PEDIATRICS Vol. 108 No. 5 November 2001, pp. 1072-1079

A Randomized, Controlled Trial of Kangaroo Mother Care: Results of Follow-Up at 1 Year of Corrected Age

Received Feb 25, 2001; accepted May 2, 2001.

Nathalie Charpak*, Juan G. Ruiz-Peláez*, ‡, Zita Figueroa de C.§,and Yves Charpak ∥

From the * Fundación Canguro, Santa Fe de Bogotá, Colombia; ‡ Unidad de Epidemiología Clínica, Facultad de Medicina, Pontificia Universidad Javeriana, INCLEN, Bogotá, Colombia; § Instituto de Seguros Sociales de Colombia, Programa Madre Canguro de la Clinica del Niño, Fundación Canguro, Santa Fe de Bogotá, Bogotá, Colombia; and ∥ Evaluation Médicale, Médico-Sociale et Sante Publique (EVAL), Paris, France.

OBJECTIVE

To assess the effectiveness and safety of Kangaroo Mother Care (KMC) for infants of low birth weight.

METHODS

An open, randomized, controlled trial of a Colombian social security referral hospital was conducted. A total of 1084 consecutive infants who were born at ≦ 2000 g were followed, and 746 newborns were randomized when eligible for minimal care, with 382 to KMC and 364 to "traditional" care. Information on vital status was available for 693 infants (93%) at 12 months of corrected age. KMC consisted of skin-to-skin contact on the mother’s chest 24 hours/day, nearly exclusive breastfeeding, and early discharge, with close ambulatory monitoring. Control infants remained in incubators until the usual discharge criteria were met. Both groups were followed at term and at 3, 6, 9, and 12 months of corrected age. The main outcomes measured were morbidity, mortality, growth, development, breastfeeding, hospital stay, and sequelae.

RESULTS

Baseline variables were evenly distributed, except for weight at recruitment (KMC: 1678 g; control participants: 1713 g). The risk for death was lower among infants who were given KMC, although the difference was not significant (KMC: 11 [3.1%] of 339; control participants: 19 [5.5%] of 324; relative risk: 0.57; 95% confidence interval: 0.17-1.18). The growth index of head circumference was statistically significantly greater in the group given KMC, but the developmental indices of the 2 groups were similar. Infants who weighed≦ 1500 g at birth and were given KMC spent less time in the hospital than those who were given standard care. The number of infections was similar in the 2 groups, but the severity was less among infants who received KMC. More of these infants were breastfed until 3 months of corrected age.

CONCLUSIONS

These results support earlier findings of the beneficial effects of KMC on mortality and growth. Use of this technique would humanize the practice of neonatology, promote breastfeeding, and shorten the neonatal hospital stay without compromising survival, growth, or development.

KEY WORDS

Kangaroo Mother Care • low birth weight • randomized • controlled trial •