Kangaroo mother care (MMC) or KMC has been recommended by the World Health Organization (WHO) as the standard of care for preterm or low birth weight infants after receiving the hospital care they need. It basically consists of the baby being carried – normally by her mother – in a sling that allows skin-to-skin contact and numerous studies have shown that in this way the risk of the child dying or contracting infections is reduced.
What the experts have not yet agreed on is what would be the ideal moment to start this intervention. Now, a review of studies by Indian scientists has concluded that skin-to-skin contact between a mother and her low-birth-weight or premature baby within 24 hours of birth and following this practice for eight hours a day seems to be the most effective in reducing infection and increasing the child’s chances of survival.
The researchers analyzed 31 trials involving 15,559 babies, of which 27 studies compared kangaroo mother care with traditional care, while another four compared early versus late initiation of KMC. The results have been published in BMJ Global Health and showed that, compared with conventional care, MMC appeared to decrease the risk of mortality by 32% during hospitalization for delivery or 28 days after birth, while the risk of serious infection , such as sepsis, appeared to decrease by 15%.
Lower infant mortality regardless of gestational age or weight
Among the main findings of the analysis, it stands out that the decrease in mortality in these babies was observed regardless of their gestational age or the weight they had at the time of enrollment, the time of initiation and the place of initiation of the kangaroo mother care method (hospital or community).
Kangaroo mother care appeared to decrease the risk of mortality by 32% during hospitalization for delivery or 28 days after birth
Mortality was also lower depending on the daily duration of MMC, with less risk observed when the duration was at least eight hours per day compared to a shorter duration. Results from studies comparing early to late MMC showed a 33% decrease in neonatal mortality and a probable 15% decrease in the risk of clinical sepsis up to 28 days after early initiation of MMC.
The work has certain limitations because the participants were aware of the intervention and this could have influenced the results, and very low birth weight, extremely preterm and highly unstable infants were often not included in the studies, but the authors state that the risk of bias in the included studies was generally low and that their “findings support the practice of KMC for preterm and low birth weight infants as soon as possible after birth and for at least eight hours a day”.
“Future research should focus on overcoming the barriers and facilitators for large-scale implementation of KMC in facilities and community settings. Data on long-term neurodevelopmental outcomes are also needed,” these scientists conclude.
Kangaroo care has been known since 1978 and “there is solid evidence regarding its advantages over traditional care (incubator) in terms of reducing mortality, nosocomial infections, apnea (episodes of respiratory pauses), hypothermia (reduction in body temperature) and the increase and facilitation of breastfeeding and the establishment of the mother-child bond”, says Adolfo Gómez Papí, neonatologist and attending physician of the Pediatrics, Neonatal Unit and ICU service at the Joan XXIII Hospital of Tarragona, in statements to SMC Spain.
In the opinion of the expert, “this study confirms the reduction in mortality, in a very high percentage (32% on average). Another novelty is that they verify that the earlier ‘kangaroo care’ is started and the more hours a day they are enjoyed, the better results. Therefore, “the advantages of ‘kangaroo care’, which is becoming more widespread, are confirmed, and emphasis is placed on starting early and practicing it at least eight hours a day.”
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