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Kangaroo mother care is becoming an integral part of the care of low birth weight infants worldwide. It provides economic savings to families and health care facilities and many physiologic and psychobehavioral benefits to mothers and infants, the most important of which is the promotion of successful breastfeeding. The benefits of breastfeeding, of human milk over formula, and of feeding from the breast per se, are beyond dispute, and so KMC should be actively promoted. The full impact of KMC on breastfeeding low birth weight infants is yet to be realized.

Background: Infants with neurodevelopmental abnormality need to start therapy early, and because of this they should be detected as soon as possible. Currently, no widely accepted method of early evaluation exists., Objectives: To assess and compare, in terms of predicting neurodevelopmental outcome at 1 year of age: (i) a perinatal risk rating (PRR); (ii) the Dubowitz Neurological Assessment (DNA); and (iii) the Infant Neuromotor Assessment (INA)., Design and Setting: A prospective neurodevelopmental follow-up study on graduates from the Groote Schuur Hospital (GSH) neonatal intensive care unit (NICU)., Subjects: A cohort of 130 consecutive NICU graduates were selected according to high-risk criteria., Outcome Measures: Each infant was examined at term gestational age on the DNA before discharge, and a PRR was allocated. Study infants were seen again at 18 weeks of age when an INA was done, and at 1 year of age a Griffiths Developmental Assessment and full neurological examination was carried out., Results: All of the 130 infants assessed at term were seen at 18 weeks. Thereafter 5 were lost to follow-up and 2 died. The outcome for the remaining 123 is known., Conclusions: Prediction of a normal outcome at 1 year of age was 96% on the DNA and 98% for the PRR, but for an abnormal outcome they predicted only 56% and 42%, respectively. The INA done at 18 weeks predicted a normal outcome at 1 year in 99% of cases if 3 or less abnormal signs were present and an abnormal outcome in 82% of cases with 4 or more abnormal signs. Based on these findings a protocol for follow-up of these high-risk infants is suggested.

Objective: To assess the efficacy of recombinant human erythropoietin (rHuEpo) in the treatment of the anemia of prematurity., Methodology: A double-blind, placebo-controlled study was conducted on 80 preterm infants (< or = 32 weeks; postnatal age, 2 to 8 weeks; central hematocrit < or = 35%). Patients were randomly assigned to receive subcutaneous rHuEpo (Eprex, 600 U/kg per week) or an equivalent volume of placebo, for up to 6 weeks. All patients received supplements of vitamin E (25 IU) and iron (3 mg/kg per day). The iron supplement was increased if declining serum ferritin measurements were noted., Results: Treatment and placebo groups did not differ significantly with respect to mean gestational age, birth weight, hematocrit, or reticulocyte count at study entry. Fewer transfusions were administered to those receiving erythropoietin (7 compared with 21; P = .002). Compared with the placebo group, the infants receiving rHuEpo had a higher mean hematocrit (32.3 +/- 4% vs 29.3 +/- 6.2%; P = .014) and absolute reticulocyte count (223 +/- 73 vs 124.9 +/- 73 x 10(9)/L; P < .001) at the end of the study. The mean neutrophil count was not significantly reduced at study exit (P = .8), nor at any other period during the trial in the rHuEpo group. Intercurrent events (mostly infections) were not increased in the treatment group, although there was one case of sudden infant death syndrome at age 4 months., Conclusions: Using a dose of rHuEpo of 600 U/kg per week, this study has shown a clear reduction in the requirement for blood transfusion in preterm infants.