For randomization, we use computer generated random numbers.

Blinding: The sealed envelope will be opened by the staff on duty under the supervision of study doctor. The interventions which will be written on the slip will be carried out by the resident doctors and staff on duty not involved in the study. 

 INTERVENTION-Residents doctors and staff involved in KMC of neonates trained for Kangaroo mother care by showing live demonstration of KMC by primary investigators and showing a video produced by World Health Organization in collaboration with AIIMS, New Delhi. Randomly allocated intervention group neonates with KMC during KMC position by trained staff and resident doctors according to the treatment orders and protocols specified in AIIMS NICU protocol. KMC in KMC group neonate provided for maximum possible duration in a day till mother will be comfortable [minimum 4 hours per day]. 

ï‚· A comfortable environment will be provided for mothers by wearing hospital clothes after washing their hands, keeping the opening in front, and then lying on the bed and head elevated to a 45° angle to provide a comfortable reclining position. In order to emphasize skin-to-skin contact, the newborn was then placed on the mother’s bare chest while only wearing a diaper, socks, cap, and mittens. In order to maintain the newborn’s open airway and promote mother-child eye contact, a soft blanket was placed around the mother and child. To help with KMC, the mother’s hands were placed over the blankets and gently pressed against the neonate’s back to stabilize them. 

ï‚· Determine a time that’s suitable for the mother and the baby when the child is ready for KMC. The early sessions are crucial and require for a lot of interactions. Explain her how to adhere to the KMC process patiently, gently, and with compassion. Invite her to bring her husband, mother-in-law, or any other family member. It contributes to the family’s positive mental state and guarantees the mother’s support. 

 Short: 4 hours a day. 

Extended: five to eight hours per day.

Length: nine to twelve hours every day.

Continuous: More than twelve hours per day recorded for at least two days consecutively or more before being discharged. 

ï‚· KMC is linked to a lower incidence of serious illnesses in neonates, such as pneumonia. KMC has been found to be more effective than incubator care for stable newborns in the majority of studies. This is because KMC encourages greater maternal and family involvement in care, provides adequate thermal care, reduces nosocomial infections, improves exclusive breastfeeding and weight gain, and is less expensive than incubator care. The baby’s five senses are fully satisfied by KMC. The baby listens to her mother voice and has skin-to-skin contact (touch) to sense the warmth of her mother, listens to her voice and heartbeat (hearing), sucks breast milk (taste) has eye contact with her (vision) and smells her odor (olfaction) 

ï‚· Following that, a pulse oximetry probe will be attached to the neonate’s right wrist prior to feeding in order to measure vital signs like heart rate and oxygen saturation. For an entire one minute, the respiratory rate was recorded. ï‚· Finally after 30 minutes of feed administration and KMC neonates’ physiological parameters and feeding intolerance parameters were assessed including any feed regurgitation and abdominal distension. KMC was continued for maximum possible duration. Feed intolerance and NEC grading was defined based on AIIMS NICU protocol.