DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20200105

A study on breastfeeding initiation in low birth weight and very low birth weight babies and their developmental outcome with special reference to kangaroo mother care

Bramhini Sura, Gangadhar B. Belavadi

Abstract


Background: Kangaroo Mother Care (KMC) was developed for caring of low birth weight (LBW) babies in developing countries. Study was done with the objective to evaluate the factors affecting initiation of breast feeding and effect of Kangaroo Mother Care (KMC) on morbidity problems and developmental outcome in Low Birth Weight (LBW) and Very Low Birth Weight (VLBW) babies.

Methods: Prospective follow-up cohort study was carried out at Neonatal Intensive Care Unit (NICU) at Narayana medical college hospital Nellore from January 2018 to December 2019 and details of neonates were recorded on prestuctured proforma. Kangaroo mother care was given to one group. ASQ 3 questionnaire was used to assess the developmental outcome of the infants.

Results: In this study, 100 babies were divided into two groups, case group consists of 50 babies where KMC is given and another control group consists 50 babies where KMC is not given. Mean gestational age for case and control group babies were 34.5 and 33.7 weeks respectively. Mean Birth weight in cases (1700 gr) and control (1580) grams respectively. Number of Male babies were more in cases (51%) and Group B (53%). Main factors affecting the initiation of breastfeeding in babies are LSCS (62% and 48%), RDS (50% and 40%), Apnea (24% and 25%) and seizures (20% and 14%) respectively in case and controls. Rates of exclusive breastfeeding is significantly increased in cases (90%) when compared to control (72%). Morbidity in cases is comparatively lesser than controls. At 6 months of corrected gestational age, mean weight in cases (5.2 kg) is significantly more than mean weight in control (4.7 kg). Significant development is noticed in communication (p=0.036), gross motor (0.04), and fine motor (0.05) compare to controls. Percentage of babies who acquired better personal social skills are more in cases (80%).

Conclusions: The main factors affecting the initiation of breastfeeding in LBW and VLBW babies are LSCS, RDS, not secreted milk and seizures. KMC helps to achieve smooth and early transition to direct breastfeeding, increases the exclusively breastfeeding rate, better growth and developmental outcome and reduces the morbidities in LBW neonates.


Keywords


Developmental outcome, Exclusive breastfeeding, Head circumference, Kangaroo mother care, Low birth weight

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References


Organization WH. International statistical classification of diseases and related health problems, tenth revision, 2nd ed. World Health Organization; 2004.

WHO. Global nutrition targets 2025: low birth weight policy brief Geneva. World Health Organization; 2014.

Mehrban S. Disorders of weight and gestation. In: Singh Mehrban., eds. Care of the newborn. 4th edn. Sagar Publication; New Delhi: 1991:112-25.

National Neonatalogy Forum of India. National Neonatal Perinatal Database-Report for year 2000. New Delhi: National Neonatology Forum, India; 2001.

Bang AT, Bang RA, Baitule S, Reddy MH, Deshmukh M. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India: Lancet. 1999;354:1955-61.

Barker DJ. Mothers, babies, and health in later life. Elsevier Health Sciences; 1998.

Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. New Eng J Med. 2005 Jan 6;352(1):9-19.

Aylward GP. Neurodevelopmental outcomes of infants born prematurely. J Develop Behavioral Pediatr. 2014 Jul 1;35(6):394-407.

Brévaut-Malaty V, Busuttil M, Einaudi MA, Monnier AS, D’Ercole C, Gire C. Longitudinal follow-up of a cohort of 350 singleton infants born at less than 32 weeks of amenorrhea: neurocognitive screening, academic outcome, and perinatal factors. Eur J Obstetr Gynecol Reproduct Biol. 2010 May 1;150(1):13-8.

Marlow N. Motor and executive function at 6 years of age after extremely preterm birth. Pediatr. 2007;120(4):793-804.

Bigelow AE, Littlejohn M, Bergman N, McDonald C. The relation between early mother–infant skin‐to‐skin contact and later maternal sensitivity in South African mothers of low birth weight infants. Infant Mental Health J: Offi Pub World Assoc Infant Mental Health. 2010 May;31(3):358-77.

Tripathy AK, Mishra L, Bakhshi S, Arya LS. Breast feeding and childhood hematological malignancy. Ind J Pediatr. 2004 May 1;71(5):417-8.

Chye JK, Lim CT. Breastfeeding at 6 months and effects on infections. Singapore Med J. 1998 Dec;39(12):551-6.

Hoyer S, Horvat L. Successful breast‐feeding as a result of a health education programme for mothers. J Advan Nursing. 2000 Nov;32(5):1158-67.

Lauer JA, Betrán AP, Barros AJ, de Onís M. Deaths and years of life lost due to suboptimal breast-feeding among children in the developing world: a global ecological risk assessment. Pub Health Nutrit. 2006 Sep;9(6):673-85.

Bera A, Datta P, Hazra A, Ghosh J, Sardar S, Paria A. Kangaroo mother care in low birth weight babies: measures to mitigate challenges in implementation. Astrocyte. 2014 Oct 1;1(3):190.

Scharf RJ, Stroustrup A, Conaway MR, DeBoer MD. Growth and development in children born very low birthweight. Archiv Dis Childhood-Fetal Neonatal Edit. 2016 Sep 1;101(5):F433-8.

Jayaraman D, Mukhopadhyay K, Bhalla AK, Dhaliwal LK. Randomized controlled trial on effect of intermittent early versus late kangaroo mother care on human milk feeding in low-birth-weight neonates. J Human Lactat. 2017 Aug;33(3):533-9.

Gathwala G, Singh B, Singh J. Effect of Kangaroo Mother Care on physical growth, breastfeeding and its acceptability. Trop Doctor. 2010 Oct;40(4):199-202.

Swarnkar K, Vagha J. Effect of kangaroo mother care on growth and morbidity pattern in low birth weight infants. J Krishna Instit Med Sci Uni. 2016 Jan 1;5(1):91-9.

Narayan S, Natarajan N, Bawa KS. Maternal and neonatal factors adversely affecting breastfeeding in the perinatal period. Med J Armed Forces Ind. 2005 Jul 1;61(3):216-9.

Suman Rao PN, Udani R, Nanavati R. Kangaroo mother care for low birth weight infants: a randomized controlled trial. Ind Pediatr. 2008;45(1):17.

Heidarzadeh M, Hosseini MB, Ershadmanesh M, Tabari MG, Khazaee S. The effect of kangaroo mother care (KMC) on breast feeding at the time of NICU discharge. Iranian Red Cres Med J. 2013 Apr;15(4):302.

Tessier R, Cristo MB, Velez S, Giron M, Nadeau L, de Calume ZF, et al. Kangaroo Mother Care: A method for protecting high-risk low-birth-weight and premature infants against developmental delay. Infant Behav Develop. 2003 Aug 1;26(3):384-97.

Lakew W, Worku B. Follow-up profile and outcome of preterms managed with kangaroo mother care. Open J Pediatr. 2014 Apr 21;4(02):143.

Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, et al. Kangaroo mother care and neonatal outcomes: a meta-analysis. Pediatr. 2016 Jan 1;137(1):e20152238.

Ribeiro CD, Pachelli MR, Amaral NC, Lamônica DA. Development skills of children born premature with low and very low birth weight. Codas. 2017;29(1):e20160058.

Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregna Childbirth. 2016 Dec;16(1):90.

Ballot DE, Ramdin T, Rakotsoane D, Agaba F, Chirwa T, Davies VA, et al. Assessment of developmental outcome in very low birth weight infants in Southern Africa using the Bayley Scales of Infant Development (III). BMJ Paediatr Open. 2017;1(1).