https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article Mother’s Practices Concerning Care of Low-Birth-Weight Neonates in Rapareen Teaching Hospital for Children in Erbil City ABSTRACT Background and Objectives: Low birth weight is a major contributor to an indirect cause of neonatal mortality. The study's goal was to evaluate mothers' practice regarding low- birth-weight neonate's care. Methods: This is a quantitative descriptive cross-sectional study. The research was con- ducted at Erbil's Rapareen Teaching Hospital for Children. Non-probability (purposive) sample of 245 mothers who visited the NICU at RTHC. The questionnaire format was used to collect data during a direct face to face interview. The data collecting period was from January 1st to August 1st, 2022, with interviews lasting roughly 20-30 minutes. Ne- onates with low birth weights who were admitted to the hospital were included. Formal and ethical authorization was obtained prior to data collection. Validity is determined by a panel of 15 experts in the field. Person correlation was used to determine and quantify internal consistency reliability, which was 0.81. The pilot trial included 15 mothers. The connection between variables was determined using inferential statistical analysis (Chi- square). A P-value is regarded statistically significant if it ≤ 0.05. Results: The study results reveal, housewives outnumbered mothers aged between 27 to 33years old. Completed secondary school. We had a middle-class income and lived in the city. Normal vaginal delivery was used to birth the babies. In public hospitals, neo- nates aged 1 to 5 days were born, with females being the majority. Most women exam- ine the umbilical cord for symptoms of infection. Moreover, half of those interviewed did not apply ointment to their skin. Furthermore, the study found a statistically signifi- cant association between socio-demographic characteristics such as the mother's age at marriage, mode of delivery, antenatal care, house ownership, the mother's occupation, socioeconomic status, and the mothers' practices, with p-values of 0.002, 0.004, 0.012, 0.033, 0.007, and 0.034, respectively. Conclusion: The outcome of the study revealed that most of mothers had good practices for age, low income, infection, and house ownership, which are the primary causes of low birth weight newborns in Erbil. Improving mothers' practices will lead to improved maternal care for LBW and reduction in LBW in Erbil. Keywords: Mothers; Intensive Care Units; Low Birth Weight; Umbilical Cord; Occupations. Barzan Issa Omar; General Directorate of Health, Gulan Health Center, Erbil, Kurdistan Region, Iraq. (Correspondence: barzanissa466@gmail.com) Shukir Saleem Hasan; Department of Nursing, College of Nursing, Hawler Medical University and Tishk International University, Erbil, Kurdistan Region, Iraq. 92 Received: 03/09/2022 Accepted: 26/11/2022 Published: 30/05/2024 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. mailto:Barzanissa466@gmail.com. https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article Low birth weight is the delivery of a live infant weighing less than 2500g, according to the World Health Organization (WHO).There are two levels of low birth weight: very low and extremely low [1]. Around the world, 18 million LBW infants are born each year. Ethiopia had a 28.3% prevalence of LBW infants in sub-Saharan Africa, while Zimbabwe had 199 per 1,000 live births. About 5 to 6 million children in Nigeria are impacted by LBW each year[2]. Every year, it causes between 60% and 80% of all neonatal deaths [3]. Low birth weight babies are more susceptible to morbidity, stunted growth, impaired cognitive devel- opment, and continued underweight and stunted weight throughout infancy. Girls are more likely to develop into women with short stature and an underdeveloped pelvis, which increases the risk of obstetric complications during childhood [4]. Health conditions like infections, high blood pres- sure, malaria, and syphilis can all cause LBW [3]. Birth weight (BW) has a direct im- pact on a child's development and survival and places a financial and social burden on individuals, families, health care systems, and governments [5]. Pulmonary tubercu- losis and IUGR share a number of maternal characteristics, risk behaviors, and social determinants in common, such as maternal malnutrition, low body mass index, pov- erty, black race, close child spacing, low maternal education, subpar antenatal care, substance abuse, and emotional and physi- cal stress are causes to have LBW neo- nates. Chorioamnionitis, vaginitis, bacteriu- ria, and systemic or remote site infections like sepsis and periodontal disease are ad- ditional factors that contribute to LBW ne- onates [6] . Respiratory failure, hypoxia, and intra-ventricular hemorrhage cause the immediate squeal of LBW [7]. The car- diovascular, nervous, and metabolic sys- tems are all involved in the complex process of producing heat [9]. Infants who are underweight are more at risk for complications like cerebral palsy, mental retardation, respiratory diseases, sudden infant death syndrome, and physical and neurological disabilities[9]. Increased breastfeeding and weight gain may result from parental caregiving for LBW [10]. Increased breastfeeding and weight gain may result from parental caregiving for LBW[11]. Nowadays all mothers who give birth at hospital received instruction on good hygiene and how to keep the baby warm [13]. Breast milk is sufficiently rich in vitamins, minerals, protein, carbohydrates, and lipids to support adequate growth and development of LBW neonates, and it has the advantages of bioavailability and economic viability [14]. Kangaroo Mother Care, a special approach to caring for LB infants, entails keeping the infant close to the mother while solely breastfeeding [15]. A quantitative; cross-sectional descriptive study was used for conducting this study. The study was carried out at Rapareen Teaching Hospital for Children (RTHC) in Erbil city. It has been established in 2005. The inpatient department includes the Emergency, Surgery unit, medical unit, and Neonatal Intensive Care Unit (NICU). This study was conducted in Rapareen teaching hospital for children in /Erbil and the time interval was between 1st of Jan to 1st of Aug. 2022.Non-probability purposive of 245 mothers who attended NICU at RTHC were selected. Data was gathered through direct interview by using the questionnaire format which was prepared by the investigator after rich interview of related. According to nonofficial census of RTHC there were, 630 cases associated with the LBW and admitted to NICU in 9 months (11). Non-probability of 245 causes, after the calculation of the sample size 93 Copyright ©2024The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. INTRODUCTION METHODS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article consistency reliability was determined and measured through applying Person corre- lation(r), and this was 0.81, and indicated that the scales were adequately reliable the practice. Pilot study was conducted on 15 mothers. The data was analyzed through using SPSS software for statistical analysis Version 25, for calculating descrip- tive statistical analysis (frequency and per- centage). Inferential statistical analysis (Chi -square) and (Fisher’s Exact Test) used to determine the association between varia- bles. The P-value considered statistically significant if it's ≤ 0.05. The study shows that the highest percent- age 35.1% of the mothers aged between 27-33 years old, most 75.5% were house- wives. One quarter (24.5% )of the mothers graduated from secondary school. The ma- jority 97.6% were Muslim. Regarding the mother's socioeconomic status, the cur- rent study shows that the highest percent- ages 91.8% of them were in middle eco- nomic live level. Finally, regarding the mother's residential areas 60% were living in Urban. Concerning mothers' obstetrical history table 1, shows, that more than one- third 40.4 % of the mothers had a normal vaginal delivery. The highest percentages 44.1% were married at the age of 20-26 years. Regarding biographical characteris- tics of LBW table 2 Regarding mothers’ antenatal care 57.1% of mothers apply ointment to their LBW umbilical. One-third 35.9% of neonates aged were between 1-5 days, and a half 51.8% were close relatives. Meanwhile, females represented the high- est percentage 58.8%. Regarding the place of delivery, the study found that more than half 63.3% of the babies were born in public hospitals and only one quarter 27.8% of the babies were breastfeeding. by substitution the numbers into the Ya- mane formula as follow: n=sample size N= population size e=level of precision or sample errors = 0.05 Were recruited to the study. All mothers with their LBW neonates LBW neonates who admitted to hospital. LBW aged be- tween first day to one month and admitted to the hospital with their mother. Mothers those are free of medical and psychological problems. Mothers who agreed to partici- pate in the study. Before data collection, formal permission was obtained from Hawler Medical University Collage of Nurs- ing and RTHCH for conducting the study. Ethical approval was obtained from the scientific and ethical committee number 106 in 7 / 10/ 2021 , and finally the verbal permission was taken from the mothers before starting interview. The tool was not consisting of personal information such as personal phone number, address, personal information, and the researcher promised to keep the data for confidentiality and anonymity. The tool of data collection con- sisted of two parts: Part one: this part con- sists of three sections: Section one consist- ed of items that related to the socio- demographical characteristics of the moth- ers. Second section was to assess the mothers' obstetrical history. Section three was to assess the biographic information of LBW. Second part was to assessment the mother's practice regarding LBW baby: This part consisted of 14 related questions. Three Likert scales include: good 3, fair 2, and poor 3. The scores were rating be- tween 1-10 for poor practices, 11-20fair practices, and 21-28 good practices. Data was gathered through the direct interview (face to face) by using the questionnaire format which was prepared by the investi- gator. Validity of the study instrument was determined initially through the panel of 15 experts of different specialties. Internal 94 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. RESULT https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article 95 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 1: Assessment of Socio-Demographic Characteristics of the Mothers (n= 245) Variables F. (%) Age/years old Less than 20 20-26 27-33 34-40 More than 40 30(12.2) 75(30.6) 86(35.1) 42(17.2) 12 (4.9) Occupation Housewife Public employee Private employee Student Self-employee 185 (75.5) 44(18) 12(4.9) 2 (0.8) 2 (0.8) Level of education Illiterate Can read and write Primary school Secondary school Diploma institute High degree 58 (23.7) 21(8.6) 36(14.7) 60(24.5) 34(13.9) 36 (14.7) The religions Muslim Christian Yazidi 239(97.6) 3(1.2) 3(1.2) Socio-economic status Low Middle High 2(0.8) 225(91.8) 18 (7.3) Residential areas Urban Rural Sub-urban 147(60) 64(26.1) 34 (13.9) Table 2: Mothers' obstetrical history (n=245) Mothers' obstetrical history F. (%) Mode of delivery NVD CS NVD with episiotomy 100(40.4) 62(25.3) 83(34.3) Age at married/years Less than 20 20-26 27-33 34-40 More than 40 105(42.9) 108(44.1) 21(8.6) 11(4.5) 0(0) Antenatal care Private facilities Primary health centers Both sector 215(87.8) 4(1.6) 26(10.6) Total 245(100) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article 96 ointment to their LBW umbilical. The ma- jority 82.9% of mothers pay attention to umbilical for signs of infection. More than half of mothers 54.7% did not apply ointment on skin to protect dermatitis. Majority of mothers 89.4% change ba- bies’ body's position to keep them from pressure area. Moreover, the study re- veals a highly significant and some signifi- cance association between socio- demographical characteristics such as the age of the mother at /marriage, Mode of the delivery, Antenatal care, house own- ership, Occupation of the mother and Socio-economic status (12). With p – value: 0.002, 0.004, 0.012, 0.033, 0.007 and 0.034 respectively (table 5). Table 4 shows the highest percentage 62% of mothers keep temperature between35- 36.5 °C. Meanwhile 49% of them give relax- ing massage to their neonates. Almost three quarters 72.2% of mothers feel com- fort while breastfeed to LBW. Using a cup or a spoon till the baby can suck effectively is refused by more than half of mothers 59.2%. 81.2% of mothers feed their neo- nates 6-8 times in 24hrs some of mothers 42.4% pick their LBW when crying while breastfeeding. Three quarter 75.1% of mothers did not put their LBW in quiet and healthy environment during feeding. Wip- ing the breast nipple when feeding to pre- vent infection was done by 60.8%. Almost 94.7% of mothers did not give their LBW 15 -20ml/kg/day. Most mothers 79.6% clean cord daily. 57.1% of mothers apply Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 3: Assessment of Biographical Characteristics of LBW (n= 245) Biographical Characteristics of LBW F. (%) Age of neonate/days 1-5 6-10 11-15 16-20 More than 20 88(35.9) 85(34.7) 36(14.7) 20(8.2) 16(6.5) Parents’ degree of relatives Close relative Distance relative 127(51.8) 118(48.2) Gender of neonate Female Male 144(58.8) 101(41.2) Place of the delivery Home Public hospital Private hospital 8(3.3) 155(63.3) 82(33.5) Gestational age Full- term Post-term Preterm 244(99.6) 1(0.4) 1(0) Type of feeding Breastfeed Bottle-feeding Both NG tube Nothing per oral 68(27.8) 58(23.7) 52(21.2) 63(25.7) 4(1.6) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article 97 Copyright ©2024The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 4: Mothers’ Practice Regarding Caring for LBW Neonates (n= 245) Practices of mothers of LBW Did you…… Good Fair Poor F (%) F (%) F (%) Keep the ambient body temperature in the incubator at around 35-36.5 °C 152(62) 87(35.5) 6(2.4) Give the baby a warm, relaxing massage. 120(49) 16(6.5) 109(44.5) Breastfeed your neonate and notice it comforting for you and the neonate. 177(72.2) 28(11.4) 40(16.3) feed neonate using a cup or a spoon until the baby can suck effectively 84(34.3) 16(6.5) 145(59.2) Feed your neonate 6-8 times within 24 hours. 199(81.2) 41(16.7) 5(2) Feed your baby and pick him\her up when crying? 59(24.1) 104(42.4) 82(33.5) Place your baby in a quiet and healthy environment, particularly during feeding. 57(23.3) 4(1.6) 184(75.1) Wipe the breast nipple before each feeding to prevent infection. 149(60.8) 15(6.1) 81(33.1) Give 15-20ml/kg/day to your neonate weight < 1kg? 12(4.9) 1(0.4) 232 (94.7) The clean cord of your neonate daily? 195(79.6) 27(11) 23 (9.4) Appling any ointment on your neonates' umbilical? 140(57.1) 18(7.3) 87(35.5) Observe your baby's umbilical for signs of inflammation or any discharge. 203(82.9) 32(13.1) 10(4.1) Apply any topical skin ointment to reduce dermatitis and the risk of sepsis. 99(40.4) 12(4.9) 134(54.7) Change the baby's body position by doing a range of motion your baby to prevent pressure area breakdown. 219(89.4) 12(4.9) 14(5.7) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article 98 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 5: Association Between Mothers’ Practices and Socio-Demographical Characteristics Regarding Caring Mothers’ practices Socio-demographical characteristics Good Fair Poor P-value F (%) F (%) F (%) Age/ years Less than 20 20-26 27-33 34-40 58(55.2) 59(54.6) 11(52.4) 5(45.5) 47(44.8) 49(45.4) 8(38.1) 5(45.5) 0(0) 0(0) 2(9.5) 1(9.1) 0.002 HS Level of education Illiterates Can read and write Primary school Secondary school Diploma institute High degree 34(58.6) 13(61.9) 16(44.4) 30(50) 17(50) 23(63.9) 24(41.4) 8(38.1) 19(52.8) 29(48.3) 17(50) 12(33.3) 0(0) 0(0) 1(2.8) 1(1.7) 0(0) 1(2.8) 0.706 NS Mode of the delivery NVD CS Episiotomy 21(14.7) 29(33.3) 2(13.3) 107(74.8) 44(50.6) 11(73.3) 15(10.5) 14(16.1) 2(13.3) 0.004 HS The religion Muslim Christian Yazidi 229(95.8) 3(100) 3(100) 9(3.8) 0(0) 0(0) 1(0.4) 0(0) 0(0) 0.992 NS Antenatal care Private facilities Primary health centers Both sector 51(23.7) 0(0) 1(3.8) 141(65.6) 2(50) 19(73.1) 23(10.7) 2(50) 6(23.1) 0.012 S Table 5: Association between Overall Mothers’ Practices and Socio-Demographical Characteristics Regarding Caring for LBW Mothers’ practices Socio-demographical characteristics Good Fair Poor P-value F (%) F (%) F (%) House ownership Owned Partially owned Rent 174(96.1) 20(90.9) 41(97.6) 7(3.9) 1(4.5) 1(2.4) 0(0) 1(4.5) 0(0) 0.033 S Occupation of the mother Housewife Public employee Private employee Student Self-employee 72(38.9) 29(65.9) 6(50) 1(50) 0(0) 22(11.9) 0(0) 0(0) 1(50) 0(0) 91(49.2) 15(34.1) 6(50) 0(0) 2(100) 0.007 HS Socio-economic status Low Middle High 1(50) 91(40.4) 7(38.9) 1(50) 132(58.7) 11(61.1) 0(0) 2(0.9) 0(0) 0.034 S https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article antenatal care the highest percentage of them 87.8% attend privet facilities, At the same time in a study that has been done by Abdullah CS [20] there was accepted the same similarity between age at early stage, attending facilities. One-third 35.9% of neonates aged between 1-5 days, and a half 51.8% were close relatives. Mean- while, females represented the highest percentage 58.8%. Regarding the place of delivery, the study found that more than half 63.3% of the babies were born in pub- lic hospitals and only one quarter 27.8%of the babies were breastfeeding the study result dose not constant with another study that majority of mothers breast feed to their neonates [23].The highest percent- age 62%of mothers keep temperature be- tween35-36.5 °C, the study result is con- stant with another study which confirm that the mothers kept their baby and tried keep their body temperature normally [19]. Meanwhile 49% of them give relaxing massage to their neonates. Almost three quarter 72.2% of mothers feel comfort while breastfeed to LBW there is ac- ceptance between this finding and another study done by [20]who were did the simi- lar steps that have been done in our study as having relaxing massage. Using a cup or a spoon till the baby can suck effectively refused by more than half of mothers 59.2%.81.2% of mothers feed their neo- nates 6-8 times in 24hrs,the findings are similar with the findings confirmed the similarity [25].some of mothers 42.4% pick their LBW when crying while breastfeed- ing. Three quarter 75.1% of mothers did not put their LBW in quiet and healthy en- vironment during feeding. Wiping the breast nipple since feeding to prevent in- fection implemented by 60.8%. Almost all 94.7% of mothers did not give their LBW 15-20ml/kg/day the results of those find- ings are similar to the findings that con- firmed that LBW babies were give less The results of highest percentage of ma- ternal age 35.1% were between 27-33 years old which is consistent with the find- ings of ,Talie Asmare (2019) who found that the most age of their participants were between 25 to 32 years old [4], which is similar to the results of study [13] who showed that majority of attendances were in between 23-31 years old, and most 75.5% were housewives also this finding is accepted by another study (14) who confirmed that mostly attendances were house wives. One quarter 24.5% of the mothers graduated from secondary school. at the same time these findings are accepted by another investigation pro- posed by [15] showed that most of partic- ipants have not got high degrees and study secondary schools. The majority of mothers 97.6% were Muslims there is ac- ceptance between our findings and anoth- er survey [14].The current study shows that the highest percentages 91.8% of mothers live living middle economic sta- tus, in another study unlike our study that have been conducted by Borders AEB [16] Most of participants live in high economic status. Regarding the mother's residential areas the majority 60% were living in Ur- ban, unlike our study the majority of par- ticipants in a study done by Abdullah who confirmed that participants were live in rural area [14]. Concerning mothers' ob- stetrical history current study shows, that around one-third 28.2% of the mothers had a normal vaginal delivery. Unlike our study the majority of mothers delivered their baby through CS [15].The highest percentages 44.1% were married at the age of 20-26 years, these findings are ac- cepted by a study by Schuler and the col- leagues[17]almost most of the attendanc- es were get married when their ages were between 20-27 ages. Regarding mothers’ 99 Copyright ©2024The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. DISCUSSIONS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article I would like to recognize, appreciate, and acknowledge all mothers who have low birth weight baby in Neonatal Intensive Care unit for their grateful cooperation, support and help. the study approved by ethical committee/Hawler Medical University-Erbil The author reports no conflict of interests. [1] Muchemi OM, Echoka E, Makokha A. Factors associated with low birth weight among ne- onates born at Olkalou District Hospital, Central Region, Kenya. Pan African Medical Journal. 2015;20(1). [2] Dahlui M, Azahar N, Oche OM, Aziz NA. Risk factors for low birth weight in Nigeria: evi- dence from the 2013 Nigeria Demographic and Health Survey. Global health action. 2016 Dec 1;9(1):28822. [3] Tshotetsi L, Dzikiti L, Hajison P, Feresu S. Maternal factors contributing to low-birth- weight deliveries in Tshwane District, South Africa. PloS one. 2019 Mar 1;14(3): e0213058. [4] Eshete A, Alemu A, Zerfu TA. Magnitude and risk of dying among low-birth-weight neo- nates in Rural Ethiopia: a community-based cross-sectional study. International journal of pediatrics. 2019 May 16;2019. [5] Schuler C, Ntow GE, Agbozo F. Mothers' ex- periences with neonatal care for low-birth- weight infants at home; A qualitative study in the Hohoe Municipality, Ghana. Journal of Pediatric Nursing. 2019 Mar 1;45: e44-52. [6] Cutland CL, Lackritz EM, Mallett-Moore T, Bardají A, Chandrasekaran R, Lahariya C, Nisar MI, Tapia MD, Pathirana J, Kochhar S, Muñoz FM. Low birth weight: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine. 2017 Dec 12;35(48Part A):6492. [7] Kader M, Perera NK. Socio-economic and nutritional determinants of low birth weight in India. North American journal of medical sciences. 2014 Jul;6(7):302. than 15 ml/day [5].Majority of mothers 79.6% clean cord daily. 57.1% of mothers apply ointment to their LBW umbilical, special attention to cleaning of umbilical cord also accepted by another finding in an investigation [21] .The greater part 82.9% of mothers pay attention to umbili- cal for signs of infection. More than half of mothers 54.7% did not apply ointment to skin to protect dermatitis. Majority of mothers89.4% change baby's body's posi- tion to keep them from pressure area, these findings were also supported by a conducted study [22].Moreover, the study reveals a significant association between socio-demographical characteristics such as the age of the mother at /marriage, Mode of the delivery, Antenatal care re- sults of those findings are similar to the findings that confirmed in [23]. House ownership, Occupation of the mother and Socio-economic status, so these findings are accepted by another study [24]who confirmed that there were significance as- sociation between mode of delivery and house ownership. The outcome of the study revealed that most of the mothers had good practice regarding care of LBW neonates in Erbil city. At the same time Mothers have not got good practice regarding kangaroo mother care. Meanwhile there were sig- nificant association between socio- demographical characteristics such as (the age of the mother at /marriage, Mode of the delivery, Antenatal care, house owner- ship, occupation of the mother and socio- economic status). Meantime there were not any significant association between level of education and religion of partici- pants. 100 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. 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This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.09 Erbil j. nurs. midwifery, Vol. 7, No. (1), May, 2024 Original Article [28] Tadesse Berehe T, Modibia LM. Assessment of quality of antenatal care services and its determinant factors in public health facili- ties of Hossana town, Hadiya zone, Southern Ethiopia: A Longitudinal Study. Advances in Public Health. 2020 Aug 17;2020. [29] Khan A, Nasrullah FD, Jaleel R. Frequency and risk factors of low birth weight in term pregnancy. Pakistan Journal of Medical Sci- ences. 2016 Jan;32(1):138. 102 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/