Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial

Abstract Background Around 70% neonatal deaths occur in low birth weight (LBW) babies. Globally, 15% of babies are born with LBW. Kangaroo Mother Care (KMC) appears to be an effective way to reduce mortality and morbidity among LBW babies. KMC comprises of early and continuous skin-to-skin contact b...

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Main Authors: Sarmila Mazumder, Sunita Taneja, Suresh Kumar Dalpath, Rakesh Gupta, Brinda Dube, Bireshwar Sinha, Kiran Bhatia, Sachiyo Yoshida, Ole Frithjof Norheim, Rajiv Bahl, Halvor Sommerfelt, Nita Bhandari, Jose Martines
Format: Article
Language:English
Published: BMC 2017-06-01
Series:Trials
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13063-017-1991-7
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author Sarmila Mazumder
Sunita Taneja
Suresh Kumar Dalpath
Rakesh Gupta
Brinda Dube
Bireshwar Sinha
Kiran Bhatia
Sachiyo Yoshida
Ole Frithjof Norheim
Rajiv Bahl
Halvor Sommerfelt
Nita Bhandari
Jose Martines
author_facet Sarmila Mazumder
Sunita Taneja
Suresh Kumar Dalpath
Rakesh Gupta
Brinda Dube
Bireshwar Sinha
Kiran Bhatia
Sachiyo Yoshida
Ole Frithjof Norheim
Rajiv Bahl
Halvor Sommerfelt
Nita Bhandari
Jose Martines
author_sort Sarmila Mazumder
collection DOAJ
description Abstract Background Around 70% neonatal deaths occur in low birth weight (LBW) babies. Globally, 15% of babies are born with LBW. Kangaroo Mother Care (KMC) appears to be an effective way to reduce mortality and morbidity among LBW babies. KMC comprises of early and continuous skin-to-skin contact between mother and baby as well as exclusive breastfeeding. Evidence derived from hospital-based studies shows that KMC results in a 40% relative reduction in mortality, a 58% relative reduction in the risk of nosocomial infections or sepsis, shorter hospital stay, and a lower risk of lower respiratory tract infections in babies with birth weight <2000 g. There has been considerable interest in KMC initiated outside health facilities for LBW babies born at home or discharged early. Currently, there is insufficient evidence to support initiation of KMC in the community (cKMC). Formative research in our study setting, where 24% of babies are born with LBW, demonstrated that KMC is feasible and acceptable when initiated at home for LBW babies. The aim of this trial is to determine the impact of cKMC on the survival of these babies. Methods/design This randomized controlled trial is being undertaken in the Palwal and Faridabad districts in the State of Haryana, India. Neonates weighing 1500–2250 g identified within 3 days of birth and their mothers are being enrolled. Other inclusion criteria are that the family is likely to be available in the study area over the next 6 months, that KMC was not initiated in the delivery facility, and that the infant does not have an illness requiring hospitalization. Eligible neonates are randomized into intervention and control groups. The intervention is delivered through home visits during the first month of life by study workers with a background and education similar to that of workers in the government health system. An independent study team collects mortality and morbidity data as well as anthropometric measurements during periodic home visits. The primary outcomes of the study are postenrollment neonatal mortality and mortality between enrollment and 6 months of age. The secondary outcomes are breastfeeding practices; prevalence of illnesses and care-seeking practices for the same; hospitalizations; weight and length gain; and, in a subsample, neurodevelopment. Discussion This efficacy trial will answer the question whether the benefits of KMC observed in hospital settings can also be observed when KMC is started in the community. The formative research used for intervention development suggests that the necessary high level of KMC adoption can be reached in the community, addressing a problem that seriously constrained conclusions in the only other trial in which researchers examined the benefits of cKMC. Trial registration ClinicalTrials.gov identifier: NCT02653534 . Registered on 26 December 2015 (retrospectively registered).
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spelling doaj.art-c19eac6a737745b3acf213bcbb013b982022-12-22T03:40:26ZengBMCTrials1745-62152017-06-0118111010.1186/s13063-017-1991-7Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trialSarmila Mazumder0Sunita Taneja1Suresh Kumar Dalpath2Rakesh Gupta3Brinda Dube4Bireshwar Sinha5Kiran Bhatia6Sachiyo Yoshida7Ole Frithjof Norheim8Rajiv Bahl9Halvor Sommerfelt10Nita Bhandari11Jose Martines12Centre for Health Research and Development, Society for Applied StudiesCentre for Health Research and Development, Society for Applied StudiesChild Health Division, National Rural Health MissionChild Health Division, National Rural Health MissionCentre for Health Research and Development, Society for Applied StudiesCentre for Health Research and Development, Society for Applied StudiesCentre for Health Research and Development, Society for Applied StudiesDepartment of Maternal, Newborn, Child and Adolescent Health, World Health OrganizationCentre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of BergenDepartment of Maternal, Newborn, Child and Adolescent Health, World Health OrganizationCentre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of BergenCentre for Health Research and Development, Society for Applied StudiesCentre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of BergenAbstract Background Around 70% neonatal deaths occur in low birth weight (LBW) babies. Globally, 15% of babies are born with LBW. Kangaroo Mother Care (KMC) appears to be an effective way to reduce mortality and morbidity among LBW babies. KMC comprises of early and continuous skin-to-skin contact between mother and baby as well as exclusive breastfeeding. Evidence derived from hospital-based studies shows that KMC results in a 40% relative reduction in mortality, a 58% relative reduction in the risk of nosocomial infections or sepsis, shorter hospital stay, and a lower risk of lower respiratory tract infections in babies with birth weight <2000 g. There has been considerable interest in KMC initiated outside health facilities for LBW babies born at home or discharged early. Currently, there is insufficient evidence to support initiation of KMC in the community (cKMC). Formative research in our study setting, where 24% of babies are born with LBW, demonstrated that KMC is feasible and acceptable when initiated at home for LBW babies. The aim of this trial is to determine the impact of cKMC on the survival of these babies. Methods/design This randomized controlled trial is being undertaken in the Palwal and Faridabad districts in the State of Haryana, India. Neonates weighing 1500–2250 g identified within 3 days of birth and their mothers are being enrolled. Other inclusion criteria are that the family is likely to be available in the study area over the next 6 months, that KMC was not initiated in the delivery facility, and that the infant does not have an illness requiring hospitalization. Eligible neonates are randomized into intervention and control groups. The intervention is delivered through home visits during the first month of life by study workers with a background and education similar to that of workers in the government health system. An independent study team collects mortality and morbidity data as well as anthropometric measurements during periodic home visits. The primary outcomes of the study are postenrollment neonatal mortality and mortality between enrollment and 6 months of age. The secondary outcomes are breastfeeding practices; prevalence of illnesses and care-seeking practices for the same; hospitalizations; weight and length gain; and, in a subsample, neurodevelopment. Discussion This efficacy trial will answer the question whether the benefits of KMC observed in hospital settings can also be observed when KMC is started in the community. The formative research used for intervention development suggests that the necessary high level of KMC adoption can be reached in the community, addressing a problem that seriously constrained conclusions in the only other trial in which researchers examined the benefits of cKMC. Trial registration ClinicalTrials.gov identifier: NCT02653534 . Registered on 26 December 2015 (retrospectively registered).http://link.springer.com/article/10.1186/s13063-017-1991-7Community-initiated Kangaroo Mother CareLow birth weight babiesMortality
spellingShingle Sarmila Mazumder
Sunita Taneja
Suresh Kumar Dalpath
Rakesh Gupta
Brinda Dube
Bireshwar Sinha
Kiran Bhatia
Sachiyo Yoshida
Ole Frithjof Norheim
Rajiv Bahl
Halvor Sommerfelt
Nita Bhandari
Jose Martines
Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial
Trials
Community-initiated Kangaroo Mother Care
Low birth weight babies
Mortality
title Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial
title_full Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial
title_fullStr Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial
title_full_unstemmed Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial
title_short Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial
title_sort impact of community initiated kangaroo mother care on survival of low birth weight infants study protocol for a randomized controlled trial
topic Community-initiated Kangaroo Mother Care
Low birth weight babies
Mortality
url http://link.springer.com/article/10.1186/s13063-017-1991-7
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