Feasibility and efficacy of early KMC in very low birth weight babies receiving noninvasive respiratory care in NICU: is it the way forward in resource limited setting?

Shruthi Purushotham, N. Karthik Nagesh


Background: Objective of the study was to assess the feasibility and efficacy of early KMC in VLBW babies receiving respiratory care in NICU.

Methods: This is a prospective observational study conducted in a Multispecialty hospital with a level 3B NICU.

Results:A total of 19 babies on non-invasive respiratory support and partial parenteral nutrition through PICC line were included in the study. Most of the babies (84%) had birth weight of less than 1250 gm. Forty eight percent of the babies were less than 30 weeks of gestation at the time of commencement of KMC. Average weight gain in our study was 11.27gm/kg/day which was comparable to others. KMC was initiated at an average of 7.91 days of age and the average duration was1.69 + 0.6 hour/day. 84.2% of the mothers did KMC for less than 3 hrs per day while 15.8% of them did KMC beyond 3 hrs per day. Of the 19 babies, 17 of them were on High flow nasal canula Oxygen and 13 of them on CPAP during KMC. Only one baby succumbed to NEC during the study. The most common reason for discontinuation of KMC in the study group was lack of confidence in the mother (31%) which was overcome by constant support from the nursing staff and the family members.

Conclusions:Kangaroo mother care was found to be a feasible and effective method of care of VLBW babies even while on non-invasive respiratory support in NICU.  



Full Text:



Sample registry system. Office of the Registrar General and Census Commissioner (India). India SRS Statistical Report 2012. New Delhi, India: Office of the Registrar General and Census Commissioner (India), 2013.

India new-born action plan. Accessed on 15 July, 2016.

Sundaram V, Chirla D, Panigrahy N, Kumar P. Current status of NICUs in India: a nationwide survey and the way forward. Indian J Pediatr. 2014;81:1198-204.

Karthik Nagesh N, Razak A. Arch Dis Child Fetal Neonatal Ed. 2016;0:F1-5. Doi: 10.1136/archdischild-2015-308169

Whitelaw A, Sleath K. Myth of the marsupial mother: Home care of very low birth weight babies in Bogota, Columbia. Lancet. 1985;25:1206-8.

Charpak N, Figueroa Z. Kangaroo mother care programme practical rules. Bogota, Columbia: Kangaroo Foundation; 2001.

Rey ES, Martinez HG. Manejo racional del niño prematuro.Curso de Medicina Fetal. Bogota: Universidad Nacional; 1983.

World Health Organization. Kangaroo Mother Care: A Practical Guide. Geneva, Switzerland: World Health Organization; 2003.

Ramanathan K, Paul VK, Deorai AK, Taneja U and George G. Kangaroo Mother Care in very low birth weight infants. Indian J Paediatr. 2001;68:1019-23.

Gupta M, Jora R, Bhatia R. Kangaroo mother care in LBW infants: a Western Rajasthan experience. Indian J Paediatr. 2007;74:747-9.

Kadam S, Binoy S, Kanbur W, Mondkar JA, Fernandez A. Feasibility of Kangaroo Mother Care in Mumbai. Indian J Paediatr. 2005;72:35-8.

Worku B, Kasil A. Kangaroo Mother care: a randomized controlled trial on effectiveness of early kangaroo mother care of Low Birth Weight infants in Addis Ababa. Ethopia J Tropical Pediatr. 2005;51:93-7.

Charpak N, Riuz-Pelaez JG, Charpak Y. Rey-martinez Kangaroo Mother Program. An alternative way of caring for Low Birth Weight infants? One year mortality in two cohort study. Pediatrics. 1994;94:804-10.

Ludington Hoe SM, Andreson G, Simpson S, Hollingsead A, Argote LA, Rey H. Birth related fatigue in 34-36 week preterm neonates; rapid recovery with very early kangaroo [skin to skin] care. J Obstet Gynecol Neonatal Nurs. 1999;28:94-103.

Cattaneo A, Davanzo R, Worku B, Surjono A, Echeverria M, Bedri A et al. Kangaroo mother care for low birth weight infants: a randomized control trial in differing settings. Acta Pediatr. 1998;87:976-85.

Parmar VR, Kumar A, Kaur R, Parmar S, Kaur D, Basu S, et al. Experience with kangaroo mother care in a neonatal intensive care unit (NICU) in Chandigarh, India. Indian J Pediatr. 2009;76(1):25-8.

Anchieta M, Xavier CC, Colosimo EA, Souza MF. Weight of preterm newborns during the first twelve weeks of life. Braz J Med Biol Res. 2003;36(6):761-70.

Suman RP, Udani R, Nanavati R. Kangaroo mother care for low birth weight infants: a randomized controlled trial: Indian paediatrics. 2008;45(1):17-23.