Long Term Outcomes ofKangaroo Mother Care inVery Low Birth Weight Infants

摘要

Introduction: Kangaroo Mother Care (KMC) has been gaining acceptance as an effective alternative to incubator based Conventional Medical Care (CMC) in preterm or Low Birth Weight (LBW) infants especially in resource scarce developing countries.Aim: To report and analyse the long-term effects of KMC for relatively stable Very Low Birth Weight (VLBW) infants on nutritional indicators and feeding conditions at 6?12 months of corrected age.Materials and Methods: This randomized controlled trial was done at a Level III Neonatal Intensive Care Unit (NICU) of a teaching institution in southern India. One hundred and forty neonates with birth weight <1500gm were enrolled. Inborn singleton, VLBW (birth weight <1500gm) infants, tolerating spoon feeds of 150mL/kg/day and haemodynamically stable (not on oxygen or respiratory support, no apnea for 72 hours, not on any intravenous fluids) were eligible. Infants with major malformation were excluded. Babies were randomized to KMC group or CMC group. At 6 to 12 months corrected age, the assessment included the measurement of growth parameters in terms of malnutrition, wasting, stunting and having small head. Feeding information was collected in relation to duration of exclusive or partial breastfeeding (months of chronological age and of corrected age), the age (chronological age and corrected age) at which weaning diet was started and the type of weaning diet. Comparisons between study groups for primary outcomes and secondary outcomes were performed with Odds Ratio (OR) calculator using Medcalc online statistical software.Results: A total of 91 infants were followed at 6?12 months of corrected age. There was no difference between two groups in the incidence of malnutrition, wasting, stunting and having small head (47.7% vs 31.9%, p-0.13), (34.1% vs. 31.9%, p-0.83), (22.7% vs 12.8%, p-0.22) and (18.2% vs.31.9%, p-0.14). Although KMC group babies had better head growth and lesser weight and length compared to the CMC group, it was not statistically significant. The breast feeding and weaning rates at 6 months post birth were similar in both the groups.Conclusion: KMC group does not differ significantly with CMC group in terms of long-term growth and feeding pattern at 6 to 12 months of corrected age.