Results

Kangaroo Mother Care and the Bonding Hypothesis

PEDIATRICS Vol. 102 No. 2 August 1998, p. e17

Réjean Tessier*, Marta Cristo, Stella Velez, Marta Girón, SW; Zita Figueroa de Calume, Juan G. Ruiz-Paláez, Yves Charpak, and Nathalie Charpak

From the *School of Psychology, Laval University, Québec, Canada; ISS-World Lab, Kangaroo Mother Care Program, Clinica del Nino, Santa Fe de Bogotá, Colombia; - Clinical Epidemiology Unit, Faculty of Medicine, Javeriana University, Santa Fe de Bogotá, Colombia; and EVAL (Institut pour l'Évaluation dans le domaine Médical, Médico-social et de Santé Publique), Paris, France.

TABLE 5

Mother’s Perception and Mother and Child’s Observed Sensitivity by Intervention Groups (KMC vs TC) and Child’s Need of NICU at Birth

	With NICU		Without NICU
	KMC (n = 47)	TC (n = 35)	KMC (n = 199)	TC (n = 207)
	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD
Mothers’ perception	(a)	(b)	(c)	(d)
Sense of competence	.24 ± 1.3	.30 ± .87	.14 ± .98	.10 ± .97	ac > bd**1
Stress and worry	.07 ± .91	.17 ± 1.3	.04 ± .94	.08 ± .93	NS
Support	.20 ± 1.3	.25 ± .89	.14 ± .99	.06 ± .91	ab > cdt2
Mothers’ sensitivity
Sensitivity	.77 ± .09	.75 ± .15	.73 ± .12	.71 ± .13	ab > cd**2
Response to child’s distress	.90 ± .12	.85 ± .15	.89 ± .15	.91 ± .15
Socioemotional growth fostering	.61 ± .14	.66 ± .16	.59 ± .16	.57 ± .15	ab > cd**2
					b > a*3
Cognitive growth fostering	.35 ± .19	.42 ± .24	.33 ± .20	.30 ± .18	ab > cd**2
					b > a*3
Child’s clarity of cues	.66 ± .12	.67 ± .15	.64 ± .14	.62 ± .16	ab > cd*2
Child’s responsivity to mother	.33 ± .12	.34 ± .15	.31 ± .13	.29 ± .14	ab > cd*2
(a), (b), (c), and (d) Represent group means.
* P < .05;
** P < .01;
*** P < .001; t < .10. 1 Group effect; 2 NICU effect; 3 interaction effect.

Kangaroo Mother Care and the Bonding Hypothesis

PEDIATRICS Vol. 102 No. 2 August 1998, p. e17

Réjean Tessier*, Marta Cristo, Stella Velez, Marta Girón, SW; Zita Figueroa de Calume, Juan G. Ruiz-Paláez, Yves Charpak, and Nathalie Charpak

TABLE 4

Mother’s Perception and Mother and Child’s Observed Sensitivity by Intervention Groups (KMC vs TC) and Delay From Starting Intervention

Delay 1 (1-2 Days)		Delay 2 (3-14 Days)		Delay 3 (> 14 Days)
KMC (n = 100)	TC (n = 70)	KMC (n = 92)	TC (n = 85)	KMC (n = 50)	TC (n = 91)
Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD
Mothers’ perception	(a)	(b)	(c)	(d)	(e)	(f)
Sense of competence	.26 ± .95	.15 ± .82	.15 ± 1.0	.10 ± 1.2	.09 ± 1.2	.12 ± .85	ace > bdf**1
Stress and worry	.06 ± 1.0	.25 ± .77	.12 ± .97	.03 ± .97	.05 ± 1.1	.24 ± 1.3	f > d > b3f > e3
Social support	.10 ± 1.0	.04 ± .93	.03 ± .98	.09 ± .93	.15 ± 1.2	.32 ± .77	ace < bdf1f > e3
Mothers’ sensitivity
Sensitivity	.73 ± .11	.71 ± .13	.72 ± .12	.73 ± .13	.75 ± .12	.69 ± .15	ace > bdf1e > f3
Response to distress	.87 ± .16	.90 ± .14	.92 ± .13	.91 ± .15	.88 ± .15	.87 ± .16	cd > ab = ef*2
Socioemotional growth fostering	.57 ± .16	.56 ± .16	.59 ± .15	.61 ± .15	.60 ± .15	.55 ± .15
Cognitive fostering	.30 ± .20	.28 ± .17	.31 ± .19	.35 ± .21	.37 ± .20	.30 ± .19	e > f*3
Child’s clarity of cues	.64 ± .15	.63 ± .15	.64 ± .14	.62 ± .18	.64 ± .13	.64 ± .14
Child’s responsivity	.29 ± .14	.31 ± .15	.31 ± .12	.29 ± .13	.33 ± .12	.28 ± .11
(a), (b), (c), (d), (e), and (f) Represent group means.
* P < .05;
** P < .01;
*** P < .001; t < .10. 1 Group effect; 2 delay effect; 3 interaction effect.

Kangaroo Mother Care and the Bonding Hypothesis

PEDIATRICS Vol. 102 No. 2 August 1998, p. e17

Réjean Tessier*, Marta Cristo, Stella Velez, Marta Girón, SW; Zita Figueroa de Calume, Juan G. Ruiz-Paláez, Yves Charpak, and Nathalie Charpak

TABLE 3

Differences in Hospital Stay and Need of NICU Patterns from Birth to Term by Intervention Groups (KMC vs TC) and Birth Weight Categories

Weight	Stay in Hospital (days)		Stay in NICU (days)
Weight	TC ()	KMC ()	TC ()	KMC ()
<1201 g	40.0 ± 10.5	35.5 ± 17.0	7.2 ± 0.0	8.9 ± 14.1
1201 g-1500 g	26.9 ± 14.0	20.2 ± 8.8	2.6 ± 6.4	1.9 ± 4.1
1501 g-1800 g	10.0 ± 9.2	10.7 ± 7.8	.56 ± 2.0	1.8 ± 4.4
>1800 g	6.2 ± 7.6	6.7 ± 7.1	.34 ± 1.5	1.1 ± 4.9

Kangaroo Mother Care and the Bonding Hypothesis

PEDIATRICS Vol. 102 No. 2 August 1998, p. e17

Réjean Tessier*, Marta Cristo, Stella Velez, Marta Girón, SW; Zita Figueroa de Calume, Juan G. Ruiz-Paláez, Yves Charpak, and Nathalie Charpak

TABLE 2

A Comparison Between the KMC Group and the TC Control Group Based on Factors Related to Newborn Infants

Variables	KMC	Controls	F(p)	Variables	KMC	Controls	F(p)
Weight at birth, g (mean ± SD)	1660 ± 268	1736 ± 259	.002	Distribution of weight at birth, g n (%)
Length at birth, cm	41.4 ± 2.9	41.9 ± 2.8	.06	<1201	20 (8)	16 (7)
(mean ± SD)				1201-1500	45 (18)	39 (16)	.62
				1501-2000	181 (74)	187 (77)
Head perimeter at birth (mean ± SD)	30.3 ± 1.8	30.6 ± 1.7	.10	Lubchenco classification, n (%)
Gestational age at birth	33.1 ± 2.3	33.7 ± 2.6	.02	PT-AGA*	175 (71)	165 (68)
(mean ± SD)				PT-SGA	52 (21)	48 (20)	.29
Male/female,n	131/115	105/137	.03	T-SGA	19 (8)	29 (12)
Weight at eligibility, g (mean ± SD)	1633 ± 225	1707 ± 235	.000	Asphyxia according to Apgar at 1 min, n (%)
Age at eligibility (days)	10.0 ± 10.5	8.6 ± 10.0	.11	No asphyxia (8-10)	141 (64)	137 (66)
(mean ± SD)				Mild (6-7)	68 (31)	57 (27)	.55
Head perimeter, 41 weeks (mean ± SD)	34.7 ± 1.6	34.7 ± 1.6	.97	Moderate (4-5)	8 (4)	7 (3)
				Severe (0-3)	4 (2)	8 (4)
Weight (g) at 41 weeks (mean ± SD)	2851 ± 527	2855 ± 513	.93	Feeding, n(%)
				Breastfeeding only	105 (43)	111 (46)
Height at 41 weeks, cm	46.8 ± 2.3	47.0 ± 2.3	.42	Breast and formula	135 (55)	111 (46)	.01
(mean ± SD)				Formula	6 (2.4)	20 (8.3)
* PT-AGA indicates preterm, appropriate for gestational age; PT-SGA, preterm, small for gestational age; T-SGA, term, small for gestational age.

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