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  • Title: Kangaroo mother care.
    Author: Doyle LW.
    Journal: Lancet; 1997 Dec 13; 350(9093):1721-2. PubMed ID: 9413460.
    Abstract:
    This article presents the findings of a case-control study of Kangaroo-mother care (KMC) among mothers in Bogota, Colombia. The study group included mothers from one hospital in Bogota who were encouraged to maintain skin-to-skin contact with their infants, with frequent breast feeding and early discharge from the maternity unit. The other hospital relied on traditional care. Findings indicate that infant mortality rates were similar with both types of care. The KMC infants were at higher risk of an adverse outcome. More detailed analysis was made of infants weighing under 2000 g. 1084 KMC infants with low birth weights were considered for inclusion in the study. These infants were required to be free of infections, adjusted to extrauterine life, and free of malformations or diseases. This reduced the random sample to 382 infants allocated to KMC and 364 allocated to traditional care. KMC required the following: strapping the baby upright to the mother's chest in skin-to-skin contact, frequent breast feeding, formula supplements if weight gain did not exceed 20 g/day, and early discharge. Traditional care included incubation until the temperature stabilized, discharge after reaching 1700 g, and severely restricted parents' access. A comparison between the two infant groups showed similar mortality rates: 1.6% for KMC infants and 2.9% for traditional care infants. The KMC group had a 1.1-day shorter hospital stay, infections were less severe, and breast feeding rates were higher. Breast feeding was engaged in by 98.0% of KMC infants and 92.5% of traditional infants. This study was flawed in that low-birth-weight infants may not be strong enough to suck and swallow at birth. Traditional care can include close parent contact and early introduction of breast feeding in the hospital. Before KMC can be applied to all infants, research needs to identify those most likely to benefit, to determine that benefits outweigh risks, and to perform long-term follow-up.
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