The Effect of Kangaroo Care by Mother and Surrogate on Nutritional Behavior of Preterm Neonates: A Clinical Randomized Controlled Trial

Abstract

Comparison of the effect of mother and surrogate kangaroo care on nutritional behavior of preterm neonates: A Randomized Controlled Trial

Abstract: Background: kangaroo care (KC) is skin-to-skin contact that promotes the growth and development of preterm neonates, improves breastfeeding and causes early hospital discharge. However, in many cases such as cesarean section or illness, divorce and death of the mother, they are not able to provide KC properly and the neonate, especially the preterm one, is deprived of the numerous benefits of this type of care. This could be addressed by father’s or surrogate provider’s care (including a family member, friend or social network member). The aim of this study was to investigate the effect of KC by mother and her surrogate on nutritional behavior of preterm neonates. Methods and materials: This study was a randomized, controlled clinical trial carried our on 70 preterm neonates admitted to the neonatal intensive care unit of Khalij Fars Hospital in Bandar Abbas who divided to intervention and control groups. For the neonates of the intervention group, KC was performed (once by the mother and twice by the surrogate) 3 times a day and the neonates of the control group received KC by the mother 3 times a day for up to 5 days and 60 minutes each time. For neonates of both groups, Preterm Infant Breastfeeding Behavior Scale (PIBBS) was measured once before the intervention and then after the intervention. Physiological functions include temperature, pulse rate, respiratory rate, and arterial oxygen saturation was measured and recorded each time, once before and immediately after the doing KC for 5 days. Results: Although PIBBS score in both groups increased significantly during 5 days (p <0.001), this was not significant between groups (mean difference: 0.66, 95% confidence interval: 1.03 to-2.36, p=0.193). The mean Physiological functions (pulse, respiration and temperature) were not significantly different between the two groups and within the groups during 5 days, while the mean arterial oxygen saturation within the groups during 5 days was significantly different (p = 0.043), however, there was no significant difference between the two groups (mean difference: 0.102, 95% confidence interval: -0.68 to 0.88; p = 0.951). Conclusion: The results showed that KC care by the surrogate had at least an equivalent effect of this care by the mother on nutritional behavior and arterial oxygen saturation of the preterm newborn. The results of this study can be used in planning to promote the health of infants when the mother is unable to provide KC, especially for mothers with cesarean section.