Feasibility, acceptability and cost of kangaroo mother care in Recife, Brazil

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Abstract
This descriptive study on kangaroo mother care (KMC) of low-birthweight infants (LBWIs) was carried out in a tertiary care hospital in Recife, Brazil. Of 244 LBWIs weighing less than 1750 g admitted over 14 months, 112 (46%) died before inclusion, 18 (7%) were excluded, and 114 (47%), after stabilization, were cared for by KMC 24 hours a day until discharge. No deaths were recorded in hospital; two twins died of severe pneumonia after discharge and before the age of 3 months. There were no episodes of moderate or severe hypothermia but mild hypothermia (36–36.4°C axillary temperature) occurred at a rate of 30 episodes per 100 infant days, mainly related to occasional separation from the mother. One hundred infants (88%) were discharged on exclusive breastfeeding, eight (7%) were still taking expressed breast-milk from a cup and six (5%) were being fed breast-milk plus formula. The mean daily weight gain during KMC was 15 g. At follow-up, 87% were still exclusively breastfed at 1 month and 63% at 3 months. KMC was acceptable to mothers and staff. An important advantage of KMC over previous conventional care is cost—US$20 vs US$66 per bed/day. This study confirms that KMC for stabilized LBWIs in hospital is feasible, acceptable and cheap and in hospitals with limited resources is an appropriate alternative to conventional incubator care.