Baby Care

Saving kids: Safdarjung hosp makes pitch to WHO for Immediate Kangaroo Mother Care | Delhi News

Saving kids: Safdarjung hosp makes pitch to WHO for Immediate Kangaroo Mother Care | Delhi News
Written by Publishing Team

New Delhi: Immediate Kangaroo Mother Care (KMC) is more effective in helping reduce deaths of premature and low birth weight babies. This recommendation was sent by Safdarjung Hospital to World Health Organization after conducting a study, which found that this technique could reduce newborn deaths by up to 25%.
“Healthcare providers have been separating small and sick babies from their mothers for decades believing that is best for them. The new evidence means we must establish the practice of KMC globally. WHO is in the process of reviewing the current recommendations on care of preterm or low birth weight newborns considering the new evidence,” said Dr Harish Chellani, one of the study investigators and professor and principal consultant, Safdarjung Hospital.
KMC is skin-to-skin contact care of the mother for newborns that helps in their growth and development and involves exclusive breast-feeding. Until now, it was believed that KMC should be given only after the premature or underweight child had been kept in an incubator for 3 to 7 days and it helped reduce mortality by 40%. However, there was no evidence of immediate KMC.
The study results show that intervention babies in Mother–Newborn Care Unit (MNCU) had 25% less mortality at 28 days of life, 35% less incidence of hypothermia, and 18% less suspected sepsis compared with control babies cared for in a conventional NICU.
The initiative was first started by Safdarjung Hospital in 2017 and it was the first Centre-run facility to introduce it. However, for implementation of immediate KMC, the pediatric unit required mothers (or surrogates) to be with babies soon after birth, and continue to be with them 24×7 till discharge, which was zero-separation. Since there was not enough space in the existing NICU to have mothers’ beds inside, a new one was designed and named MNCU.
The study has been done on 3,211 babies born underweight or premature in five countries — Ghana, India, Malawi, Nigeria and Tanzania — with the lead being done at Safdarjung Hospital.
In all, 1,609 infants were given KMC through the mother’s body immediately after birth. They were exposed to skin-to-skin contact for about 16 hours a day. Another 1,602 babies were placed in the control group. They were contacted with the mother’s skin after 3 to 7 days, and that too for only 1.5 hours. In immediate KMC, 191 (12%) children died, while in the control group 249 (15.7%) kids passed away.
Infants with a birth weight between 1kg and 1.79kg were assigned to receive immediate KMC (intervention) or conventional care in an incubator or a radiant warmer until their condition stabilized and KMC thereafter (control). The primary outcomes were death in the neonatal period (the first 28 days of life) and in the first 72 hours of life.
Another important aspect found through immediate KMC was on breast-feeding. During the study, breast feeding was initiated within the first 24 hours after birth in 58.5% of the infants in the MNCU and in 45.5% of infants in the conventional NICU. Full breast-feeding occurred within 7 days in 78.4% infants in MNCU and 69% in conventional NICU.
“Since the mother is with her baby in MNCU, expressed breast milk is readily available as first feed soon after birth. Skin-to-skin contact with the baby results in better lactation. Babies can be put to the breast earlier for non-nutritive sucking, which helps them develop reflexes faster and improves milk output of the mother by stimulating prolactin reflex,” said Chellani.

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