الفهرس 
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Abstract
Kangaroo care is an important, effective and universal approach to promote the
health and well-being of preterm, term neonates and their families. It is defined as early,
long-term, and ongoing care in which the mother holds the neonate upright while providing
warmth and skin-to-skin contact to improve the physical and emotional needs of the
newborn and their mother. Kangaroo Care consists of three components: early and
sustained skin-to-skin contact, early Breast feeding, and early hospital discharge. It has
tremendous benefits for the mother, increases maternal bonding through physical contact
around the breast as part of KC, reduces maternal stress, increases oxytocin levels to
stimulate milk production, improves physical and mental condition, promotes early onset
and effective Breast feeding, reduces parental anxiety and boosts self-confidence.
The present study aimed to determine the effect of kangaroo care applied by
mothers of premature neonates on the amount of maternal milk expression. It was
conducted at three Neonatal Intensive Care Units; Maternity University Hospital at ELShatby,
Alexandria University Children’s Hospital in Smouha and at El-Raml Hospital
for Children (Wingat). A convenient sample of 60 mothers who have admitted premature
neonates in the previously mentioned settings comprised the study subjects. Those
Mothers visited their premature neonates regularly, five days a week for a duration of
three weeks.
Two tools were used for data collection, Tool I Socio-Demographic characteristics of
mothers and clinical data of the premature neonates’ structured interview schedule. It
included two parts: Part 1; Socio-Demographic data of mothers such as age, education,
occupation and number of living children. Part 2; Clinical data of premature neonates such as
gestational age, birth weight, current weight, diagnosis and clinical condition. Tool II
Maternal milk expression record. It was developed by the researcher to assess the amount of
maternal milk expression daily for three consecutive weeks.
The tools were tested for their content validity by five experts in the pediatric nursing
field, The validity was 95% for tool I and 100% for tool II, pilot study was carried out on 6
mothers who were excluded from the study and the needed Modification was done. The
reliability of the study tools (I, II) was ascertained by Cronbach’s coefficient alpha test,
which was 0.846 for tool 1 and 0.996 for tool II.
Socio-Demographic data of mothers and clinical data of the premature neonates
were assessed using Tool I. The mothers in the control group followed regular visit in
Neonate Intensive Care Units. The researcher taught every mother in the study group about
the Kangaroo Care technique and applied it for 15–20 minutes once a day for five days a
week for three weeks. The researcher trained every mother in both groups (study and
control group) about technique of milk expression and its recording, this was done under
the researcher’s supervision.
The main findings of current study showed the following:
• The high percentage of the mothers age ranged from 20 to less than 25 years were
63.4% for the control and 43.3% for study groups. While the least percentages of
their ages ranged from 25 to less than 30 years were 13.2% for control and 20% for study groups.
• Equal percentage of mothers’ education were 16.7% for either read-write level, or
just Primary schools certificate holders in the study and 10% for the control groups.
More than quarter of mothers in the study group (26.7%) and 16.7 of them in the
control group were a university-degree holder. In addition, the mothers
‘occupation were housewife for the majority of them in study (76.6%) and control
(83.3%) groups.
• Significant difference appeared between the three studied weeks for the mothers in
the study group. where more than two third of mothers (70%) expressed 500 ml
and more at the end of the 3rd week compared to 63.3% of those mothers at the end
of the week as well as 33.3% at end of the 1st week.
• Significant differences were found regarding the mothers’ ages and their amount of
milk expression at the end of the 1st & the 3rd weeks where all mothers who ages 25
to less than 30 years (100%) expressed less than 250 ml of breast milk in the 1st
week compared to none of them who ages ranged from 20 to less than 25 years and
30 years and more respectively.
• Significant differences were found regarding the mothers’ level of education and
their total amount of milk expression at the end of the 2nd & 3rd weeks, where the
total amount of expressed milk through the second week was 500 ml and more for
42.1% of mothers who had university degree compared to 26.3% of them who was
illiterate, plus an equal percentage of those mothers who had secondary,
preparatory primary education (10.5% for each).
• There was a significant difference in the 3rd third week, where the total amount of
expressed milk was 500 ml and more for 61.9% of mothers who had previous
experience in breast feeding compared to 38% of those who had not.