scholarly journals The Hammock as a Therapeutic Alternative at The Neonatal Intensive Care Unit

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Silvana Alves Pereira ◽  
Gentil Gomes da Fonseca Filho ◽  
Norrara Scarlytt de Oliveira Holanda ◽  
Daniela Elizabeth de Castro Vieira ◽  
Cristiane Aparecida Moran
Keyword(s):  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Vestibular Stimulation ◽  
Kangaroo Mother Care ◽  
University Hospitals ◽  
Normal Birth ◽  
Skin Contact ◽  
Quasi Experimental ◽  
Maternal Presence ◽  
Collection Form

Background: Among the therapeutic alternatives complementary to humanized care, there is the vestibular stimulation. Provided by the gentle swing in a hammock, it simulates the containment and maternal movements found in the intrauterine environment and is considered a safe method that reduces stress levels in very low birthweight premature newborn (PTNB). Objective: To observe the time of hospitalization and the discharge weight of the PTNB that passed through the positioning in the hammock and kangaroo mother care. Methods: A quasi-experimental study involving two university hospitals including PTNB. The PTNB were allocated into two groups: Kangaroo Mother Care (KMC) composed by PTNB selected according to the maternal presence and vestibular stimulation (VS) composed by PTNB whose maternal presence was not possible. The KMC were kept in skin-to-skin contact with the mother. The VS were positioned in dorsal decubitus in a hammock of cotton adapted within the incubator. The time of hospitalization and weight monitoring were recorded daily by the nursing team in a collection form. Results: From the 40 PTNB included in this study, 47.5% were female and 40% had normal birth, 20 of them were allocated in the VS group and 20 in the KMC group. The time of hospitalization were not different between the groups (p=0.12), but the discharge weight were higher in the VS group (p<0.05). Conclusion: The data indicate that the hospitalization time is similar between the PTNB who received KMC and VS, and that the discharge weight is higher for the group that received the VS.

scholarly journals Evaluating the role of kangaroo mother care on the lactation among the newborn low birth weight babies

2021 ◽  
Vol 10 (2) ◽  
pp. 579
Author(s):  
Purnima Margekar ◽  
Premlata Parekh ◽  
Shubalaxmi Margekar
Keyword(s):  
Breast Feeding ◽  
Neonatal Intensive Care ◽  
Close Contact ◽  
Kangaroo Mother Care ◽  
Outcome Variable ◽  
Control Group ◽  
Case Group ◽  
Feeding Mode ◽  
Skin Contact

Background: A universally available and biologically sound method of care for all new-borns, but in particular for premature babies, with three components including skin-to-skin contact, exclusive breastfeeding and support to the “mother infant dyad”. The present study was done to evaluate the role of kangaroo mother care (KMC) on the lactation.Methods: A prospective case control study of KMC was conducted in a teaching institution with a tertiary level neonatal intensive care unit (NICU) over a 12-month period from August 2013 to August 2014 on 50 new-borns weighing less than 1.8 kg. In order to provide KMC, special bag or kangaroo pouch was designed to keep the baby in close contact with mother. The primary outcome variable was “breast feeding”. Mode of feeding at admission to either group was noted down. Before allocating to either group, it was assured that baby was tolerating enteral feeds & there was no regurgitation.Results: Sixty six percent of neonates in case group and eighty percent of control group were on tube feed while 30% of case group and 16% of control group were on spoon feed at the time of enrolment in study. Spoon feeding plus breast feeding was established 28% of KMC group and in 4% control group, while only breast feeding was established in 30% of KMC group and 26% of control group on discharge.Conclusions: More babies in KMC group were shifted to breast-feeding on discharge. In addition to that KMC group demonstrated more weight gain and duration of stay was shorter in them.

Innovative need-based low-cost kangaroo mother care (KMC) chair

2020 ◽  
Vol 6 (4) ◽  
pp. 220-224
Author(s):  
Ashish Jain ◽  
Jerin C Sekhar ◽  
Nisha Kumari ◽  
Nidhi Jain
Keyword(s):  
Low Income ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Low Cost ◽  
Kangaroo Mother Care ◽  
Low Income Countries ◽  
Mortality And Morbidity ◽  
Beneficial Effects ◽  
Level Of Satisfaction ◽  
Tertiary Teaching

ObjectivesLow birthweight neonates contribute substantially to mortality and morbidity. Their management in low-income countries is difficult due to shortage of skilled staff and limited resources. Kangaroo mother care (KMC) is an effective way of providing warmth, stimulation and protection against infection, thereby decreasing mortality. We intended to perform a need-based survey among mothers and to develop an economic and comfortable chair to facilitate and optimise KMC. We also evaluated the level of satisfaction among mothers using the developed chair.DesignIterative product development.SettingA tertiary teaching hospital having level 3 neonatal intensive care and KMC ward.MethodsAn initial design for KMC chair was developed based on the structured response of 40 mothers to a need-based questionnaire. The prototype was reviewed by experts, including nursing staff, and a comfortable chair with minimum logistics was developed. A formative assessment of satisfaction was done using a questionnaire after introducing it in clinical practice.Results67.5% of mothers were satisfied with the head rest, inclination and height, while 72.5% were satisfied with the in-built KMC cloth and platform for placing utensils. 86.6% of nurses found the chair helpful to mothers; 83.3% were satisfied with the length of in-built KMC cloth; and 80% expressed their overall satisfaction in the KMC chair. 70% of nurses found the chair to facilitate safe position for the baby and to improve breast feeding.ConclusionThis innovative and need-based KMC chair would help mothers of different builds perform KMC comfortably. This might prolong the duration of KMC, thereby having beneficial effects on the neonate.

scholarly journals Kangaroo mother care: need of the day

2019 ◽  
Vol 12 (12) ◽  
pp. e228402
Author(s):  
Rubina Sohail ◽  
Noreen Rasul ◽  
Ammara Naeem ◽  
Humayun Iqbal Khan
Keyword(s):  
Developing Countries ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Kangaroo Mother Care ◽  
Preterm Baby ◽  
Mortality And Morbidity ◽  
Safe Delivery ◽  
Live Births ◽  
Skin Contact ◽  
Skin To Skin

Each year approximately 20 million low birthweight babies are born globally. Prematurity is a leading cause of neonatal mortality in developing countries and results in 60%–80% of neonatal deaths. Neonatal mortality is the major contributor to under-5 mortality. According to Pakistan Demographic and Health Survey 2017–2018, neonatal mortality in Pakistan is 42 per 1000 live births and under-5 mortality is 74 per 1000 live births. One out of every 22 newborns dies in Pakistan, which is an alarming figure. Majority of these deaths are preventable. They can be prevented by well-trained midwives, safe delivery, early initiation of breast feeding within an hour after birth and skin-to-skin contact. Pakistan is among the top 10 countries with the highest number of preterm births and with limited resources to manage the burden. Kangaroo mother care (KMC) is a safe and economical alternative to provide preterm care in developing countries. In babies at gestational age less than 37 weeks or with neonatal weight less than 2.5 kg, skin-to-skin contact prevents hypothermia and infection. Neonatal mortality and morbidity can be reduced by providing preterm care through KMC. This case report is of a preterm baby who was delivered at 33 weeks of gestation with a weight of 1.3 kg and was saved by KMC in the paediatric department of Services Hospital in Lahore.

scholarly journals Impact of continuous Kangaroo Mother Care initiated immediately after birth (iKMC) on survival of newborns with birth weight between 1.0 to <1.8 kg: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
WHO Immediate KMC Study Group ◽  
Rajiv Bahl
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Skin Contact ◽  
Clinical Trials Registry ◽  
Skin To Skin

Abstract Background: Globally about 15% of newborns are born with a low birth weight (LBW), as a result of preterm birth, intrauterine growth restriction or both. Up to 70% of neonatal deaths occur in this group within the first three days after birth. Kangaroo Mother Care (KMC) applied after stabilization of the infant, has shown to reduce mortality by 40% among hospitalized infants with birth weight <2.0 kg. In these studies, infants were randomized and KMC initiated after about three days of age, by when the majority of neonatal deaths would have already occurred. The aim of this trial is to evaluate the safety and efficacy of continuous KMC initiated as soon as possible after birth compared to the current recommendation of initiating continuous KMC after stabilization in neonates with birth weight between 1.0 and <1.8 kg. Methods: This randomized controlled trial is being conducted in tertiary care hospitals in five low- and middle-income countries (LMICs) in South Asia and Sub-Saharan Africa. All pregnant women admitted in these hospitals for childbirth are being pre-screened. After delivery, all neonates with birth weight between 1.0 and <1.8 kg are being screened for enrolment. Eligible infants are randomized into intervention and control groups. The intervention consists of continuous skin-to-skin contact initiated as soon as possible after birth, promotion and support for early exclusive breastfeeding, and provision of health care for mother and baby with as little separation as possible. This efficacy trial will primarily evaluate the impact of KMC started immediately after birth on neonatal death (between enrolment and 72 hours of age, and deaths between enrolment and 28 days of age), and other key outcomes. Discussion : This is the first large multi-country trial studying immediate KMC in low- and middle-income countries. Implementation of this intervention has already resulted in an important enhancement of the paradigm shift in LMIC settings in which mothers are not separated from their baby in the neonatal intensive care units (NICU). The findings of this trial will not only have future global implications on how the LBW newborns are cared for immediately after birth, but also for the dissemination of designing NICUs according to the “Mother-Newborn Intensive Care Unit (M-NICU) model.” Trial registration : Clinical Trials Registry India (CTRI)- CTRI/2018/08/01536 (retrospectively registered); Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12618001880235 (retrospectively registered). https://anzctr.org.au/ACTRN12618001880235.aspx Funding: The study is funded by a grant from the Bill and Melinda Gates Foundation to the World Health Organization (Grant agreement OPP1151718) Keywords : Immediate Kangaroo Mother Care (iKMC), low birth weight babies, mortality, skin-to-skin contact, breastfeeding, mother-neonatal intensive care unit (M-NICU)

scholarly journals The effects of a hospital-based perinatal breastfeeding program on exclusive breastfeeding in Taiwan: a quasi-experimental study

2020 ◽  
Vol 37 (3) ◽  
Author(s):  
Ching-Hsueh Yeh ◽  
Ya-Pi Ng Yang ◽  
Bih-O Lee
Keyword(s):  
Hospital Discharge ◽  
Exclusive Breastfeeding ◽  
Intervention Program ◽  
Kangaroo Mother Care ◽  
Control Group ◽  
Breastfeeding Support ◽  
Skin Contact ◽  
Breastfeeding Rate ◽  
Quasi Experimental ◽  
Experimental Group

Objective: To examine if a perinatal breastfeeding program would improve the exclusive breastfeeding rate at a baby-friendly hospital. Background: The Ten Steps to Successful Breastfeeding and Baby-Friendly Hospital Initiative have been widely used to improve breastfeeding outcomes worldwide. A hospital-based multi-strategy intervention may provide an opportunity to increase breastfeeding in different countries. Study design and methods: The study used a quasi-experimental design. Data was collected in a Baby Friendly hospital. A total of 60 mother-infant dyads were included. The experimental group took part in the multi-component perinatal breastfeeding program, while the control group received routine care. The multi-strategy program included prenatal breastfeeding education, birth kangaroo mother care (skin-to-skin contact and non-separation practices) at first breastfeed, continuous 24-hour rooming-in, ongoing kangaroo mother care with breastfeeding on cue, and hospital support visits. The exclusive breastfeeding rate was measured at hospital discharge, and one-month postpartum. Results: The mothers who participated in the intervention had a greater exclusive breastfeeding rate at hospital discharge and one month postpartum than those in the control group. In the experimental group, 90% of the infants completed the first feeding within two hours after birth. At discharge, 93.3% of the mothers in the experimental group and 53.3% in the control group were exclusively breastfeeding. At one month postpartum, 83.3% of the mothers in the experimental group and 36.7% in the control group were still exclusively breastfeeding. Discussion: The intervention program used in the current study is different to previous studies. The current intervention not only included prenatal education and postpartum support, but also included birth kangaroo mother care at first breastfeed and ongoing kangaroo mother care with breastfeeding on cue. Breastfeeding should be promoted through perinatal comprehensive clinical and social support starting in the prenatal period and continuing through intrapartal, postpartum, and follow-up periods. Conclusion: This study was the first study to use a hospital-based multi-strategy intervention including the non-separation of mother-infant dyads and other breastfeeding support for mothers in Taiwan. The program was associated with a significant improvement in the exclusive breastfeeding rate at one month postpartum.

scholarly journals The effects of a hospital-based perinatal breastfeeding program on exclusive breastfeeding in Taiwan: a quasi-experimental study

2020 ◽  
Vol 37 (3) ◽  
Author(s):  
Ching-Hsueh Yeh ◽  
Ya-Pi Ng Yang ◽  
Bih-O Lee
Keyword(s):  
Hospital Discharge ◽  
Exclusive Breastfeeding ◽  
Intervention Program ◽  
Kangaroo Mother Care ◽  
Control Group ◽  
Breastfeeding Support ◽  
Skin Contact ◽  
Breastfeeding Rate ◽  
Quasi Experimental ◽  
Experimental Group

Objective: To examine if a perinatal breastfeeding program would improve the exclusive breastfeeding rate at a baby-friendly hospital. Background: The Ten Steps to Successful Breastfeeding and Baby-Friendly Hospital Initiative have been widely used to improve breastfeeding outcomes worldwide. A hospital-based multi-strategy intervention may provide an opportunity to increase breastfeeding in different countries. Study design and methods: The study used a quasi-experimental design. Data was collected in a Baby Friendly hospital. A total of 60 mother-infant dyads were included. The experimental group took part in the multi-component perinatal breastfeeding program, while the control group received routine care. The multi-strategy program included prenatal breastfeeding education, birth kangaroo mother care (skin-to-skin contact and non-separation practices) at first breastfeed, continuous 24-hour rooming-in, ongoing kangaroo mother care with breastfeeding on cue, and hospital support visits. The exclusive breastfeeding rate was measured at hospital discharge, and one-month postpartum. Results: The mothers who participated in the intervention had a greater exclusive breastfeeding rate at hospital discharge and one month postpartum than those in the control group. In the experimental group, 90% of the infants completed the first feeding within two hours after birth. At discharge, 93.3% of the mothers in the experimental group and 53.3% in the control group were exclusively breastfeeding. At one month postpartum, 83.3% of the mothers in the experimental group and 36.7% in the control group were still exclusively breastfeeding. Discussion: The intervention program used in the current study is different to previous studies. The current intervention not only included prenatal education and postpartum support, but also included birth kangaroo mother care at first breastfeed and ongoing kangaroo mother care with breastfeeding on cue. Breastfeeding should be promoted through perinatal comprehensive clinical and social support starting in the prenatal period and continuing through intrapartal, postpartum, and follow-up periods. Conclusion: This study was the first study to use a hospital-based multi-strategy intervention including the non-separation of mother-infant dyads and other breastfeeding support for mothers in Taiwan. The program was associated with a significant improvement in the exclusive breastfeeding rate at one month postpartum.

scholarly journals Kangaroo mother care affect stability vital signs of low birth weight babies

2020 ◽  
Vol 8 (5) ◽  
pp. 1702
Author(s):  
Nunik Yuli Astuti ◽  
Regina Vidya Trias Novita
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Vital Signs ◽  
Kangaroo Mother Care ◽  
Control Group ◽  
Skin Contact ◽  
Before And After ◽  
Duration Of Hospitalization ◽  
Quasi Experimental ◽  
The Stability

Background: The Kangaroo Mother Care (KMC) is defined as skin-to-skin contact between mother and her new-born. KMC is a simple way to increase the life expectancy of low birth weight and premature infants. The purpose of this study is to explore the stability of vital signs for Low Birth Weight (LBW) infants before and after using KMC.Methods: the design was a quasi-experimental pre and posttest without a control group has been conducted in private hospital perinatal inward Tangerang with 30 LBW babies.Results: The result shows that the stability of vital signs with t-test the baby's temperature that the resulting p=0.001; α=0:05, heart frequency p=0.004; α=0:05, breath frequency p=0.004; α=0:05 and oxygen saturation p=0.011; α=0:05. The stability of vital signs through KMC could be a complement and alternative to conventional nursing for LBW babies and length of stay in hospital could be minimized.Conclusions: The stability of these vital signs through the KMC can be used as a complementary and alternative in the treatment of LBW, particularly those with low birth weight, which can decrease the duration of hospitalization and use of the incubator is an absolute equipment used.

scholarly journals “So sometimes, it looks like it’s a neglected ward”: Health worker perspectives on implementing kangaroo mother care in southern Malawi

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243770
Author(s):  
Mai-Lei Woo Kinshella ◽  
Sangwani Salimu ◽  
Brandina Chiwaya ◽  
Felix Chikoti ◽  
Lusungu Chirambo ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Service Providers ◽  
Health Workers ◽  
Health Management ◽  
Low Cost ◽  
Newborn Health ◽  
Kangaroo Mother Care ◽  
World Health ◽  
District Health ◽  
Skin Contact

Introduction Kangaroo mother care (KMC) involves continuous skin-to-skin contact of baby on mother’s chest to provide warmth, frequent breastfeeding, recognizing danger signs of illness, and early discharge. Though KMC is safe, effective and recommended by the World Health Organization, implementation remains limited in practice. The objective of this study is to understand barriers and facilitators to KMC practice at tertiary and secondary health facilities in southern Malawi from the perspective of health workers. Methods This study is part of the “Integrating a neonatal healthcare package for Malawi” project in the Innovating for Maternal and Child Health in Africa initiative. In-depth interviews were conducted between May-Aug 2019 with a purposively drawn sample of service providers and supervisors working in newborn health at a large tertiary hospital and three district-level hospitals in southern Malawi. Data were analyzed using a thematic approach using NVivo 12 software (QSR International, Melbourne, Australia). Findings A total of 27 nurses, clinical officers, paediatricians and district health management officials were interviewed. Staff attitudes, inadequate resources and reliance on families emerged as key themes. Health workers from Malawi described KMC practice positively as a low-cost, low-technology solution appropriate for resource-constrained health settings. However, staff perceptions that KMC babies were clinically stable was associated with lower prioritization in care and poor monitoring practices. Neglect of the KMC ward by medical staff, inadequate staffing and reliance on caregivers for supplies were associated with women self-discharging early. Conclusion Though routine uptake of KMC was policy for stable low birthweight and preterm infants in the four hospitals, there were gaps in monitoring and maintenance of practice. While conceptualized as a low-cost intervention, sustainable implementation requires investments in technologies, staffing and hospital provisioning of basic supplies such as food, bedding, and KMC wraps. Strengthening hospital capacities to support KMC is needed as part of a continuum of care for premature infants.

scholarly journals Kangaroo mother care practices for low birthweight newborns in a district hospital in Indonesia

2021 ◽  
Vol 27 (4) ◽  
pp. 354-364
Author(s):  
Septyana Choirunisa ◽  
Asri Adisasmita ◽  
Yulia Nur Izati ◽  
Hadi Pratomo ◽  
Dewi Iriani
Keyword(s):  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Cox Regression ◽  
District Hospital ◽  
Kangaroo Mother Care ◽  
Intensive Care Unit Treatment ◽  
Cox Regression Analysis ◽  
History Of ◽  
Care Practices ◽  
To Receive

Purpose: Kangaroo mother care (KMC) was introduced in Indonesia 30 years ago, but the extent of its use has not been fully documented. Therefore, this study aimed to examine the use of KMC and evaluate the characteristics of infants who received KMC at Koja District Hospital in North Jakarta, Indonesia. This retrospective cohort study recorded the characteristics of infants with birthweights less than or equal to 2,200 g at the above-mentioned hospital.Methods: Data collected from infant registers included gestational age, birthweight, Apgar score, number of complications, history of neonatal intensive care unit treatment, and KMC status. Cox regression analysis was conducted.Results: This study found that 57.7% of infants received KMC. Infants with birthweights over 1,500 g were 2.16 times (95% CI: 1.20-3.89) more likely to receive KMC.Conclusion: Efforts to promote KMC are recommended, specifically for infants with birthweights greater than 1,500 g. KMC for infants with other conditions can also be considered based on the infants' stability.

scholarly journals Scaling up kangaroo mother care in the Philippines using policy, regulatory and systems reform to drive changes in birth practices

2021 ◽  
Vol 6 (8) ◽  
pp. e006492
Author(s):  
Anthony Patrick Calibo ◽  
Socorro De Leon Mendosa ◽  
Maria Asuncion Silvestre ◽  
John Charles Scott Murray ◽  
Zhao Li ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Environmental Changes ◽  
Scale Up ◽  
Newborn Care ◽  
The Philippines ◽  
Kangaroo Mother Care ◽  
Multidisciplinary Teams ◽  
Local Data ◽  
Skin Contact ◽  
Low Middle Income Countries

The WHO recommends kangaroo mother care (KMC) for stable preterm and low birthweight babies because it has been demonstrated to reduce mortality by up to half compared with conventional incubator-based care. Uptake of KMC in low/middle-income countries has been limited, despite its suitability for low-resource environments. This paper reviews factors that contributed to the adoption and expansion of KMC in the Philippines. Early introduction began in 1999 but national scale-up was slow until 2014 after which a significant improvement in national adoption was observed. The proportion of target hospitals implementing KMC rose from 3% to 43% between 2014 and 2019, with 53% of preterm and low birthweight babies receiving KMC by the end of this period. Expansion was led by the government which committed resources and formed partnerships with development partners and non-governmental organisations. Scale-up of KMC was built on the introduction of evidence-based newborn care practices around birth. Practice changes were promoted and supported by consensus-based policy, protocol, regulatory and health insurance changes led by multidisciplinary teams. A new approach to changing and sustaining clinical practice used hospital teams to conduct on-the-job clinical coaching and use local data to make environmental changes to support practices. Institutionalisation of early skin-to-skin contact, non-separation of mother and newborn and early initiation of exclusive breast feeding, with increased responsibility given to mothers, drove a cultural change among staff and families which allowed greater acceptance and uptake of KMC. Financial and programmatic support must be sustained and expanded to address ongoing challenges including staffing gaps, available space for KMC, willingness of some staff to adopt new practices and lack of resources for clinical coaching and follow-up.

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