Prolonged skin-to-skin contact beginning shortly after delivery, even before the baby has been stabilized, has been shown to lower mortality in newborns with very low birth weight by 25%, according to a study conducted in low- and middle-income countries at the request of Karolinska Institutet researchers and printed in The New England Journal of Medicine.
Mortality Rates Of Pre-Term Babies Reduce With More Skin Touch With Mothers
Kangaroo Mother Care (KMC), or continuous skin-to-skin contact between newborn and mother, is among the most efficient approaches to reduce infant mortality worldwide. The World Health Organization (WHO) strongly advises that skin-to-skin contact should begin as soon as a low-weight infant is adequately stable, which often takes several days for babies weighing less than 2 kg at birth.
The point of letting skin-to-skin contact with very small, unstable babies immediately after birth has been met with strong opposition, but as per Nils Bergman, doctor and researcher at the Department of Women’s and Children’s Health, Karolinska Institutet, Sweden, and one of the study’s initiators, approximately 75% of deaths occur before the infant has been considered adequately stable.
The latest study, funded by the Bill & Melinda Gates Foundation and headed by WHO, looked at whether immediate Kangaroo Mother Care or iKMC, leads to even greater survival rates for newborns weighing 1 to 1.8 kg in low- and middle-income countries. The research was carried out in five medical universities, Ghana, India, Malawi, Nigeria, and Tanzania, where infant mortality rates ranged between 20 and 30% before the study.
Before the trial began, training in basic newborn care was offered, and basic equipment was purchased to measure the babies’ oxygen levels and offer assisted breathing. The hospitals that took part in the study were also taught safe skin-to-skin contact for fragile newborns. The KI researchers, assisted by a colleague from the University of Stavanger, Norway, were in charge of teaching and ensuring the quality of basic care in both groups, as well as the iKMC methodology in the intervention group, through frequent visits to the study locations.
In the research, 3,211 infants were randomly assigned to one of two groups: those who received iKMC and continued skin-to-skin contact at the neonatal unit, where the mothers also received medical care, and those who received standard care, in which mothers and babies are cared for in separate units and are only reunited during infant feeding. Mothers and infants from both groups were moved to the normal KMC unit as soon as the newborns had stabilized sufficiently. The newborns in the iKMC group got around 17 hours of skin-to-skin contact each day during the first 72 hours, compared to 1.5 hours in the control group.
The iKMC group had a 12% mortality rate over the first 28 days, compared to a 15.7% mortality rate in the control group, resulting in a 25% decrease. In addition, there were considerably fewer newborns in the iKMC group who had a low body temperature or bacterial blood poisoning.
As per Björn Westrup, who is a consultant and researcher at the Department of Women’s and Children’s Health, Karolinska Institutet, and co-initiator of the study, the primary point is that low weight newborn babies should receive skin-to-skin contact immediately after birth and then at a mother-infant couplet care unit, where mothers and babies are cared for together without having to be separated. The findings imply that this care paradigm, which does not require a lot of resources, might have a big impact on people’s health.
According to the experts, iKMC can save the lives of an extra 150,000 tiny babies each year.
In light of new research, WHO is revisiting its existing recommendations on kangaroo mother care, which were released in 2015. The World Health Organization advises KMC for all newborns, but the latest study adds to the body of data on the lifesaving importance of urgent KMC for unstable little newborns.