Effect of Kangaroo Mother Care on Bilirubin Level in Term Neonates and on Satisfaction of Cesarean Mothers Delivered by Cesarean Section: A Randomized Controlled Clinical Trial

Abstract

Abstract: Background: Separation of Mother and baby after cesarean section leads to the delayed outset (initiation) of feeding and, subsequently, to hyperbilirubinemia. Using safe methods, the nurses can prevent incidence of the neonatal hyperbilirubinemia. Breastfeeding is often one of the best ways is to minimize hyperbilirubinemia. One of the best measures for early feeding baby is kangaroo mother care. Those mothers after surgery have physical problem (such as pain and fatigue) are less likely to do the kangaroo mother care. Objective: this study evaluated the effects of kangaroo mother care on the level of bilirubin in the newborn after cesarean and maternal satisfaction from care after birth. Patients and Methods: This study was a randomized controlled clinical trial that conducted on 105 mothers undergoing elective cesarean section in two control and experimental groups in West Azerbaijan province-Iran from August through the end of December 2014. Neonates of the experimental group received KMC in the recovery room and subsequent further daily care at 7:00, 13:00, and 19:00 for half an hour for three days. The bilirubin level of the neonates in both groups was checked in birth time, 24, 36, and 120 hours after birth by a Bilicheck device from their forehead. To measure the satisfaction of the mothers, a previously approved questionnaire applied. Experience of the mothers with the KMC method only in the experiment group was measured. Data analysis was performed using SPSS-13 software. Findings: Significant differences were seen between experimental and control groups in Bilirubin level 24 hours after birth, 36 hours after birth, and 120 hours after birth (p-value< 0.001). The average increase in the bilirubin level from birth up to the fifth day in the control was in comparison with experiment group to a greater extent and statistically was significant. Mean satisfaction of mothers in the experiment group was significantly higher than the control group (p-value< 0.001). The experience of mothers for skin to skin contact in the experiment group was close to "totally agree= 5". In KMC group breast feeding start time (minute) was 30.75 (6.84) vs. 135.45 (12.48), in control group (p =0.001). Conclusion: Findings of the present study indicated that KMC reduced the neonatal bilirubin after C-section. Thus, it can be recommended as an effective nursing experiment in reducing the neonatal physiological jaundice. KMC by mothers might improve mothers’ satisfaction and postnatal care.