Publications

BACKGROUND: It is plausible that one of the key biological pathways through which kangaroo mother care (KMC) improves health outcomes in low birth weight (LBW)  infants is by enhancing human milk intake and quality. This hypothesis needs to  be tested. OBJECTIVES: This study aims to estimate the effect of promotion and  support of KMC in LBW infants compared with control during the neonatal period on  human milk intake and human milk components. METHODS: We randomly assigned 550  LBW infants (1500-2250 g) to the intervention arm with promotion of and support  for continuous skin-to-skin contact and exclusive breastfeeding through home  visits or to no such intervention (control) during the neonatal period. All  infants received routine home-based postnatal care visits. We estimated human  milk intake by the infant over a 14-d period using the deuterium dilution  technique and measured the concentration of carbohydrate, protein and amino  acids, fat, lactoferrin, and secretory immunoglobulin A (sIgA) in human milk of a  subsample of 250 mothers. RESULTS: The mean infant human milk intake was 331 ±  144 g/d or 142 ± 57 g/kg/d in the control arm and 368 ± 135 g/d or 154 ± 50  g/kg/d in the intervention arm participants, yielding a mean difference of 37  [95% confidence interval (CI): 12, 63] g/d or 12 (95% CI: 2, 22) g/kg/d. The mean  concentration of carbohydrate in human milk in the intervention arm was 51.2 ±  6.1 g/L against 50 ± 6.8 g/L in the control arm. The corresponding values for  protein were 15.0 ± 2.9 g/L and 16.3 ± 4.6 g/L, respectively. We did not find any  substantial differences in the concentration of amino acids, fat, lactoferrin, or  sIgA between the study arms. CONCLUSIONS: Our findings show that KMC is  associated with a substantially higher human milk intake in LBW infants during  the neonatal period. There was no evidence of any effect of KMC on the  concentration of several human milk components. This trial was registered at  Clinical Trials Registry-India as CTRI/2017/04/008430.