1.1 Participants In this study, newborns and their mothers who were hospitalized in the obstetrics of Liping County Maternity and Child Health Hospital between December 2019 and December 2020 were selected. According to the wishes of the patients, mothers and newborns who voluntarily participated in KMC were selected as the KMC group, a total of 186 cases. In the traditional way, newborn infants were placed in a stroller and followed by medical care as a control group, with a total of 161 cases. The KMC group performed kangaroo care in the KMC ward set up in the obstetric ward.
Inclusion criteria: 1) Accept KMC on a voluntary basis, and the parturient and family members sign informed consent; 2) The parturient or other major KMC implementers have no history of major illnesses; 3) Have certain learning ability and normal communication skills; 5) Mother Babies are generally in good condition, with stable vital signs; 6) Late preterm infants (gestational age between 34-36 weeks [+6]), preterm infants with stable vital signs; 7) Term low birth weight infants with stable vital signs; 8) Mother Newborns with obstetric comorbidities and complications and the mother's postpartum condition is stable. Exclusion criteria: 1) Newborns whose vital signs are not stable; 2) KMC implementers suffer from infectious diseases that may increase the risk of infection through skin contact and the mother’s own conditions that are not suitable for breastfeeding; 3) Newborns who require close medical observation Children; 4) Birth weight is less than 2000g; 5) Newborns with diseases that are not suitable for KMC. Halfway withdrawal criteria: 1) The parturient has severe malaise, fever, nausea, vomiting, diarrhea, etc.; 2) The parturient has bad emotions and is unwilling to continue KMC or breastfeeding; 3) The parturient has a situation that requires treatment; 4) The newborn has a condition Unsteady vital signs; 6) sudden accidents of newborns; 7) newborns with diseases that affect breastfeeding.
Joint intervention content 1) Propagating and educating pregnant women in obstetric outpatient clinics through multimedia broadcasting, setting up publicity boards, and distributing brochures; 2) Conducting centralized educating and educating pregnant women and their families in hospital through slide interpretation + oral education; 3) Voluntary participation KMC pregnant women and their family members sign informed consent; 4) KMC operation and precautions are trained for pregnant women and their families participating in KMC; 5) During the implementation of KMC, the tube bed nurse collects and reports data, and the main members of the project team Data collection and analysis, and regular quality control.
Encourage mothers to implement KMC as soon as possible after returning to the ward for childbirth, adjust the indoor temperature and humidity in the KMC implementation area according to the KMC operation guide , help newborns change diapers, wear socks and hats, and leave newborns exposed to the mothers Before the chest and abdomen of the newborn, the newborn is in a prone position, and the newborn's head is slightly raised parallel to one side to maximize the contact area between the premature baby and the mother. Cover the back of the newborn with a thin quilt. Instruct the mother to place one hand on the baby's back and one hand to hold the buttocks to avoid slipping. Do not limit the time of kangaroo-style care and encourage continuous and long-term skin contact. The main participant is the mother of the newborn, or relatives such as the father or grandmother. If the mother interrupts KMC due to physical factors or no other family members participate Next, perform KMC every morning, noon, and evening, and each skin contact time should be no less than 1 hour.
1.3 Observation indicators
1.3.1 Neonatal vital signs monitoring Record the four body temperature and breathing of newborns in the KMC group and the control group during the implementation of KMC.
1.3.2 The evaluation method of neonatal pain is by changing diapers or collecting heel blood. Within a short period of time (not more than 1 minute) after the stimulation occurs, the newborns in the KMC group are carried back to the mother’s chest for KMC, and the newborns in the control group undergo KMC. Embrace and comfort. After the newborn is carried back, observe and record the newborn's performance according to the scale indicators. This study refers to the Neonatal Infant Acute Pain Assessment Scale (Neonatal Infant Acute Pain Assessment Scale, NIAPAS), which is a professional tool for assessing pain from multiple dimensions, including gestational age, alertness, 9 indicators such as response to operation, heart rate, respiration, etc., with a total score of 0-18. The higher the total score, the more severe the pain. The internal consistency reliability of the scale Cronbach's α coefficient is 0.723, the inter-rater reliability is 0.991~0.997, and the reliability is relatively high []. Because the scale is relatively objective, it can be better used for full-term infants. In the evaluation of pain in premature infants, this study selected them for the evaluation of pain in neonates.
1.3.3 Comparison of newborn health indicators Observe the sleep, mood and vomiting of newborns in the KMC group and the control group within 24 hours.
The newborn sleep evaluation method records the continuous sleep time of newborns in the KMC group and the control group in a quiet state, and calculates the total continuous sleep time within 24 hours. The quiet state is when the baby's facial muscles are relaxed, the eyes are closed, and the breathing is even. Except for almost no startle and slight mouth movement, there is no other activity, and the baby is completely at rest .
Feeding condition of the newborns A few minutes after the newborns are fed and burped, the newborns in the KMC group are carried back to KMC, and the newborns in the control group are brought back to the stroller and lie on their sides. Observe the vomiting of the newborns in the two groups and record them within 24 hours Number of vomiting.
The neonates’ emotions were evaluated by the nursing staff, and after excluding the triggers such as hunger, after going to the toilet, tight packages, disease, etc., the number of daily crying and the duration of each crying of the two groups of newborns were recorded.
1.3.4 Breastfeeding situation This section uses the Breast-feeding Assessment Tools (BAT) developed and revised by Matthews. The measurement tool has 4 items for each latitude. The item has a minimum score of 0 and a maximum of 3 points. The total score is 0-12, and the total score is more than 8 points for successful breastfeeding , The reliability and validity of the scale are good, and the internal consistency coefficient of the scale in domestic research is 0.97 []. This part of the content is carried out by the nursing staff before the mother is discharged from the hospital. The mother will score the expression of specific items and record the specific time of successful breastfeeding of the mother with a total score of> 8 to understand the exclusive breastfeeding situation of the mother before discharge from the hospital. And implementation time. The time to achieve successful breastfeeding and exclusive breastfeeding is compared to the time of birth of a newborn.
1.3.5 Quality control This subject was carried out in the pilot hospital in the pilot area of the neonatal safety project of the WHO/China CDC Maternal and Child Health Center (Liping County Maternity and Child Health Hospital, Qiandongnan Miao and Dong Autonomous Prefecture, Guizhou Province). It will be implemented after the review and approval of the hospital ethics committee (Li Fuyou Ji Zi  No. 3). Project participants are trained and assessed in a standardized manner, and the main person in charge of the project conducts statistics and quality control on data and scales every month.
1.3.6 Statistical methods Use SPSS 22.0 software for statistical analysis, independent sample t test for measurement data conforming to normal distribution, single-factor analysis of variance for comparison of multiple groups of measurement data; for non-measurement data that does not conform to normal distribution The Mann-Whitney U nonparametric test was used for comparison; the RXC combined tabular chi-square test was used for the classification data. P<0.05 indicates that the difference is statistically significant.