The impact of partial kangaroo mother care on growth rates and duration of hospital stay of low birth weight infants In Kenyatta National Hospital

Abstract

lntrod uction: Neonatologists Rey and Martinez in Bogota, Colombia introduced kangaroo mother care in order to cope with the overcrowding, recurrent nosocomial infections and scarcity of resources in hospitals caring for low birth weight infants (4). This method of care consists of three components: Kangaroo position, Kangaroo nutrition and Kangaroo discharge policies with strict follow-up (5). Numerous studies both in developed and developing countries highlight the practice of KMC in different settings, as well as its benefits and limitations. This study assesses the impact of KMC on the duration of hospitalization and growth rates of LBW infants subjected to it. Objective: To determine the effect of KMC on the rates of growth and duration of hospital stay ofLBW infants at the Newborn Unij of KNH. Design: Randomized controlled trial. Methods: The study was carried out in Kenyatta National Hospital Newborn Unit over a period of nine months. Growth rates and durations of hospital stay of the low birth weight infants on Kangaroo mother care were compared with those of the infants on the traditional method of care. A total of 156 infants were recruited with 81 infants in the control group and 85 infants in the KMC group. Each group was stratified into two weight categories, the IOOO-1499g and 1500-1750g categories. KMC was practised for eight hours per day. Main outcome measures: Durations of hospital stay and growth rates of the infants in the two groups were the outcome measures observed.

Results: Baseline characteristics were similar in the two groups except for mothers' age. The mean age of the mothers in the KMC group was 26.5 years while that of the mothers in the control group was 24 years, P value of the difference being 0.04. The mean weight at recruitment of the control group was 1489g while that of the KMC group was 1480g. The mean gestation at recruitment of the KMC group was 34 weeks while that of the control group was 34.8 weeks. The KMC group infants demonstrated significantly higher growth rates as shown by the higher mean weight gain of 22.Sg/kg/day compared with 16.7g/kg/day in the control group, P value < 0.001; higher mean head circumference gain of 0.91 em/week compared with 0.S4cmlweek in the control group, P value < 0.001 and higher mean MUAC gain of 0.76cmlweek compared with 0.48cm/week in the control group, P value 0.002. The KMC group stayed in the hospital for a mean duration of 16.3 days compared with the 18.1 days in the control group, P value 0.199. When the KMC and control groups in the two weight categories were compared separately, the KMC infants demonstrated significantly higher mean weight, head and mid upper arm circumference gains, P values < 0.05. The duration of hospital stay was significantly shorter in the KMC infants in both weight categories, P values <0.05. Using logistic regression analysis, KMC was the strongest predictor of mean weight, mean head circumference and mean MUAC growth while mother's older age was the strongest predictor of mean duration of stay, with KMC being an independent predictor of duration of stay. Conclusion: The low birth weight infants offered KMC at KNH Newborn Unit demonstrated higher growth rates and were discharged earlier. The results of this study suggest that KMC should be promoted actively and mothers encouraged to start it as soon as their LBW babies are stable.