Population Council Research that makes a difference

A simple method to care for low-birth-weight infants

Low birth weight (LBW) is a major contributor to infant mortality. In some countries 15–20 percent of LBW babies die in their first year of life. Past efforts to reduce neonatal and infant mortality have focused on preventing LBW, but these efforts have had limited success.

LBW and premature (i.e., less than 37 weeks' gestation) babies born in hospitals are usually kept in incubators. These babies are especially prone to heat loss and particularly vulnerable to life-threatening respiratory and gastrointestinal diseases. Hospital neonatal intensive care is costly, and, in developing countries, resources for neonatal care are scarce, so nurseries are overcrowded and staffing is insufficient. The risk of infection in such circumstances is high because it is often necessary for infants to share an incubator.

In 1979, Drs. Martinez and Rey of the Maternal Child Institute in Bogotá, Colombia, developed a simple method to care for LBW infants called the "kangaroo mother care" (KMC) method to overcome the inadequacies of neonatal care in developing countries. KMC is used in hospitals, and the stabilized LBW infant is placed without clothes—except for diapers, a cap, and booties—upright between the mother's breasts held inside a pouch or mother's blouse, to maximize skin-to-skin contact.

KMC was developed as a curative method to reduce infant morbidity and mortality by promoting breastfeeding on demand, thermal maintenance, and maternal–infant bonding. The method has been demonstrated to reduce severe illness in infants. But Kangaroo Mother Care has never been proven to reduce neonatal or infant mortality, because most of this mortality occurs in the early neonatal period, before infants are considered stabilized and thereby eligible for KMC. Nor have there been attempts to adapt and evaluate community-based kangaroo care.

The Population Council forged a new frontier for KMC by formally adapting the method for community-based application, and is testing its impact where it is likely to reduce infant mortality, in areas where the incidence of LBW is highest, and where most births occur at home without medical or trained assistance or institutional support, including technology such as incubators to stabilize infants.