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Kangaroo Mother Care in Hospitalized Low Birth-Weight Infants on Respiratory Support

A Feasibility and Safety Study

Bisanalli, Shridevi MD; Nesargi, Saudamini DNB; Govindu, Ram Mohan MD; Rao, Suman PN MD, DM

Section Editor(s): Dowling, Donna PhD, RN; ; Schierholz, Elizabeth PhD, APRN, NNP-BC;

doi: 10.1097/ANC.0000000000000666
Original Research
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Background: Low birth-weight (LBW) infants on respiratory support are often deprived of kangaroo mother care (KMC) due to fear of instability. Data on safety of KMC in these infants are lacking.

Primary Objective: To determine the feasibility of KMC in LBW infants on continuous positive airway pressure or synchronized intermittent mandatory ventilation.

Secondary Objectives: To compare vital signs (heart rate [HR], respiration, temperature, and SpO2) and ventilatory parameters (FIO2, peak inspiratory pressure [PIP], and positive end-expiratory pressure [PEEP]) before, during, and after KMC, and assess the mother's perception of the KMC intervention.

Methods: LBW infants stable on respiratory support were given KMC for 1 hour. Vital signs and ventilator parameters were recorded before, every 15 minutes during and after KMC. Feasibility was defined as continuation of KMC for 1 hour without interruption, with stable vital signs (HR > 100/min, SpO2 > 90%, and temperature 36.5°C-37.5°C) and ventilator parameters (no change in PIP, PEEP, or increase in FIO2 not more than 0.1) without tube dislodgement.

Results: Twenty LBW infants with a mean birth weight of 1390 ± 484 g were included. All infants completed 1-hour duration of KMC without interruption. No significant changes in temperature, respiratory rates, or saturations were noted. The HR and FIO2 were marginally higher during KMC than before or after (HR before 147.3 ± 11.5, during 150.8 ± 11, and after 147.3 ± 11.1, P = .04; FIO2 before 30.6 ± 8.1, during 31.8 ± 8.1, and after 30.7 ± 8.0, P = .034). No accidental extubation or dislodgement of lines occurred. Most mothers were happy.

Implications for Practice: The vital signs were stable during KMC. KMC is feasible in infants receiving respiratory support.

Implications for Research: Effectiveness of early initiation and prolonged duration of KMC.

Department of Neonatology, St John's Medical College Hospital, Bangalore, India.

Correspondence: Suman PN Rao, MD, DM, Department of Neonatology, St John's Medical College Hospital, Sarjapur Rd, Koramangala, Bangalore 560034, India (raosumanv@gmail.com).

Dr Bisanalli conceived, designed, collected, and drafted the manuscript; Dr Rao conceived, supervised the research, and edited the manuscript and act as a guarantor for this article; Ms Nesargi analyzed and edited the manuscript; and Dr Govindu helped with analysis and edited the manuscript.

The authors declare no conflicts of interest.

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© 2019 by The National Association of Neonatal Nurses