Effect of kangaroo mother care in low birth weight infants on human milk intake: a randomized controlled trial
Bireshwar Sinha1, Sarmila Mazumder2, Archana Thakur2
1Society for Applied Studies, New Delhi, India; DBT/Wellcome India Alliance Clinical and Public Health Fellow, Hyderabad, India.
Background:
It is plausible that one of the key biological pathways through which kangaroo mother care (KMC) improves health outcomes in low birth weight (LBW) infants is by enhancing human milk intake and quality. This hypothesis needs to be tested.
Objectives:
This study aims to estimate the effect of promotion and support of KMC in LBW infants compared with control during the neonatal period on human milk intake and human milk components.
Methods:
We randomly assigned 550 LBW infants (1500-2250 g) to the intervention arm with promotion of and support for continuous skin-to-skin contact and exclusive breastfeeding through home visits or to no such intervention (control) during the neonatal period. All infants received routine home-based postnatal care visits. We estimated human milk intake by the infant over a 14-d period using the deuterium dilution technique and measured the concentration of carbohydrate, protein and amino acids, fat, lactoferrin, and secretory immunoglobulin A (sIgA) in human milk of a subsample of 250 mothers.
Results:
The mean infant human milk intake was 331 ± 144 g/d or 142 ± 57 g/kg/d in the control arm and 368 ± 135 g/d or 154 ± 50 g/kg/d in the intervention arm participants, yielding a mean difference of 37 [95% confidence interval (CI): 12, 63] g/d or 12 (95% CI: 2, 22) g/kg/d. The mean concentration of carbohydrate in human milk in the intervention arm was 51.2 ± 6.1 g/L against 50 ± 6.8 g/L in the control arm. The corresponding values for protein were 15.0 ± 2.9 g/L and 16.3 ± 4.6 g/L, respectively. We did not find any substantial differences in the concentration of amino acids, fat, lactoferrin, or sIgA between the study arms.
Conclusions:
Our findings show that KMC is associated with a substantially higher human milk intake in LBW infants during the neonatal period. There was no evidence of any effect of KMC on the concentration of several human milk components. This trial was registered at Clinical Trials Registry-India as CTRI/2017/04/008430.
