Implementing Kangaroo mother care in a resource-limited setting in rural Bangladesh

AimThis study evaluated stable and unstable low birthweight infants admitted to a Kangaroo mother care (KMC) unit at a resource-limited rural hospital in Bangladesh. MethodsThis was a descriptive consecutive patient series study of 423 low birthweight neonates <2500g enrolled from July 2007 to December 2010. KMC was initiated as soon as possible after birth, regardless of health, and we monitored skin-to-skin contact, weight gain, exclusive breastfeeding, length of hospital stay and death rates. ResultsMean birthweight was 1796g, and mean gestational age was 34.9weeks. Mean (median, 90th percentile) time of skin-to-skin initiation for stable and unstable neonates was 1.1h (0.3-2.5) and 1.7h (0.3-3.0), respectively. Adjusted mean daily skin-to-skin contact duration was significantly higher for unstable infants. About 99% of neonates were exclusively breastfed. The death rate was 8.3% (stable 1.9%, unstable 19%) at discharge. Neonatal mortality rate was 90 per 1000 live births (stable: 23 per 1000; unstable: 203 per 1000). ConclusionSkin-to-skin duration was higher for unstable than stable low birthweight infants, and exclusive breastfeeding was almost universal at discharge. KMC was suitable for unstable infants and may be successfully implemented in resource-limited hospitals.