Design: Cochrane systematic review and meta-analysis of randomised trials
Population: 35 trials; 28 with data on 12,021 preterm or low-birthweight infants and their caregivers
Primary outcome: Mortality, neurodevelopment, morbidity, growth and breastfeeding
Effect: Breastfeeding at 6 months RR 1.26 (1.16 to 1.37); intensive visits with kangaroo care, 6-month mortality HR 0.75 (0.60 to 0.93)

A Cochrane review published on 12 October pooled randomised trials of home visiting for families of preterm and low-birthweight infants after hospital discharge. It included 35 trials, 28 of which contributed data on about 12,000 infants. About 70% of participants came from one large Indian trial of community-initiated kangaroo mother care.

Compared with no home visits, visits likely increased the proportion of infants still breastfeeding at six months (RR 1.26, 95% CI 1.16 to 1.37; four trials, 1,217 infants, moderate certainty). Effects on cognitive and motor development and on growth were small or absent, and the effect on mortality was very uncertain because the data were tiny.

Where some home visiting already existed, more intensive programmes — more frequent visits by trained staff, with kangaroo mother care — likely reduced all-cause mortality at six months (HR 0.75, 95% CI 0.60 to 0.93; one trial, 8,402 infants) and slightly reduced possible serious bacterial infection at 28 days (RR 0.89, 0.82 to 0.97).

For obstetric and neonatal discharge planning, the evidence supports building home contact around breastfeeding, and, in Indian settings, around kangaroo mother care continued at home. The mortality estimate rests on a single trial, so it is strong for that model rather than for home visiting in general.

Before discharging a preterm or low-birthweight baby, confirm who will visit the home and when.
Make breastfeeding support an explicit task of the first home visits — that is where the benefit was clearest.
In Indian practice, link discharge to community kangaroo mother care continued at home; that is the model tested in the large trial.
Ask at postnatal review whether visits actually happened, not only whether they were arranged.

Why it matters

The benefit of home follow-up shows up in feeding and, with kangaroo care, survival — not in neurodevelopment.

The statistics, in plain English

An RR of 1.26 means about a quarter more babies were still breastfeeding at six months with home visits, and the interval does not cross 1, so the effect is unlikely to be chance. The mortality hazard ratio of 0.75 means about a quarter fewer deaths by six months, but it comes from one trial, so it describes that programme rather than home visiting in general. Where an interval crosses 1, as for development and growth, the review could not show any effect.