Impact of Kangaroo Mother Care (KMC) Initiated Immediately after Birth Versus After Stabilization on Clinical Outcomes in Very Low and extremely Birth Weight (<1500 g) Newborns

Abstract Background: Kangaroo Mother Care (KMC) enhances survival and growth in very low birth weight (VLBW) infants. However, the optimal timing remains uncertain. Aims and Objectives: Compare length of stay (LOS), incidence of NEC, BPD, antibiotic duration, overall survival and weight gain between early KMC (initiated within the first week) and standard KMC (after stabilization). Methods: A retrospective cohort study at a tertiary NICU was conducted over two six-month periods. Medical records of VLBW (<1500 g) neonates meeting inclusion criteria were reviewed. Standard care was unchanged. The primary outcome was survival; secondary outcomes included sepsis, antibiotic use, length of stay, and wait gain. Results: Of total 322 neonates,201 standard KMC (Group A) and 121 received early KMC (Group B) LOS were comparable (27.8±18.7 Vs 27.2±17.1 days), Compared to group A, group B has lower incidence of NEC (40.8% Vs 10.7%, p<0.0001), sepsis (37.3%Vs26.4%, p=0.04) and BPD (18.9%Vs10.7%, p=0.05). total antibiotic days of therapy per 1,000 patient-days (393.3 vs 117.7 days), oxygen support (20.3 Vs 10.6 days, p<0.0001), Mortality was marginally lower with early KMC (2.5% Vs 1.7%). Daily weight gain was higher with early KMC (12.59 Vs17.19 g/kg/day, p=0.09) but not significant. Conclusion: In this study, early KMC significantly reduced NEC, sepsis, BPD, antibiotic use, oxygen support, and marginally lowered mortality, with comparable NICU stay and a non-significant trend toward higher weight gain.