The World Health Organisation (WHO) recommends that all low-birthweight infants receive kangaroo mother care (KMC) after stabilisation. However, the effect of immediate kangaroo mother care intervention was elusive. The WHO KMC Study Group intended to establish this effect. So, they conducted a trial in five hospitals across Asia and Africa that involved low birth weight infants. They were to either receive immediate kangaroo mother care (intervention) or conventional care in an incubator or a radiant warmer until their condition stabilised and kangaroo mother care afterwards (control). They were to primarily ascertain the number of deaths within the two groups within the first 28 days and the first 72 hours of life.
By 28 days after delivery, there were 12% and 15.7% infant deaths in the intervention and control groups, respectively. Within four days of life, 4.6% and 5.8% of deaths had occurred in the two groups, respectively. The data and safety monitoring board stopped the trial earlier than expected due to the overwhelming reduction in mortality among infants within the intervention group.
The authors published their findings in the New England Journal of Medicine. In their discussion, they asserted that immediate KMC improved survival among low-birthweight infants for several reasons.
First, in the intervention group, the mothers were constantly near their infants so, their normal flora immediately colonised the babies’ skins to confer protection against infections. Second, these babies were likely to receive early breastfeeding, didn’t suffer, and were under constant monitoring by their mothers. Third, few hands handled the infants, thus reducing the risk of infection further. Lastly, but not least, the infants had constant monitoring from their mothers, and hence any deviation from the normal conditions was immediately reported and assessed.
Studies like this one widen the clinicians’ routine care beyond the national or global clinical guidelines for low-birthweight infants. It may further reduce the number of neonates that succumb to the complications of prematurity. Such research data allow health care providers to confer evidence-based treatment protocols on a case-by-case basis. They also aid the health policymakers to widen the scope of care. We highly commend the WHO KMC Study Group for executing a trial with real-world repercussions and generalisability.
To read more about the publication, visit nejm.org.