Continuous skin-to-skin contact immediately after delivery, even before the baby is stabilized, can reduce premature infant mortality by 25%, study finds published in Nature.
The "kangaroo mother" method involves carrying a premature infant on the stomach in skin-to-skin contact. This method is known to contribute to the good health and well-being of infants born at term or prematurely. Regarding the latter, on the other hand, the WHO has until now recommended that skin-to-skin contact be offered only once the young have stabilized, which can take several days for those weighing less than 2 kg at birth. But is this really the best approach?
"The idea of offering skin-to-skin contact immediately after birth to very small, unstable babies has met with quite strong resistance, but about 75% of deaths occur before infants have been deemed sufficiently stable “, underlines Nils Bergman, of the Karolinska Institut, in Sweden.
In a new study, funded by the Bill &Melinda Gates Foundation and led by WHO, Bergman and his team investigated whether immediate kangaroo mother care could or not lead to better survival rates for infants with a birth weight of 1-1.8 kg.
This work has focused on babies born in middle-income countries. The data was collected from five teaching hospitals in Ghana, India, Malawi, Nigeria and Tanzania where the mortality of these infants ranged from 20-30% before the study.
Before the start of this work, training in basic neonatal care and the "kangaroo method" was given to the nursing staff of each hospital by doctors from the University of Stavanger, Norway. They were also offered basic equipment to measure infant oxygen levels and provide assisted ventilation.
For this study, 3211 premature babies were randomly assigned to two groups. Members of one group enjoyed skin-to-skin contact with their mothers immediately after birth, while the others waited to be stabilized. In the meantime, these infants were cared for in separate units and only reunited with their mothers for feeding.
In the first 72 hours after birth, infants in the first group enjoyed approximately 17 hours of skin-to-skin contact per day, compared to 1.5 hour in the control group.
Result, mortality during the first 28 days was 12% in the "kangaroo" group compared to 15.7% in the control group, which corresponds to a discount of around 25% . Infants in the first group also had better body temperature and suffered less from bacterial blood poisoning.
"The main message of this study is that low birth weight newborns should receive skin-to-skin contact immediately after birth and then in a care unit as a mother-child couple where mothers and babies would be cared for together “, concludes Björn Westrup, co-author of this work. “Our results suggest that this model of care, which in itself is not resource-intensive, may have significant health effects “.
Researchers estimate this approach could save the lives of an additional 150,000 newborns worldwide every year . In the meantime, the WHO is reviewing its current recommendations on kangaroo mother care.
