A study on breastfeeding initiation in low birth weight and very low birth weight babies and their developmental outcome with special reference to kangaroo mother care

Background: Kangaroo Mother Care (KMC) was developed for caring of low birth weight (LBW) babies in developing countries. Study was done with the objective to evaluate the factors affecting initiation of breast feeding and effect of Kangaroo Mother Care (KMC) on morbidity problems and developmental outcome in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) babies.Methods: Prospective follow-up cohort study was carried out at Neonatal Intensive Care Unit (NICU) at Narayana medical college hospital Nellore from January 2018 to December 2019 and details of neonates were recorded on prestuctured proforma. Kangaroo mother care was given to one group. ASQ 3 questionnaire was used to assess the developmental outcome of the infants.Results: In this study, 100 babies were divided into two groups, case group consists of 50 babies where KMC is given and another control group consists 50 babies where KMC is not given. Mean gestational age for case and control group babies were 34.5 and 33.7 weeks respectively. Mean Birth weight in cases (1700 gr) and control (1580) grams respectively. Number of Male babies were more in cases (51%) and Group B (53%). Main factors affecting the initiation of breastfeeding in babies are LSCS (62% and 48%), RDS (50% and 40%), Apnea (24% and 25%) and seizures (20% and 14%) respectively in case and controls. Rates of exclusive breastfeeding is significantly increased in cases (90%) when compared to control (72%). Morbidity in cases is comparatively lesser than controls. At 6 months of corrected gestational age, mean weight in cases (5.2 kg) is significantly more than mean weight in control (4.7 kg). Significant development is noticed in communication (p=0.036), gross motor (0.04), and fine motor (0.05) compare to controls. Percentage of babies who acquired better personal social skills are more in cases (80%).Conclusions: The main factors affecting the initiation of breastfeeding in LBW and VLBW babies are LSCS, RDS, not secreted milk and seizures. KMC helps to achieve smooth and early transition to direct breastfeeding, increases the exclusively breastfeeding rate, better growth and developmental outcome and reduces the morbidities in LBW neonates.

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A STUDY OF IMPLEMENTATION OF KANGAROO MOTHER CARE IN LOW BIRTH WEIGHT INFANTS .

10.36106/ijar/4600116 ◽

2021 ◽

pp. 1-2

Author(s):

Navaney Hiru ◽

Yogesh goel ◽

Rasbihari Rasbihari

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Kangaroo Mother Care ◽

Control Group ◽

Kangaroo Care ◽

Randomized Control ◽

And Control

INTRODUCTION :-Kangaroo mother care is a evidence based cost effective approach and avert up to 4.5lk preterm .(1,2) death each year .if near universal coverage is achieve investment in KMC has benets beyond survival including healthy growth and long term development. Edgar Rey and Hectare Martinez develop kangaroo mother care in Colombia as a substitute for incubator in the low birth weight infant . KMC is dene as early prolong and continuous skin to skin contact between the mother and the low birth 5 weight infant both in hospital and after discharge with exclusive breast feeding and proper follow up. Published nding from different countries demonstrated KMC promote stable heart rate R.R and oxygen saturation and thermal regulation in infants 6-13. The present OBJECTIVE :- study was conducted to study through a randomized control trial the effect of KMC on breastfeeding, weight gain and length of hospitalizations 2. of very low birth weight neonates and To access the acceptability of KMC by nurses and mother . METHODS :-Babies whose birth weight was less than 1500 Grams were included in the study once they were stable. The effect of Kangaroo Mother Care on breast feeding rates, weight gain and length of hospitalization of very low birth weight neonates was studied through a randomized control trial in 56 neonates. The Kangaroo group (n = 28) was subjected to Kangaroo Mother Care of at least 4 hours per day in not more than 3 sittings. The babies received Kangaroo Care after shifting out from NICU and at home. The control group (n = 28) received only standard care (incubator or open care system). Attitude of mothers and nurses towards KMC was assessed on Day 3 +/- 1 and on day 7 +/- 1 after starting Kangaroo Care in a questionnaire using Likert's scale. The results of the clinical trial reveal that the neonates RESULTS:- in the KMC group demonstrated better weight gain after the rst week of life (15.9 +/- 4.5 gm/day vs. 10.6 +/- 4.5 gm/day in the KMC group and control group respectively p < 0.05) and earlier hospital discharge (27.2 +/- 7 vs. 34.6 +/- 7 days in KMC and control group respectively, p < 0.05). The number of mothers exclusively breastfeeding their babies at 6 week follow-up was double in the KMC group than in the control group (12/14 vs. 6/14) (p < 0.05)

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Initiation of Breastfeeding Among Mothers of Very Low Birth Weight Infants

PEDIATRICS ◽

10.1542/peds.111.6.1337 ◽

2003 ◽

Vol 111 (6) ◽

pp. 1337-1342 ◽

Cited By ~ 53

Author(s):

M. M. Smith ◽

M. Durkin ◽

V. J. Hinton ◽

D. Bellinger ◽

L. Kuhn

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Initiation Of Breastfeeding

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High Blood Pressure during Pregnancy is not a Protective Factor for Preterm Infants with Very Low Birth Weight. A Case-Control Study

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0037-1601883 ◽

2017 ◽

Vol 39 (04) ◽

pp. 155-161 ◽

Cited By ~ 1

Author(s):

Annibal Sabino ◽

Eduardo de Souza ◽

Ana Goulart ◽

Adriana Lima ◽

Nelson Sass

Keyword(s):

Blood Pressure ◽

Birth Weight ◽

Low Birth Weight ◽

Protective Factor ◽

Case Control Study ◽

Very Low Birth Weight ◽

Case Control ◽

World Health ◽

Control Group ◽

Control Study

Objective To evaluate whether the presence of maternal blood pressure reduces the risks of morbidity, perinatal mortality and morbidity at 24 months of age in very low birth weight infants (VLBWIs) compared with a control group. Methods A retrospective, observational, case-control study. Total 49 VLBWIs were allocated to the study group, called the maternal arterial hypertension group (AHG), and matched with 44 in the control group (CG). The infants were assessed during hospitalization and at 12 and 24 months corrected age at a specialized clinic. For the assessment of growth, the World Health Organization (WHO) Anthro software (Geneva, 2006) was used, and for the psychomotor assessment, the Denver II test was used. Results In relation to the antenatal variables, the infants of the AHG had more centralized circulation assessed by Doppler, received more corticosteroids and magnesium sulfate, and were born by cesarean section more frequently. In terms of the postnatal and in-hospital outcomes, the AHG had a higher gestational age at birth (30.7 versus 29.6 weeks) and a lower frequency of 5-minute Apgar scores of less than 7 (26.5% versus 52.3%). The CG had a higher rate of pulmonary dysplasia (30.2% versus 8.3%). There were no differences in terms of hospital mortality, complications, somatic growth and functional problems at 24 months of corrected age. Conclusion The presence of maternal hypertension, especially preeclampsia, was not a protective factor against morbidity, mortality and evolution in VLBWIs aged up to 24 months. Therefore, the clinical practice should be focused on prolonging the pregnancy for as long as possible in these conditions as well.

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Effect of short term recombinant human erythropoietin (rHuEPO) therapy in the prevention of anemia of prematurity (AOP) in very low birth weight (VLBW) neonates

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v38i3.14340 ◽

2013 ◽

Vol 38 (3) ◽

pp. 119-123 ◽

Cited By ~ 6

Author(s):

BHN Yasmeen ◽

MAKA Chowdhury ◽

MM Hoque ◽

MM Hossain ◽

R Jahan ◽

...

Keyword(s):

Folic Acid ◽

Birth Weight ◽

Low Birth Weight ◽

Recombinant Human Erythropoietin ◽

Very Low Birth Weight ◽

Controlled Trial ◽

Control Group ◽

Short Term ◽

Human Erythropoietin ◽

Anaemia Of Prematurity

Premature infants especially those with birth weight <1500 g suffer from Anaemia of prematurity (AOP) and associated problems. Erythropoietin therapy is a safe effective way to prevent and to treat anaemia of prematurity. To evaluate the effect of short term administration of recombinant human erythropoietin (rHuEPO) with iron and folic acid in very low birth weight (VLBW) neonates in the prevention of anaemia of prematurity. A randomized controlled trial was carried out at Dhaka Shishu Hospital. Sixty preterm very low birth weight (PTVLBW) babies were enrolled in this study. Thirty were assigned to rHuEPO group and 30 as control. Baseline haematologic values were estimated before administration of rHuEPO. From day 7 of life rHuEPO-200 IU/kg/dose subcutaneously every alternate day for 2 weeks was administered to rHuEPO group. All infants in both groups have received oral iron, folic acid from day 14. Clinical and haematological assessment was done at 6 and 10 weeks of life. Baseline clinical characteristics and haematologic values were almost similar in both groups. This study has shown increase in haematological values(haemoglobin and haematocrit) and reduction in the number of blood transfusions during both the 1st and 2nd follow up in rHuEPO group in comparison to control group (p<0.01). Short term rHuEPO appears to be very effective in prevention of Anaemia of prematurity. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14340 Bangladesh Med Res Counc Bull 2012; 38(3): 119-123 (December)

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Effect of Oral Erythropoietin in Prevention of Anemia of Prematurity

Bangladesh Journal of Child Health ◽

10.3329/bjch.v41i2.36106 ◽

2018 ◽

Vol 41 (2) ◽

pp. 101-109

Author(s):

Md Jamshed Alam ◽

Md Kamrul Ahsan Khan ◽

Nazmun Nahar ◽

Sanjoy Kumer Dey ◽

Md A Mannan ◽

...

Keyword(s):

Birth Weight ◽

Breast Milk ◽

Blood Transfusion ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Control Group ◽

Group Iii ◽

Anemia Of Prematurity ◽

The Mean ◽

Group Ii

Introduction: Anemia of prematurity (AOP) is a common problem of very low birth weight babies. Blood transfusion is a necessity when it occurs in moderate to severe form putting the child in to the risk of transfusion related complications. Erythropoietin, a potent stimulator of hemopoesis is available in breast milk in good amount and absorbed intact under physiologic condition. In this background oral recombinant human erythropoietin (rhEPO) can be a useful alternative to its subcutaneous administration in prevention of AOP.Objective: To evaluate the efficacy of oral rhEPO in the prevention of AOP in very low birth weight (VLBW) neonates.Methods: This randomized controlled study conducted in the NICU of BSMMU over one year. Total 60 preterm (<34 weeks)VLBW (<1500g) infants were enrolled and randomly divided into Control (group-I), Oral (group-II) and Subcutaneous (group III). Experimental groups (group-II & group-III) received rhEPO 400 IU/Kg, 3 times weekly in oral and subcutaneous (S/C) route respectively and continued for 2 weeks (Total 6 doses). Therapy was initiated 14 days after birth when the baby achieved oral feeding of at least 50 ml/kg/day of breast milk. All infants received oral iron and folic acid supplementation up to 12 weeks of postnatal age. Transfusion data were recorded. Anthropometric and hematological assessments were done at 2, 4, 6 and 12 weeks of age.Results: Baseline clinical characteristics and hematological values were almost similar in all groups. Mean hemoglobin were 11.34±0.68gm/dl, 11.88±0.54gm/dl& 12.12±1.32 gm/dl, the mean hematocrit were 34.11±2.03%, 35.66±1.65% & 36.38±3.97% and the mean reticulocyte were 7.56±2.48%, 9.85±1.50% & 9.22±3.11% in the control, oral and subcutaneous group respectively and the differences are statistically significant (p<0.05).Weight gain was higher in the intervention group at 6 and 12 weeks follow up than the control group(p<0.05).Only 2 (5.25%) infants, one in each of the intervention groups required blood transfusion, compared to 6 (31.5%) infants in control group (p<0.01).Conclusion: Oral EPO is as good as subcutaneous use of EPO in stimulating erythropoesis, maintaining HCT and Hb at high level and is safe in preterm baby.Bangladesh J Child Health 2017; VOL 41 (2) :101-109

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