Effect of early kangaroo mother care on time to full feeds in preterm infants - A prospective cohort study.


Journal

Early human development
ISSN: 1872-6232
Titre abrégé: Early Hum Dev
Pays: Ireland
ID NLM: 7708381

Informations de publication

Date de publication:
03 2021
Historique:
received: 06 10 2020
revised: 07 01 2021
accepted: 12 01 2021
pubmed: 1 2 2021
medline: 15 12 2021
entrez: 31 1 2021
Statut: ppublish

Résumé

Kangaroo mother care (KMC) is known to reduce neonatal mortality and morbidity. In preterm neonates, KMC is usually initiated only after stabilization. We aimed to assess if early initiation of KMC starting within the first week of life is safe, and reduces the time to full feeds (TFF) in preterm neonates. Prospective cohort study. Preterm neonates (Gestation ≤ 34 weeks, Birth weight ≤ 1250 g). This was studied in two epochs, (epoch 1) which was before early KMC vs. epoch 2 which was after implementation of early KMC even if they needed respiratory support, with umbilical/central lines in situ. The primary outcome of the study was time to establish full feeds (TFF) of 150 ml/kg/day. The neonatal demographic characteristics were comparable between epoch 1 and epoch 2 except for lower gestational age, higher surfactant, and any respiratory support in epoch 2. On univariate analysis, early KMC significantly reduced TFF (12.5 vs. 9 days, P < 0.001). Feed intolerance, duration of parenteral nutrition were significantly reduced, and discharge weight Z score improved significantly in epoch 2. On multivariate regression analysis early KMC, exclusive mother's own milk feeding and blood culture-positive late-onset sepsis were important predictors of TFF. Early KMC was safe and well-tolerated. Early KMC was safe and associated with reduced TFF and other nutritional benefits in moderately ill preterm neonates.

Sections du résumé

BACKGROUND
Kangaroo mother care (KMC) is known to reduce neonatal mortality and morbidity. In preterm neonates, KMC is usually initiated only after stabilization.
AIMS
We aimed to assess if early initiation of KMC starting within the first week of life is safe, and reduces the time to full feeds (TFF) in preterm neonates.
STUDY DESIGN
Prospective cohort study.
SUBJECTS
Preterm neonates (Gestation ≤ 34 weeks, Birth weight ≤ 1250 g). This was studied in two epochs, (epoch 1) which was before early KMC vs. epoch 2 which was after implementation of early KMC even if they needed respiratory support, with umbilical/central lines in situ.
OUTCOME
The primary outcome of the study was time to establish full feeds (TFF) of 150 ml/kg/day.
RESULTS
The neonatal demographic characteristics were comparable between epoch 1 and epoch 2 except for lower gestational age, higher surfactant, and any respiratory support in epoch 2. On univariate analysis, early KMC significantly reduced TFF (12.5 vs. 9 days, P < 0.001). Feed intolerance, duration of parenteral nutrition were significantly reduced, and discharge weight Z score improved significantly in epoch 2. On multivariate regression analysis early KMC, exclusive mother's own milk feeding and blood culture-positive late-onset sepsis were important predictors of TFF. Early KMC was safe and well-tolerated.
CONCLUSION
Early KMC was safe and associated with reduced TFF and other nutritional benefits in moderately ill preterm neonates.

Identifiants

pubmed: 33517173
pii: S0378-3782(21)00008-6
doi: 10.1016/j.earlhumdev.2021.105312
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105312

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Dhyey Pandya (D)

Department of Paediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411011, India.

Gouda Ankula Prasad Kartikeswar (GAP)

Department of Paediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411011, India.

Gaurav Patwardhan (G)

Department of Paediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411011, India.

Sandeep Kadam (S)

Department of Paediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411011, India. Electronic address: drsandeepkadam@gmail.com.

Anand Pandit (A)

Department of Paediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411011, India. Electronic address: peds@kemhrcpune.org.

Sanjay Patole (S)

Neonatal Directorate, KEM Hospital for Women, Perth 6009, Australia; School of Medicine, University of Western Australia, Perth 6009, Australia. Electronic address: sanjay.patole@health.wa.gov.au.

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