The birth of a newborn represents one of the most dynamic and potentially critical events in the human life cycle. Therefore, methods that enhance stabilization of neurobehavioral and state regulation, autonomic maturation, and facilitate the adaptation of the infant to the outside world should be introduced to ensure a smooth transition from fetal to neonatal life.
A stable transition becomes even more challenging when complicated by factors such as low birth weight, prematurity, and medical conditions like hypoglycemia and sepsis. Thus, Kangaroo Mother Care (KMC) was developed by Edgar Rey Sanabria and Hector Martinez at the Maternal and Child Institute of Bogotá, Colombia, in 1979. KMC provides an alternative to conventional neonatal care, offering benefits to both the baby and the mother. It effectively meets the baby’s needs for warmth, breastfeeding, weight gain, stimulation, safety, and love.
In this study, we examined the effects of KMC on physiological parameters—namely arterial oxygen saturation (SpO₂), heart rate (HR), respiratory rate (RR), and blood pressure (systolic, diastolic, and mean)to enhance and improve the care of newborns and facilitate the wider implementation of KMC.
Methods
We conducted a single-center prospective observational quasi-experimental study on low birth weight (LBW) neonates admitted to the Neonatal Intensive Care Unit (NICU). The arterial oxygen saturation, blood pressure (systolic, diastolic, and mean), heart rate, and respiratory rate of the neonates were recorded using an EMCO 4040 noninvasive blood pressure (NIBP) and pulse oximeter monitor. Readings were taken 10 minutes prior to initiating KMC (baseline readings) and then at 1 hour and 2 hours from the initiation of KMC.
Comparison of quantitative data measured at three time intervals (10 minutes before, 1 hour, and 2 hours after initiating KMC) was conducted using “repeated measures analysis of variance” or the “Friedman repeated measures analysis of variance,” depending on the results of the normality test. Pairwise multiple comparisons were conducted using the Sidak test or the Tukey test.
Results
A total of 70 eligible LBW neonates were enrolled. The mean birth weight (in grams) was 1847.94 ± 333.62. The majority fell into the LBW category (59, 84.3%), while the remaining were classified as very LBW babies (15.7%). Analysis of physiological parameters showed the following results: the mean pulse oximetry saturation (SpO₂, in %) before the initiation of KMC was 95.69 ± 1.29. The mean SpO₂ at the end of the first and second hours of KMC were 96.37 ± 1.11 and 96.83 ± 1.08, respectively. The changes in SpO₂ at the end of the first and second hours (compared with baseline readings) were statistically significant (P ≤ 0.05 for each comparison).
Twelve cases (17.1%) showed a further increase in SpO₂ at 2 hours compared to 1 hour, and this change was also statistically significant (P ≤ 0.05). Analysis of blood pressure, heart rate, and respiratory rate demonstrated stabilization, with statistically significant positive changes (detailed in Figure 2).
Discussion
The positive effects of KMC on physiological parameters can be attributed to its ability to reduce neonatal anxiety and improve maternal-infant bonding, which relaxes the neonate. KMC reduces sympathetic tone, resulting in balanced vascular tone and improved blood flow and oxygenation to peripheral tissues. The stabilization of blood pressure and heart rate after prolonged KMC can be explained by receptor and hormonal interactions. Pleasant touch stimulates oxytocin release in the brain, stabilizing heart rate as the brainstem shifts from sympathetic to parasympathetic control. The decreased respiratory rate observed in neonates can be attributed to the upright position of the infant during KMC. This position, at an angle of approximately 60 degrees, reduces compression of the diaphragm. As ventilation and perfusion are gravity-dependent, the upright posture optimizes respiratory function. Thus, neonates held in the KMC position exhibit stabilized blood pressure and respiratory rates.
Conclusion
Babies receiving KMC show statistically significant improvements in all vital physiological parameters (SpO₂, SBP, DBP, MAP, HR, and RR). Without the need for special or costly equipment, the KMC strategy offers developmentally supportive care to newborns. This study also highlights the importance of providing extended periods of KMC to achieve even greater improvements in physiological parameters among neonates.