Growth and development of abandoned babies at Kenyatta National Hospital and some children homes in Nairobi

Abstract

A cross-sectional survey was conducted on abandoned babies aged 1-18 months at KNH and 7 Children's homes in Nairobi from December 1993 to January 1995. A total of 82 abandoned babies were recruited. Each abandoned child was matched for age and sex with 2 mothered babies. There were 116 males and 130 females giving a ratio of 1:1.1. Abandoned babies were compared to mothered babies for nutritional and developmental status. Most of the abandoned babies, (78%), in this study were in institutions managed by NGOs. The institutions were characterized by a low staff/infant ratio with 6/8 having ratios of 1:5 -1:10. The institutions were also categorized into "home type", "hospital type" and "mixed hospital and home type" and it was found that 83% of the babies recruited were from "hospital type " institution. Sixty six (80.5%) of babies were abandoned in the first month of life. Abandoned babies had similar birth weight and types of illness experienced with the mothered group, however babies who were abandoned in the hospital had a significantly higher prevalence of illness (p = 0.01). bandoned infants were lighter, shorter, had lower head circumference and had significantly small LUMAC compared to mothered group (p = 0.02). abandoned males aged 1-3 months were significantly lighter (p =0.01) shorter 0-06) and had a smaller head circumference (p = 0.05). Abandoned males aged 3.5-6 months were thinner as measured by mean LUMAC (p = 0.000) and had lower mean weights (p = 0.07) and length (p = 0.06). Female abandoned infants were essentially comparable to mothered group except in the 6.5-12 months where they were thinner by mean LUMAC (p = 0.05). Abandoned babies compared to mothered babies were likely to be wasted (p = 0.001) and stunted (p < 0.001) as indicated by Z scores. Babies in " hospital like" institutions had increased risk of stunting (OR 3.3) and wasting (OR 3.5) compared to the other institutions. Mothered babies were more alert and interested in their surrounding compared to the abandoned babies (p = 0.001). Abandoned babies had significant developmental delay, as measured by the RDDST, compared to mothered babies (p = 0.000). In all 4 functions of gross motor, fine motor, speech and hearing and social and personal tested, abandoned babies were more delayed compared to mothered babies (p = 0.000 in all 4 sectors). Most delays in abandoned babies, were recorded in social personal sector 25/73(34.2%), followed by gross motor 21/73 (28.8%)and speech and hearing also 21/73 (28.8%). Age at admission was not associated with developmental achievement, however, infants abandoned over longer periods had higher rates of delayed development P — 0.007). Babies in the hospital had the highest risk of developmental delay compared to the other institutional types. preterms abandoned compared to mothered infants had lower birthweights, eight length, head circumference and significantly lower LUMAC (p = 00OO6). For chronological age, preterm abandoned babies were significantly delayed in development compared to mothered babies (p =0.03). This study has shown that mothered infants have significant advantage over abandoned ones in terms of physical growth, nutritional status and development and that institutions managed like a hospital are significantly disadvantaged. There is an urgent need to address the results of this study with managers of these institutions and authorities concerned with child care in Kenya. Preterms abandoned compared to mothered infants had lower birthweights, eight length, head circumference and significantly lower LUMAC (p = 0 0006) For chronological age, preterm abandoned babies were significantly delayed in development compared to mothered babies (p =0.03). This study has shown that mothered infants have significant advantage over abandoned ones in terms of physical growth, nutritional status and development and that institutions managed like a hospital are significantly disadvantaged. There is an urgent need to address the results of this study with managers of these institutions and authorities concerned with child care in Kenya.