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Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit
Published on: January 7, 2020
Longer duration of kangaroo care improves neurobehavioral performance and feeding in preterm infants: a randomized
Rania A El-Farrash1, Dina M Shinkar2, Dina A Ragab3
1Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights
Kangaroo care (KC) significantly improves neurobehavioral performance, breastfeeding success, and vital signs in premature infants. Longer KC durations enhance thermal control and oxygenation, leading to faster feeding advancements.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Infant physiology
Background:
- Premature infants face significant challenges including neurodevelopmental deficits and physiological instability.
- Kangaroo care (KC), a method of skin-to-skin contact, is recognized for its potential benefits in neonatal care.
- The optimal duration and impact of KC on various infant outcomes require further elucidation.
Purpose of the Study:
- To evaluate the effect of kangaroo care (KC) duration on the neurobehavioral performance of premature infants.
- To assess KC's impact on stress response, breastfeeding success, and vital signs in preterm neonates.
- To compare the outcomes of 60-minute and 120-minute daily KC sessions against conventional care.
Main Methods:
- A randomized controlled trial involving 120 premature infants assigned to 60-min KC, 120-min KC, or conventional care for at least 7 days.
- Neurobehavioral performance was assessed using the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS).
- Salivary cortisol levels, vital signs (temperature, respiration, heart rate, oxygen saturation), and breastfeeding success (Infant Breastfeeding Assessment Tool) were measured.
Main Results:
- Both KC groups showed improved neurobehavioral scores (attention, arousal, regulation) and reduced lethargy compared to controls.
- Infants in KC groups achieved higher breastfeeding success and reached full enteral feeds significantly faster.
- The 120-minute KC group demonstrated superior improvements in oxygen saturation and temperature post-session compared to the 60-minute group.
Conclusions:
- Extended kangaroo care durations positively influence preterm infant outcomes.
- KC enhances neurobehavioral development, stress regulation, and physiological stability in premature infants.
- Longer KC sessions promote faster feeding progression and better breastfeeding outcomes, supporting enhanced infant care practices.
Aim:
To investigate the effect of kangaroo care (KC) and its duration on neurobehavioral performance, stress response, breastfeeding success, and vital signs in premature infants.
Methods:
One hundred and twenty premature infants were randomized to receive either KC for 60 min daily, KC for 120 min daily or conventional care (controls) for at least 7 days. Salivary cortisol was measured before and after the first KC session and then after 7 days. Temperature, respiration rate, heart rate, and oxygen saturation were recorded, before and after KC. Neonates were evaluated by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS).
Results:
Both KC groups demonstrated higher scores for attention, arousal, regulation, nonoptimal reflexes, and quality of movements and lower scores for handling, excitability, and lethargy, compared to controls (p < 0.05). Both KC groups had higher infant breastfeeding assessment tool score and reached full enteral feeds faster than controls (p < 0.05). After the first KC session, improvement in O2 saturation and temperature was observed in KC 120-min group compared with the KC 60-min group (p < 0.05). Salivary cortisol decreased in both KC groups compared with controls after 7 days (p < 0.05).
Conclusion:
Preterm neonates who receive KC for long durations reach full enteral feeds faster, have better breastfeeding success, neurobehavioral performance, thermal control, and tissue oxygenation.
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