Dhaarani Jayaraman1, Kanya Mukhopadhyay1, Anil Kumar Bhalla1, Lakhbir Kaur Dhaliwal2. 1. 1 Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 2. 2 Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
BACKGROUND: Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC). Research aim: The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge. METHODS: A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months. Inborn neonates weighing 1 to 1.8 kg and hemodynamically stable were randomized to receive either early KMC, initiated within the first 4 days of life, or late KMC (off respiratory support and intravenous fluids). Follow-up was until 1 month postdischarge. Outcomes were proportion of infants achieving exclusive human milk feeding and direct breastfeeding, growth, mortality and morbidities during hospital stay, and postdischarge feeding and KMC practices until 1 month. RESULTS: The early KMC group ( n = 80) achieved significantly higher exclusive human milk feeding (86% vs. 45%, p < .001) and direct breastfeeding (49% vs. 30%, p = .021) in hospital and almost exclusive human milk feeding (73% vs. 36%, p < .001) until 1 month postdischarge than the late KMC group ( n = 80). The incidence of apnea (11.9% vs. 20%, p = .027) and recurrent apnea requiring ventilation (8.8% vs. 15%, p = .02) were significantly reduced in the early KMC group. There was no significant difference in mortality, morbidities, and growth during the hospital stay and postdischarge. CONCLUSION:Early KMC significantly increased exclusive human milk feeding and direct breastfeeding in LBW infants.
RCT Entities:
BACKGROUND: Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC). Research aim: The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge. METHODS: A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months. Inborn neonates weighing 1 to 1.8 kg and hemodynamically stable were randomized to receive either early KMC, initiated within the first 4 days of life, or late KMC (off respiratory support and intravenous fluids). Follow-up was until 1 month postdischarge. Outcomes were proportion of infants achieving exclusive human milk feeding and direct breastfeeding, growth, mortality and morbidities during hospital stay, and postdischarge feeding and KMC practices until 1 month. RESULTS: The early KMC group ( n = 80) achieved significantly higher exclusive human milk feeding (86% vs. 45%, p < .001) and direct breastfeeding (49% vs. 30%, p = .021) in hospital and almost exclusive human milk feeding (73% vs. 36%, p < .001) until 1 month postdischarge than the late KMC group ( n = 80). The incidence of apnea (11.9% vs. 20%, p = .027) and recurrent apnea requiring ventilation (8.8% vs. 15%, p = .02) were significantly reduced in the early KMC group. There was no significant difference in mortality, morbidities, and growth during the hospital stay and postdischarge. CONCLUSION: Early KMC significantly increased exclusive human milk feeding and direct breastfeeding in LBW infants.
Authors: Amanda S Mahoney; Molly O'Donnell; James L Coyle; Rose Turner; Katherine E White; Stacey A Skoretz Journal: Dysphagia Date: 2022-08-31 Impact factor: 2.733
Authors: Elizabeth Wastnedge; Donald Waters; Sarah R Murray; Brian McGowan; Effie Chipeta; Alinane Linda Nyondo-Mipando; Luis Gadama; Gladys Gadama; Martha Masamba; Monica Malata; Frank Taulo; Queen Dube; Kondwani Kawaza; Patricia Munthali Khomani; Sonia Whyte; Mia Crampin; Bridget Freyne; Jane E Norman; Rebecca M Reynolds Journal: J Glob Health Date: 2021-12-30 Impact factor: 4.413