Kangaroo mother care effective in low birthweight infants

Clinical question: 
How effective is kangaroo mother care (KMC) in low birthweight (LBW) infants?
Bottom line: 
KMC involves using mothers as “incubators” to maintain the infants’ body temperature and as the main source of food and stimulation for LBW infants while they mature enough to face extrauterine life in similar conditions to those born at term. Compared with conventional neonatal care, KMC was found to reduce mortality at discharge or 40–41 weeks’ postmenstrual age and at latest follow-up, severe infection/sepsis, nosocomial infection/ sepsis, hypothermia, severe illness, lower respiratory tract disease, and length of hospital stay. Moreover, KMC increased weight, head circumference, and length gain, breastfeeding, mother satisfaction with method of infant care, and some measures of maternal–infant attachment. Subgroup analyses suggest that both continuous and intermittent KMC are beneficial for stabilised LBW infants. There was no difference in neurodevelopmental outcomes at 1 year of corrected age.
Caveat: 
Although current evidence is mainly limited to the use of KMC in low/middle-income countries, there is emerging evidence use of KMC could improve breastfeeding rates in high-income countries. Since the control group in studies evaluating continuous KMC was in incubators or radiant warmers, the potential beneficial effects of KMC on morbidity and mortality of LBW infants would be expected to be greatest in settings in which conventional neonatal care is unavailable.
Context: 
LBW (less than 2500g) is associated with an increased risk of neonatal morbidity and mortality, neurodevelopmental disabilities, and cardiovascular disease at adulthood. Conventional neonatal care of LBW infants is expensive and needs both highly skilled personnel and permanent logistic support. The major component of KMC is skin-to-skin contact between a mother and her newborn. The other 2 components of KMC are frequent and exclusive or nearly exclusive breastfeeding and attempt at early discharge from hospital.
Review CD#: 
CD002771
PEARLS No: 
322
Date: 
August, 2011
Authored by: 
Brian R McAvoy