Effectiveness of Antenatal Family Counseling on Early Initiation and Duration of Kangaroo Mother Care and Growth Pattern of Preterm Neonates: A Study in a Tertiary Care Center

Abstract

Introduction: Kangaroo Mother Care (KMC) functions as an evidence-based low cost care method which improves preterm infant survival and neurodevelopmental outcomes. Despite national guidelines, delayed initiation and sub-optimal duration of KMC are common in busy tertiary units. Antenatal family counselling (AFC) may enhance caregiver readiness to practice KMC immediately after birth.

Objectives:To study the effectiveness of antenatal family counselling on early initiation and duration on KMC and growth  pattern in preterm neonates

Methods: In this quasi-experimental study (May 2024 – May 2025 ) we compared 60 consecutive preterm dyads (28–34 weeks, birth-weight < 2500 g) exposed to structured AFC (intervention group, n = 60) with 60  historical controls managed by standard postnatal counseling (control group, n = 60). AFC, delivered by a multidisciplinary team at 32–36 weeks’ gestation, consisted of a 30-min interactive session. Primary outcomes were (1) time from birth to first KMC episode; (2) cumulative daily KMC duration during the first 7 days. Secondary outcomes included weekly weight, length and head-circumference velocity until discharge, and caregiver knowledge/attitude scores.

Results

Median (IQR) age at first KMC was significantly shorter in the intervention group [6 h (4–11)] versus controls [20 h (14–32); p < 0.001]. Mean daily KMC duration was higher (7.2 ± 1.6 h vs. 4.1 ± 1.8 h; p < 0.001). Intervention infants demonstrated greater weight-gain velocity in week 1 (16.3 ± 4.5 vs. 11.8 ± 4.7 g kg⁻¹ day⁻¹) and achieved discharge weight earlier (median 14 d vs. 18 d; p = 0.02). Multivariable regression confirmed AFC as an independent predictor of early KMC (aHR 2.65, 95 % CI 1.74–4.01) and ≥6 h daily KMC (aOR 3.81, 95 % CI 1.77–8.20). Caregiver knowledge scores increased from 58 ± 9 % pre-counseling to 88 ± 6 % post-counseling (p < 0.001).

Conclusion

Structured antenatal family counselling significantly expedited initiation and increased duration of KMC, translating into improved early growth in preterm neonates. Integrating AFC into routine antenatal visits can strengthen KMC programs in resource-limited tertiary centers