Myth of the marsupial mother: home care of very low birth weight babies in Bogota, Colombia.

Because of the shortage of equipment and staff and the frequency of cross-infection in hospital, paediatricians at San Juan de Dios Hospital, Bogota, have been sending home babies weighing as little as 700 g, cared for between the mother's breasts in a vertical position and fed only on mother's milk ("kangaroo babies"). Infants as immature as 32 weeks gestation were successfully cared for at home in this way. Mother's milk was supplemented with guava juice and later with soup, but mean time to regain birth weight was 36 days. The previously publicised high survival figures for this home-care programme were found to be misleading because they omitted babies who had died in the first few days after birth. Although this approach is valuable in developing countries, home care of very low birth weight babies would not improve survival in industrialised nations. Nevertheless, care of such tiny infants in special care baby units in developed countries could benefit from similar emphasis on education and motivation of mothers and early skin-to-skin contact.