The Effect of Intermittent Kangaroo Mother Care on Breastfeeding Practice of Late Preterm Infants in China

Background China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate of babies born extremely or very preterm. However, there is limited evidence of intermittent KMC’s effect on exclusive breastfeeding in late preterm. Using hospital discharge and follow-up data collected from four postnatal wards, we investigated the association between intermittent KMC and breastfeeding practice for late preterm babies in China.Methods Intermittent KMC was recommended to the mothers of all preterm babies admitted between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the “KMC group”, those who did not in the “no-KMC group”. Basic maternal socio-demographic information was collected, feeding outcome and method were recorded daily whilst in hospital and a follow-up survey of feeding practice was conducted 42 days post-discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates.Results Among the 844 participants in the analysis, 627 (74.3%) chose to perform KMC. More mothers who provided KMC were exclusively breastmilk feeding their newborn in the 24 hours before discharge (54.6%) and at follow-up (57.3%), compared with mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the no-KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the no-KMC group, mothers who provided KMC were twice as likely to be providing their newborns with exclusive breastmilk feeding at discharge (OR=2.15 (1.53-3.02)), use breast feeding method at discharge (OR=1.61 (1.15-2.25)), provide exclusive breastmilk feeding at follow-up (OR=2.55 (1.81-3.61)), and use breast feeding method at follow-up (OR=2.09 (1.44-3.02)).Conclusions Intermittent KMC was associated with a nearly doubled increase in exclusive breastmilk feeding (outcome) and breast feeding (method) at both discharge and 42 days after discharge for late preterm babies. Intermittent KMC has the potential to increase exclusive breastfeeding rates amongst late preterm infants.