Mothers holding low birth weight newborns skin-to-skin linked with lower mortality rates

Continuous skin-to-skin contact with their mothers during the first days of life may reduce low birth weight infant deaths by more than one-third compared to conventional care, according to a new meta-analysis by researchers from Harvard T.H. Chan School of Public Health and Boston Children’s Hospital.

The meta-analysis combined studies which examined the effect of kangaroo mother care (KMC) or skin-to-skin care, typically practiced with exclusive breastfeeding, on neonatal outcomes. The most dramatic reduction in mortality rates was for low birth weight or preterm babies. Among heavier or full-term babies, there were also beneficial effects on their oxygenation, temperature regulation, and pain tolerance.

“While KMC or skin-to-skin care is particularly useful for low birth weight babies born where medical resources are limited, developed and developing countries are moving to ‘normalize’ KMC or skin-to-skin as a beneficial practice for all newborns and mothers,” said senior author Grace Chan, MD, MPH, PhD, instructor at Harvard Chan School and a faculty member at Boston Children’s Hospital.

The paper appears online December 22, 2015 in Pediatrics.

As many as 4 million babies worldwide die each year during their first month of life, and infants born early or at a low birth weight are at particular risk. Health technologies such as incubators can help improve outcomes in high-risk infants; however, such equipment is not widely available in low- and middle-income countries, where 99% of all neonatal deaths occur.

Lead author Ellen Boundy, SD ’15, who worked on the study while at Harvard Chan School and is an epidemiologist at the Massachusetts Department of Public Health, Chan, and co-authors analyzed 124 studies published between 2000 and 2014 that looked at skin-to-skin contact as a component of KMC. Some studies included additional care practices such as breastfeeding and close follow-up in their definition of KMC.

They found that among newborns weighing less than 2000 grams (4.4 pounds) who survived to receive KMC, there was a 36% reduction in mortality and 47% lower risk of sepsis or major infection. Newborns who received KMC also had higher oxygen levels and head circumference growth, as well as lower pain measures. In addition, KMC increased the likelihood of exclusive breastfeeding at hospital discharge by 50%. The results were relatively consistent across low- middle- and high-income countries.

The study was funded by Saving Newborn Lives initiative (SNL) of Save the Children.

“Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis,” Ellen O. Boundy, Roya Dastjerdi, Donna Spiegelman, Wafaie W. Fawzi, Stacey A. Missmer, Ellice Lieberman, Sandhya Kajeepeta, Stephen Wall, Grace J. Chan, Pediatrics, December 22, 2015, doi: 10.1542/peds.2015-2238.

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