An exploratory study to describe the growth and neurodevelopmental status of low birthweight infants in the context of a community-based mother-to-mother peer support implementation program in Kenya

BACKGROUND: This article examines changes in mothers' knowledge of low birthweight (LBW; <2500 g) infant care practices in a study assessing the feasibility and acceptability of peer mother support post-discharge, explores the acceptability of the intervention among mothers and healthcare workers and describes the post-intervention growth and neurodevelopmental status of the LBW infants. METHODS: A mixed methods exploratory study, using questionnaires, semi-structured interviews and focus group discussions with mothers, healthcare providers and peer mothers was conducted in three health facilities in Homa Bay County, western Kenya. Peer mothers delivered the interventions (including breastfeeding support) to mother-LBW infant pairs at 24 h post-discharge and six other time points until 3 months after birth. Infant anthropometric assessments were done at birth, discharge and 3 months after birth, while neurodevelopmental assessment was done only at 3 months using the Malawi Developmental Assessment Tool. Descriptive statistics were used to analyse the quantitative data. A thematic framework was used to analyse the qualitative data. RESULTS: Sixty mother-LBW infant pairs were enrolled in the study, but only 55 were included in the analysis because 5 mothers and their LBW infants were lost to follow-up. The median birthweight was 2050 g, median discharge weight was 2100 g and median weight gain 3 months after birth was 2820 g. The weight-for-age z-scores increased by 0.3 from birth to 3 months; similarly, the weight-for-length z-score increased by approximately 0.2. However, the length for age Z-score decreased by 0.3. At 3 months, 96% (n=53) of LBW infants had achieved their gross motor, 71% (n=42) fine motor, 89% (n=49) language and 100% social milestones. The intervention improved maternal knowledge and practice of recommended LBW infant care strategies, promoted resilience and enhanced family relationships. CONCLUSION: This exploratory study suggests that a mother-to-mother peer support intervention improved maternal knowledge, care practices and empowerment in the post-discharge care of LBW infants in a resource-limited setting. Further refinement and rigorous evaluation are needed to generate robust evidence on its effectiveness and impact on growth and neurodevelopmental outcomes.