Low birthweight infants (LBW) with a birthweight of less than 2,500 grams have an increased risk of infections and deaths. LBW infants contribute to around half of overall infant deaths during the first 28 days of life.
Kangaroo mother care (KMC) is an intervention encompassing skin-to-skin-contact between the mother and the infant along with exclusive breastfeeding. The practice of KMC is recommended by the World Health Organization (WHO) for LBW infants during the first 28 days of life because it can prevent deaths.
“Despite WHO’s recommendations, KMC is not much practiced in low-income countries. Beyond the prevention of hypothermia in infants, the ways in which KMC works to prevent infant deaths is not clearly understood. Knowledge on the wide range of benefits of KMC is lacking among health care practitioners and communities. Moreover, the potential benefits of KMC to mothers is unclear, which is often a barrier to its promotion and practice,” says Bireshwar Sinha.
Research evidence aligns with WHO recommendations
In a previous scientific study, Bireshwar with colleagues in India have shown that the promotion and support of KMC in the community can reduce the deaths of LBW infants by 25% during the first four weeks of life. As a continuation of the previous research on KMC, he designed his doctoral dissertation to address the knowledge gaps related to the possible biological pathways through which KMC operates to improve survival in LBW infants.
In his dissertation, Sinha used a randomised controlled trial design in India. He reports that the promotion and support of KMC in LBW infants substantially improves effective breastfeeding and reduces the risk of maternal postpartum depressive symptoms at 28 days after birth. He has also reported no measurable effect of KMC on the biomarkers of infant gut function and has added that the area of infant gut function is still not fully understood and needs further research.
“The findings of my research align with the WHO’s 2022 recommendations and support the promotion of KMC among LBW infants in public health programmes in low- and middle-income settings in India and other South Asian countries,” Sinha says.
In low- and middle-income settings in India, the caregivers of LBW infants often visit primary health care centres or local physicians to seek medical help for difficulties in latching, sucking, nipple-related problems, and poor breastfeeding. In addition, in the low- and middle-income countries of the Indian subcontinent (South Asia), around 20% of mothers suffer from postpartum depression and need clinical attention.
“The evidence from my studies supports offering KMC as a potential solution to ameliorate the difficulties associated with breastfeeding in LBW infants and to prevent maternal depressive symptoms in the postpartum period,” Sinha explains.
Sinha is from India. He is a doctoral student at Tampere University and working as a Scientist at the Society for Applied Studies in New Delhi, India. He is also a Clinical and Public Health Research Fellowship awardee by the DBT Wellcome Trust India Alliance.
Public defence on Friday 10 November
The doctoral dissertation of MD Bireshwar Sinha in the field of paediatrics titled “Effect of kangaroo mother care in low birth weight infants on breastfeeding performance, gut function, and maternal depressive symptoms in low middle income populations in the Indian subcontinent” will be publicly examined at the Faculty of Medicine and Health Technology of Tampere University at 12.00 on Friday 10 November 2023. The venue is Auditorium F114 of the Arvo building (address: Arvo Ylpön katu 34). The Opponent will be Professor Liisa Lehtonen from the University of Turku, Finland. Professor Per Ashorn from Tampere University acts as the Custos.
The doctoral dissertation is available online.
The public defence can be followed via a remote connection.
Photograph: Shraya Banerjee