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Intermittent kangaroo mother care and the practice of breastfeeding late preterm infants: results from four hospitals in different provinces of China.
Int Breastfeed J. 2020 07 17; 15(1):64.IB

Abstract

BACKGROUND

China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China.

METHODS

Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the "KMC group", those who did not were enrolled in the "No KMC group". Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates.

RESULTS

Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 h before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR = 2.15 (95% CI 1.53, 3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR = 1.61 (95% CI 1.15, 2.25)), be exclusive breast milk feeding at follow-up (OR = 2.55 (95% CI 1.81, 3.61)), and use breastfeeding method at follow-up (OR = 2.09 (95% CI 1.44, 3.02)).

CONCLUSIONS

Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.

Authors+Show Affiliations

Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China.Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China.University of Oxford Nuffield Department of Medicine, Oxford, UK.Save the Children UK, London, UK.Save the Children Saving Newborn Lives, Washington, DC, USA.Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China.Northwest Women & Children Hospital Department of Obstetrics, Xi'an, Shaanxi, China.Linyi Maternity and Child Health Hospital, Linyi, Shandong, China.Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China.Save the Children, Chengdu, China.Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China. yy8823@sina.com.Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China. zhaogengli@sina.com.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32680538

Citation

Zhang, Bo, et al. "Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results From Four Hospitals in Different Provinces of China." International Breastfeeding Journal, vol. 15, no. 1, 2020, p. 64.
Zhang B, Duan Z, Zhao Y, et al. Intermittent kangaroo mother care and the practice of breastfeeding late preterm infants: results from four hospitals in different provinces of China. Int Breastfeed J. 2020;15(1):64.
Zhang, B., Duan, Z., Zhao, Y., Williams, S., Wall, S., Huang, L., Zhang, X., Wu, W., Yue, J., Zhang, L., Liu, J., & Zhao, G. (2020). Intermittent kangaroo mother care and the practice of breastfeeding late preterm infants: results from four hospitals in different provinces of China. International Breastfeeding Journal, 15(1), 64. https://doi.org/10.1186/s13006-020-00309-5
Zhang B, et al. Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results From Four Hospitals in Different Provinces of China. Int Breastfeed J. 2020 07 17;15(1):64. PubMed PMID: 32680538.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intermittent kangaroo mother care and the practice of breastfeeding late preterm infants: results from four hospitals in different provinces of China. AU - Zhang,Bo, AU - Duan,Zhiying, AU - Zhao,Yingxi, AU - Williams,Sarah, AU - Wall,Stephen, AU - Huang,Limin, AU - Zhang,Xiaoqin, AU - Wu,Wenli, AU - Yue,Jieya, AU - Zhang,Lin, AU - Liu,Jun, AU - Zhao,Gengli, Y1 - 2020/07/17/ PY - 2019/12/06/received PY - 2020/07/09/accepted PY - 2020/7/19/entrez PY - 2020/7/19/pubmed PY - 2021/5/18/medline KW - Breastfeeding KW - Kangaroo mother care KW - Late preterm infants KW - Skin-to-skin contact SP - 64 EP - 64 JF - International breastfeeding journal JO - Int Breastfeed J VL - 15 IS - 1 N2 - BACKGROUND: China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. METHODS: Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the "KMC group", those who did not were enrolled in the "No KMC group". Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. RESULTS: Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 h before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR = 2.15 (95% CI 1.53, 3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR = 1.61 (95% CI 1.15, 2.25)), be exclusive breast milk feeding at follow-up (OR = 2.55 (95% CI 1.81, 3.61)), and use breastfeeding method at follow-up (OR = 2.09 (95% CI 1.44, 3.02)). CONCLUSIONS: Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk. SN - 1746-4358 UR - https://www.unboundmedicine.com/medline/citation/32680538/Intermittent_kangaroo_mother_care_and_the_practice_of_breastfeeding_late_preterm_infants:_results_from_four_hospitals_in_different_provinces_of_China_ L2 - https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-020-00309-5 DB - PRIME DP - Unbound Medicine ER -