Kangaroo Care and Its Benefits On Premature Infants

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Mariah White

George Williams College of Aurora University School of Nursing

NUR 4050 26: Nursing Research

November 23, 2021

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Abstract

Background: Premature infant morbidity and mortality rates have consistently been a high concern for those in the medical field in regards to the cost of care, effectiveness of care, and various other factors in regards to infant health. Purpose: This paper is a compilation of worldwide-original research articles studying the topic of Kangaroo Mother Care (KMC) and its effects on the morbidity and mortality in premature infants within the first three months of life. Search Method: Using the EBSCOHost database search engine, scholarly, peer-reviewed articles on the topic of KMC and the morbidity/mortality of premature infants from 2016 to 2021 were allocated and reviewed. Nine references were collected and utilized to present the effects of KMC on premature infants and its implementation in the medical field. Results: The literature showed that the implementation of KMC in premature infants is a cost-effective method that yields outcomes that are better than those cared for in conventional methods of care, including decreased morbidity and mortality rates. Nursing Implications: Nurses should recommend the utilization of KMC in premature infants to lower costs and improve patient outcomes in regards to premature infants and parents, especially with the creation of equipment such as a customized baby wrap. Conclusion: Based on the literature reviewed, KMC proves to be a cost-effective care strategy on premature infants that yields lower morbidity/mortality rates and better outcomes for both the baby and mother when compared to the conventional mother care procedures.

Keywords: Kangaroo Mother Care (KMC), skin-to-skin contact, premature infants, low birth weight infants, infant morbidity and mortality, effectiveness of kangaroo care, preterm Infants, very low birth weight infants, outcomes of Kangaroo Mother Care

Kangaroo Care and Its Benefits On Premature Infants

Mariah White

George Williams College of Aurora University School of Nursing

NUR 4050 26: Nursing Research

• The development of Kangaroo Mother Care proved to be pivotal as it decreased the mortality rate of preterm infants from 70% to 30% (1).
• The World Health Organization (WHO) has defined Kangaroo Mother Care (KMC) as “early, continuous, and prolonged skin-to-skin contact between a mother and her newborn with father/substitute(s) participating as KC providers; frequent and exclusive breastfeeding; and early discharge from hospital” (3, p. 683).
• Despite WHO recommendation, the utilization of KMC has proven to be minimal despite WHO recommendations of its use for well over a decade on an individual and community level (6).

• To investigate the benefits of KMC on premature infant morbidity and mortality with a focus on
• premature infant health,
• neurobehavioral and feeding performance, and
• stress response.

Search Methods

Articles on KMC and the morbidity/mortality of premature infants found in CINAHL Complete, Health Source: Nursing/Academic Edition, and MEDLINE with Full Text were used.

Figure 1

Kangaroo Mother Care Benefits Compared to the Standard of Care

Note: Lower values found in the data shows a positive outcome on the results. + Data from Table 2 (8). *Data from Table 2 (4). Illnesses incorporated in Table 2 were hypothermia, sepsis, and apnea (in <32-week gestation individuals). *** Measurement of stress response in infants of the 120-minute intervention group compared to the control in Table 3 (3).

• All data showed better health outcomes and positive prognosis of those involved with KMC.
• KMC is a truly medically-effective and cost-effective intervention for preterm infants. However, implementation needs to be more common and accepted in hospitals globally.
• The utilization of KMC proves to be a simple solution for neonatal health.
• The data can open doors for KMC volunteer programs and implementation of specialized baby wraps designed for KMC (2).

• KMC on premature infants showed that there were protective effects against morbidities such as hypothermia, apnea, and sepsis (4).
• Overall health of premature neonates has been shown to have positive outcomes that result in lower morbidity and mortality rates.
• Feeding performance was greatly increased in those neonates that were initiated in KMC, gaining an average of 120 grams in five days.
• Infants that received KMC showed “increased alertness/attention and reduction in the overall likelihood of a neurodevelopmental delay” (3, p. 687).
• Infants with KMC have better attention and regulation scores which proved to be statistically significant (3).
• The salivary levels of cortisol in the experimental groups were significantly lower than those in the control group after 7 days (4).

Figure 2

Kangaroo Mother Care Benefits Compared to the Standard of Care

Note: Higher values found in the data shows a positive outcome on the results. **Data from Table 2 (10). **** These categories are from the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) and data is from the 120 minute intervention group compared to the control found in Table 3 (3).

Figure 1

Kangaroo Mother Care Benefits Compared to the Standard of Care

Note: Lower values found in the data shows a positive outcome on the results. + Data from Table 2 (8). *Data from Table 2 (4). Illnesses incorporated in Table 2 were hypothermia, sepsis, and apnea (in <32-week gestation individuals). *** Measurement of stress response in infants of the 120-minute intervention group compared to the control in Table 3 (3).

Figure 2

Kangaroo Mother Care Benefits Compared to the Standard of Care

Note: Higher values found in the data shows a positive outcome on the results. **Data from Table 2 (10). **** These categories are from the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) and data is from the 120 minute intervention group compared to the control found in Table 3 (3).

​

Kangaroo Care and Its Benefits On Premature Infants

Mariah White

George Williams College of Aurora University School of Nursing

NUR 4050 26: Nursing Research

• The development of Kangaroo Mother Care proved to be pivotal as it decreased the mortality rate of preterm infants from 70% to 30% (1).
• The World Health Organization (WHO) has defined Kangaroo Mother Care (KMC) as “early, continuous, and prolonged skin-to-skin contact between a mother and her newborn with father/substitute(s) participating as KC providers; frequent and exclusive breastfeeding; and early discharge from hospital” (3, p. 683).
• Despite WHO recommendation, the utilization of KMC has proven to be minimal despite WHO recommendations of its use for well over a decade on an individual and community level (6).

• To investigate the benefits of KMC on premature infant morbidity and mortality with a focus on
• premature infant health,
• neurobehavioral and feeding performance, and
• stress response.

Search Methods

Articles on KMC and the morbidity/mortality of premature infants found in CINAHL Complete, Health Source: Nursing/Academic Edition, and MEDLINE with Full Text were used.

Figure 1

Kangaroo Mother Care Benefits Compared to the Standard of Care

Note: Lower values found in the data shows a positive outcome on the results. + Data from Table 2 (8). *Data from Table 2 (4). Illnesses incorporated in Table 2 were hypothermia, sepsis, and apnea (in <32-week gestation individuals). *** Measurement of stress response in infants of the 120-minute intervention group compared to the control in Table 3 (3).

• All data showed better health outcomes and positive prognosis of those involved with KMC.
• KMC is a truly medically-effective and cost-effective intervention for preterm infants. However, implementation needs to be more common and accepted in hospitals globally.
• The utilization of KMC proves to be a simple solution for neonatal health.
• The data can open doors for KMC volunteer programs and implementation of specialized baby wraps designed for KMC (2).

• KMC on premature infants showed that there were protective effects against morbidities such as hypothermia, apnea, and sepsis (4).
• Overall health of premature neonates has been shown to have positive outcomes that result in lower morbidity and mortality rates.
• Feeding performance was greatly increased in those neonates that were initiated in KMC, gaining an average of 120 grams in five days.
• Infants that received KMC showed “increased alertness/attention and reduction in the overall likelihood of a neurodevelopmental delay” (3, p. 687).
• Infants with KMC have better attention and regulation scores which proved to be statistically significant (3).
• The salivary levels of cortisol in the experimental groups were significantly lower than those in the control group after 7 days (4).

Figure 2

Kangaroo Mother Care Benefits Compared to the Standard of Care

Note: Higher values found in the data shows a positive outcome on the results. **Data from Table 2 (10). **** These categories are from the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) and data is from the 120 minute intervention group compared to the control found in Table 3 (3).

1. Albishry, S. N., Shouk, M. E., Alkhaldi, S., Almowlad, N., & Omer, T. (2018). The effectiveness of kangaroo mother care (KMC) on premature infant health progression in a neonatal care unit in

maternity and children’s hospital, Jeddah. International Journal of Nursing Didactics, 8(09), 27–33. https://doi.org/10.15520/ijnd.v8i09.2307

• Chavula, K., Guenther, T., Valsangkar, B., Lwesha, V., Banda, G., Bøe Wensaas, M., Luhanga,

R., Chimtembo, L., Kinney, M. V., & Dube, Q. (2020). Improving skin-to-skin practice for babies in kangaroo mother care in Malawi through the use of a customized baby wrap: A randomized control trial. PLOS ONE, 15(3), 1–16. https://doi.org/10.1371/journal.pone.0229720

• El-Farrash, R. A., Shinkar, D. M., Ragab, D. A., Salem, R. M., Saad, W. E., Farag, A. S.,

Salama, D. H., & Sakr, M. F. (2019). Longer duration of kangaroo care improves neurobehavioral performance and feeding in preterm infants: A randomized controlled trial. Pediatric Research, 87(4), 683–688. https://doi.org/10.1038/s41390-019-0558-6

• Kumbhojkar, S., Mokase, Y., & Sarawade, S. (2016). Kangaroo mother care (KMC): An alternative to conventional method of care for low birth weight babies. International Journal of Health

Sciences and Research, 6(3), 36–42.

• Mishra, P., Rai, N., Mishra, N. R., & Ranjan Das, R. (2017). Effect of kangaroo mother care on the breastfeeding, morbidity, and mortality of very low birth weight neonates: A prospective

observational study. Indian Journal of Child Health, 04(03), 379–382. https://doi.org/10.32677/ijch.2017.v04.i03.025

• Mazumder, S., Taneja, S., Dube, B., Bhatia, K., Ghosh, R., Shekhar, M., Sinha, B., Bahl, R., Martines, J., Bhan, M. K., Sommerfelt, H., & Bhandari, N. (2019). Effect of community-initiated

kangaroo mother care on survival of infants with low birthweight: A randomised controlled trial. The Lancet, 394(10210), 1724–1736. https://doi.org/10.1016/s0140-6736(19)32223-8

• Rahman, M., Azad Chowdhury, M., Hoque, M., Jahan, N., & Chandra Shaha, L. (2017). Kangaroo mother care for low birth weight babies: A randomized controlled trial in a tertiary care hospital of

Bangladesh. Journal of Pediatrics & Neonatal Care, 7(2), 1–7. https://doi.org/10.15406/jpnc.2017.07.00285

• Sari, I. P., Ardillah, Y., & Widyastuti, T. A. (2016). The determinants of infant mortality in

neonatal period. Jurnal Kesehatan Masyarakat, 12(1), 139–149. https://doi.org/10.15294/kemas.v12i1.4882

• Srinath, B. K., Shah, J., Kumar, P., & Shah, P. S. (2016). Kangaroo care by fathers and mothers: Comparison of physiological and stress responses in preterm infants. Journal of Perinatology, 36(5),

401–404. https://doi.org/10.1038/jp.2015.196

• Swarnkar, K., & Vagha, J. (2016). Effect of kangaroo mother care on growth and morbidity pattern in low birth weight infants. Journal of Krishna Institute of Medical Sciences University, 5(1),

91–99.

References