title: Long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for low-birth-weight (LBW) infants in Madagascar.
abstract: OBJECTIVE
  To examine the long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country.
  
  
  METHODS
  A randomized controlled trial with long-term follow-up was performed in LBW infants in Madagascar. Earlier continuous KMC (intervention group) was initiated as soon as possible within 24 h postbirth, and later continuous KMC (control group: conventional care) was initiated after complete stabilization. Outcome measures were mortality or readmission, nutritional indicators at 6-12 months postbirth and feeding condition at 6 months postbirth (ClinicalTrials.gov, NCT00531492).
  
  
  RESULTS
  A total of 72 infants were followed for mortality or readmission at 6-12 months postbirth. There was no difference between the two groups (7/36 vs. 7/36, Risk ratio (RR), 1.00; 95% CIs, 0.39-2.56; p = 1.00). The proportion of exclusive breast feeding (EBF) at 6 months postbirth was significantly higher with earlier KMC than later KMC (12/29 vs. 4/26; RR 2.69; 95% CIs, 1.00-7.31; p = 0.04). There were no differences in nutritional indicators between the two groups at 6-12 months postbirth.
  
  
  CONCLUSIONS
  Earlier initiated continuous KMC results in a significantly higher proportion of EBF at 6 months postbirth. Further larger-scale long-term evaluations of earlier initiated continuous KMC for LBW infants are needed.
authors.affiliation: Department of Health Informatics, Kyoto University, School of Public Health, Kyoto, Japan.
authors.forename: Shuko
authors.initials: S
authors.lastname: Nagai
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yonemoto
authors.forename: Norotiana
authors.initials: N
authors.lastname: Rabesandratana
authors.forename: Diavolana
authors.initials: D
authors.lastname: Andrianarimanana
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mori
mesh_terms: D001942:Breast Feeding; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006130:Growth Disorders; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007228:Infant Nutrition Disorders; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method; D008270:Madagascar; D008297:Male; D009034:Mother-Child Relations; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D013995:Time