Kangaroo Mother Care and Neonatal Skin Microbiome

Excerpt

Kangaroo Mother Care (KMC), a simple and low-cost intervention, is associated with a reduction in neonatal mortality and severe infection in low birth weight (LBW) neonates [1]. Initiating KMC within 24 h of birth, i.e., early KMC, is associated with even greater benefits including a lower risk of clinical sepsis than initiating KMC after 24 h of age. Reduced risk of sepsis has been noted not only with in-hospital KMC but also when KMC is initiated and practiced in the community [2]. The effect of KMC on the incidence of severe neonatal infection, especially nosocomial sepsis, may occur through multiple pathways - the increased use of breastmilk for feeding, lower incidence of hypothermia, greater time spent in care by the mother than a healthcare provider who takes care of multiple admitted neonates, and an earlier discharge from the hospital - all independently associated with reduced risk of neonatal sepsis. An additional mechanism of direct effect of KMC is through modulation of the maternal and neonatal immune system. While practicing KMC, both the mother and the baby are exposed to a common pool of microorganisms. The mature humoral and cellular immune systems of the mother respond to these micro-organisms and pass on the antibodies and leucocytes to the neonate through breast milk, thus not only providing passive immunity but also programming the neonatal immune system [3, 4]. One component of this programming is the promotion of a ‘physiological’ gut microbiome dominated by Bifidobacterium in the neonate, an interesting effect that includes the direct transfer of maternal gut bacteria to the neonatal gut through the entero-mammary route [3]. …