Preterm infants show proper growth at 1 year with Kangaroo mother care

Preterm infants receiving kangaroo mother care (KMC) exhibit different patterns of growth, but most of them have appropriate first-year growth, according to a study.

Furthermore, lower birth weight z-score (BWZ) is associated with weight-for-age (WAZ) and length-for-age z-scores (LAZ) catch-up, as well as with weight-for-length z-score (WLZ) faltering, whereas suboptimal early WAZ growth correlates with growth faltering.

“Most of the infants studied had appropriate growth and attained normal anthropometric status at 1 year of age, highlighting that KMC, breastfeeding support, and regular postnatal follow-up can support desirable growth,” said the researchers, who analysed 322 South African preterm infants’ (mean 32.8 weeks gestation) 1-year clinic records after KMC discharge.

Latent class trajectory modelling was used to identify patterns of WAZ, LAZ, WLZ, and head circumference-for-age (HCZ) z-scores (Fenton 2013 Growth Chart; WHO Growth Standards, age-corrected). Z-score patterns were characterized as follows: maintenance, faltering (progressively decreasing), gain (progressively increasing), or catch-up (rapidly increasing, exceeding birth z-score).

The researchers performed ordinal regression analysis to explore the associations of early-life maternal/infant factors, birth weight, and early (until 50 weeks postmenstrual age) WAZ gain with growth patterns. They also compared 1-year stunting (LAZ <‒2), wasting (WLZ <‒2), and overweight (BMI-for-age z-score >2).

Growth patterns

In best-fit models, the researchers identified three WAZ and LAZ patterns (ie, gradual gain, faltering, and catch-up), three WLZ patterns (ie, maintenance, faltering, and catch-up), and two HCZ patterns (ie, maintenance and gain). Most infants showed maintenance, gradual gain, or catch-up. [Eur J Clin Nutr 2026;80:62-72]

Lower BWZ correlated with LAZ catch-up (odds ratio [OR], 8.33, 95 percent confidence interval [CI], 3.13‒20.00), WLZ faltering (OR, 2.94, 95 percent CI, 1.69‒5.00), and HCZ gain (OR, 1.92, 95 percent CI, 1.23‒3.13). It also correlated with a lower likelihood of gradual WAZ gain (OR, 0.36, 95 percent CI, 0.19‒0.68) and WAZ faltering (OR, 0.56, 95 percent CI, 0.34‒0.92).

“Identifying the early-life factors that are associated with these growth patterns may therefore be useful in flagging infants whose growth should be monitored more closely,” the researchers said.

Furthermore, smaller early WAZ gain showed a significant association with gradual WAZ gain (OR, 2.27, 95 percent CI, 1.56‒3.33), WAZ faltering (OR, 1.47, 95 percent CI, 1.11‒1.96), LAZ catch-up (OR, 1.85, 95 percent CI, 1.25‒2.70), and LAZ faltering (OR, 1.39, 95 percent CI, 1.09‒1.75).

On the other hand, WAZ and WLZ faltering both correlated with stunting (45.5 percent and 23.5 percent, respectively) and wasting (21.9 percent and 10.3 percent, respectively) at 1 year (p<0.001).

“The substantial catch-up growth in our study sample is further illustrated by the fact that the rate of stunting, at 17 percent, is substantially lower than the reported South African population prevalence of stunting (31.4 percent in infants 12–17 months old),” the researchers said. [http://www.statssa.gov.za/?page_id=1854&PPN=Report%2003-00-09&SCH=7015]

“Taken together, this provides support for early, prolonged KMC, strong breastfeeding support, and regular infant follow-up as strategies to optimize preterm infant growth in a resource-constrained low-and-middle income countries setting,” they added.