We are more confident than ever that Kangaroo Mother Care works.
Westport, Conn. (Vocus) March 30, 2010
Kangaroo Mother Care is one of the most effective ways to save preterm babies, according to a new meta-analysis released today on the effectiveness of this simple, low-cost intervention in which mothers serve as human incubators for their newborns. The research, led by Dr. Joy Lawn of Save the Children, appears today in a supplement to the International Journal of Epidemiology, which outlines the most effective interventions to reduce newborn and child deaths globally.
The review examined 15 studies in eight low- and middle-income countries, including three randomized controlled trials, and found a 51 percent reduction in newborn mortality when stabilized babies weighing less than four pounds (2,000 gm) received warmth and breast milk through continuous skin-to-skin contact on the chest of their mothers. The findings suggest that up to half a million newborn deaths due to preterm birth complications could be prevented each year if Kangaroo Mother Care were available for all preterm babies, particularly in low-income countries, where newborn mortality rates are highest.
“We are more confident than ever that Kangaroo Mother Care works,” said South African-based Dr. Joy Lawn, newborn health expert for Save the Children, and lead author of the analysis. “No matter if babies are born in Lilongwe, London or Los Angeles, preterm babies need extra care to survive. Kangaroo Mother Care is low-cost and feasible, and we now have proof it is one of the most highly effective ways to give more babies the chance to survive and thrive.”
Kangaroo Mother Care has Greatest Impact During First Week of Life
While increasingly accepted in both high- and low-income countries, a previous meta-analysis of studies did not show Kangaroo Mother Care to have a significant impact on newborn mortality because the benefits of the intervention were examined after one week of age. However, Kangaroo Mother Care has the greatest impact during the first week of a preterm baby's life, when deaths are most likely to occur. Each year at least 1 million of the world's nearly 4 million newborn deaths (deaths in the first month of life) are due to preterm birth complications.
Some of the poorest countries in the world are discovering that Kangaroo Mother Care can dramatically reduce newborn deaths. The method was first developed in Colombia and is now practiced in many Latin American countries and in several Asian and African countries. In Malawi — where 20 percent of all newborns have low birthweight, and more than 20,000 mothers each year bear the tragedy of their newborn babies dying — the majority of hospitals and many health centers provide Kangaroo Mother Care. A recent BBC documentary, Invisible Lives, showed a baby born 14 weeks early and weighing less than 2 lbs (850 gm) who had survived with Kangaroo Mother Care and no technology. Malawi is not the norm, however, as few countries have managed to bring the practice to scale.
"The review released today provides sufficient evidence to recommend the routine use of this proven intervention in health facilities for all stable preterm babies," added Lawn. "This is one time when the research from low-income countries is bringing a breakthrough relevant for all countries. For instance, England and Sweden and other high income countries are starting to use Kangaroo Mother Care."
Low-Cost Intervention Provides Options for Care in Low-Income Countries
The effect of Kangaroo Mother Care is expected to be greatest in low-income countries, where other options for care of preterm babies remain limited with few neonatal care units. Babies may be separated from their mothers, reducing exclusive breastfeeding, and overcrowding of several babies in a bed increases the risk of infection. Kangaroo Mother Care halves the risk of infection compared to incubator care.
According to Lawn, funding for child survival is increasing and it is critical to base those investments on proven solutions that have the greatest impact. The supplement and reviews are focused on the development and use of the Lives Saved Tool, or LiST. This free user-friendly computer program helps guide governments and donors on investments in global child survival programs with the most significant results.
“Evidence-based policy and programming are needed to help save the millions of mothers and children who die from lack of basic care every year,” said Robert Black, MD, MPH, professor and chair of the Department of International Health at Johns Hopkins Bloomberg School of Public Health. “LiST is an easy-to-use program that can help policymakers allocate resources based on the latest and best evidence available.”
Supplement Reviews Five Other Solutions for Reducing Newborn Deaths
The Journal’s special supplement includes five other reviews of interventions with great potential to reduce newborn deaths. For instance, one meta-analysis shows how the simple injection of steroids given to women in preterm labor reduces deaths for preterm babies by 53 percent. Other featured technical reviews on newborn interventions provide new evidence summaries on tetanus toxoid immunization, folic acid for prevention of neural tube defects or spina bifida, and antibiotics for preterm pre-labor rupture of membranes.
“We have only five years left to achieve the Millennium Development Goal of reducing deaths for newborns and children,” urged Lawn. “The findings of this study add new confidence that we have interventions that work even for challenging conditions like preterm birth. There is no doubt this interventions can save lives — but the reality is that babies will continue to die unnecessarily unless we prioritize high-impact care and make sure it reaches those who need it most. This evidence is our wake-up call to bring Kangaroo Mother Care and other proven interventions to scale in low-and middle-income countries.”
Save the Children is the leading, independent organization that creates lasting change for children in need in the United States and around the world. Its Saving Newborn Lives program, supported by grants from the Bill & Melinda Gates Foundation, is a project that aims to reduce newborn deaths and improve newborn survival in high-mortality countries in Asia, Africa and Latin America. Save the Children USA is a member of the International Save the Children Alliance, a global network of 29 independent Save the Children organizations working to ensure the well-being and protection of children in more than 120 countries. Follow us on Twitter and Facebook.