Cochrane evidence supports the use of kangaroo care in stabilized low birthweight infants as an alternative to conventional neonatal care
Conventional neonatal care of low birthweight infants (< 2500 g) is expensive and requires both highly skilled personnel and logistical support. Kangaroo Mother Care (KMC) has been proposed as an alternative to conventional neonatal care of low birthweight infants. The major component of KMC is skin-to-skin contact between mother and newborn. The other two components of KMC are frequent and exclusive (or nearly exclusive) breastfeeding, and attempted early discharge from hospital.
Two Cochrane authors, based in the United States and Uruguay, worked with Cochrane Neonatal to update a 2014 version of this Cochrane Review, which includes 21 randomized controlled trials (RCTs) and a total of 3042 infants. The evidence was rated to be of moderate quality.
Compared with conventional neonatal care, KMC was found to reduce mortality at discharge or at 40 to 41 weeks' postmenstrual age and at latest follow-up, severe infection/sepsis, nosocomial infection/sepsis, hypothermia, severe illness, and lower respiratory tract disease. Moreover, KMC increased weight, length, and head circumference gain, breastfeeding at discharge or at 40 to 41 weeks' postmenstrual age and at one to three months' follow-up, mother satisfaction with method of infant care, some measures of maternal-infant attachment, and home environment. There were no differences in neurodevelopmental and neurosensory outcomes at 12 months' corrected age.
“We first conducted this Cochrane Review in 2000. Since then, we have updated it several times, with the number of studies increasing. This update added three more RCTs than the previous version,” says lead author Dr Agustin Conde-Agudelo. “Results of this updated review indicate that, currently, evidence is sufficient to support the use of kangaroo mother care in stabilized low birthweight infants as an alternative to conventional neonatal care, especially in resource-limited settings. To date, early-onset continuous kangaroo mother care in unstabilized or relatively stabilized low birthweight infants cannot be recommended on the basis of evidence provided by two small trials. This Cochrane Review provides a valuable resource for clinicians and policy makers, as it summarizes the current best evidence. It can also help direct researchers where future areas of study are needed.”
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