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Updated: May 11, 2025
Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit
Published on: January 7, 2020
Transforming neonatal nursing: a randomized controlled trial comparing kangaroo care and standard protocols for
Osama Mohamed Elsayed Ramadan1, Afrah Madyan Alshammari2, Abeer Nuwayfi Alruwaili3
1Pediatric Nursing Department, Faculty of Nursing, Cairo University, Cairo, 11562, Egypt. osama_ramadan_85@cu.edu.eg.
Background:
Respiratory Distress Syndrome (RDS) remains a leading cause of mortality among preterm infants weighing < 2000 g, particularly in resource-limited settings. While Kangaroo Mother Care (KMC) has shown promise in stable preterm infants, its effectiveness for those requiring respiratory support remains unclear. This study evaluated nurse-led implementation of KMC for preterm infants with RDS.
Methods:
A prospective, multicenter, randomized controlled trial was conducted across four neonatal intensive care units in Tanta, Egypt (January 2023-June 2024). Two hundred forty preterm infants (<2000 g) with RDS were randomly assigned to either nurse-implemented KMC (n = 120) or standard care (n = 120). The KMC protocol, implemented for a minimum of 6 h per day until hospital discharge, integrated continuous skin-to-skin contact, exclusive breastfeeding promotion, and structured parental education. Outcomes included 28-day survival, respiratory status (Silverman-Anderson Scores), nosocomial infections, maternal-infant bonding, growth trajectories, and clinical course metrics.
Results:
The KMC intervention significantly improved 28-day survival (adjusted HR = 0.42, 95% CI 0.28-0.63, p < 0.001) and reduced nosocomial infections by 55% (RR = 0.45, 95% CI 0.27-0.75, p < 0.001). KMC recipients demonstrated faster respiratory improvement, shorter CPAP duration (-2.2 days, p < 0.001), and higher rates of exclusive breastfeeding at discharge (74.2% vs. 48.3%, p < 0.001). Maternal competency scores showed progressive improvement with enhanced bonding and responsiveness.
Conclusion:
Nurse-implemented KMC is a safe, effective intervention for preterm infants with RDS, yielding significant improvements in survival, clinical outcomes, and family-centered care metrics.
Implications For Practice:
These findings support the expansion of nursing roles in implementing KMC for high-risk infants in resource-limited settings.
Trial Registration:
ClinicalTrials.gov (NCT06707376).
