comparison of kangaroo mother care and conventional cuddling care. Neonatal Netw NN 19:31–35. doi:10.1891/0730-0832.19.4.31

    Article  CAS  PubMed  Google Scholar 

  25. Rojas MA, Kaplan M, Quevedo M, Sherwonit E, Foster LB, Ehrenkranz RA, Mayes L (2003) Somatic growth of preterm infants during skin-to-skin care versus traditional holding: a randomized, controlled trial. J Dev Behav Pediatr JDBP 24:163–168

    Article  PubMed  Google Scholar 

  26. Sloan NL, Camacho LW, Rojas EP, Stern C (1994) Kangaroo mother method: randomised controlled trial of an alternative method of care for stabilised low-birthweight infants. Maternidad Isidro Ayora Study Team. Lancet Lond Engl 344:782–785

    Article  CAS  Google Scholar 

  27. Suman RPN, Udani R, Nanavati R (2008) Kangaroo mother care for low birth weight infants: a randomized controlled trial. Indian Pediatr 45:17–23

    PubMed  Google Scholar 

  28. de Vries LS, Eken P, Dubowitz LM (1992) The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res 49:1–6

    Article  PubMed  Google Scholar 

  29. Whitelaw A, Heisterkamp G, Sleath K, Acolet D, Richards M (1988) Skin to skin contact for very low birthweight infants and their mothers. Arch Dis Child 63:1377–1381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Worku B, Kassie A (2005) Kangaroo mother care: a randomized controlled trial on effectiveness of early kangaroo mother care for the low birthweight infants in Addis Ababa, Ethiopia. J Trop Pediatr 51:93–97. doi:10.1093/tropej/fmh085

    Article  PubMed  Google Scholar 

Download references

Authors’ contributions

Dr. Deepak Sharma drafted the initial manuscript, carried out the initial analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Dr. Murki conceptualized and designed the study, critically reviewed the manuscript, and approved the final manuscript as submitted.

Dr. Tejo Pratap carried out the initial analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted.

There was no honorarium, grant, or other forms of payment given to anyone to produce the manuscript.

All the authors approved the submission of this version of the manuscript and takes full responsibility for the manuscript.

Author information

Authors and Affiliations

  1. Department of Neonatology, Fernandez Hospital, Hyderguda, Hyderabad, 500029, India

    Deepak Sharma, Srinivas Murki & Oleti Tejo Pratap

Authors
  1. Deepak Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Srinivas Murki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oleti Tejo Pratap
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Srinivas Murki.

Ethics declarations

Funding

No external funding received

Conflict of interest

The authors declare that they have no competing interests

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Patrick Van Reempts

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharma, D., Murki, S. & Pratap, O.T. The effect of kangaroo ward care in comparison with “intermediate intensive care” on the growth velocity in preterm infant with birth weight <1100 g: randomized control trial. Eur J Pediatr 175, 1317–1324 (2016). https://doi.org/10.1007/s00431-016-2766-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-016-2766-y

Keywords

Search

Navigation