“The mother delivered a premature baby, and the birth weight is also quite low” is a sentence that can strike fear into the hearts of any family waiting to welcome a new member into their home. Traditionally, the birth of preterm and low birth-weight babies is associated with a long and anxious hospital stint. However, kangaroo mother care (KMC) is a simple intervention that can be practised by family members. This technique of prolonged skin-to-skin contact practised by the mother, father or carer is highly beneficial in the development of the newborn and also helps in early discharge from the hospital. Besides preterm babies, it also proves useful for those born with low birth weight.
According to the World Health Organisation (WHO), preterm and low birth-weight infants have a two- to tenfold higher risk of mortality than infants born at term and with normal birth weight.
What is kangaroo mother care?
Dr Santhosh Kumar, consultant pediatrician and neonatologist, Motherhood Hospitals, Banashankari, Bengaluru, says that kangaroo mother care is a method of standardised care for premature babies or for babies who weigh less than 2.5 kgs by way of skin-to-skin contact with the mother or father or carer while continuing exclusive breastfeeding.
Kangaroo mother care gets its name from the way kangaroos hold their babies in their pouch, says Dr Upendra Kinjawadekar, president of Indian Academy of Pediatrics.
“KMC provides a safe and natural protective shield. There is no limitation on how many hours one should practice KMC — it depends on the comfort of the carer as well as the baby,” says Dr Kinjawadekar.
Dr Rajath Athreya, senior consultant and head of department, paediatrics and neonatology, Sakra World Hospital, Bengaluru says in KMC, the mother/father/carer has the baby skin-to-skin on the chest, usually wrapped in a sling or his/her own clothing. “The recommendation is that the mother (or carer) spends eight hours or more in a day doing KMC.”
“Preterm, low birth-weight babies, especially the ones born with extremely low birth weight (<1.5kg) and <32 weeks of gestation are conventionally almost totally nursed in incubators or radiant warmer beds in Neonatal Intensive Care Units (NICUs). KMC brings the baby out of these to the mother (or carer) for close skin-to-skin contact,” he says.
How to practice kangaroo mother care
Benefits of kangaroo mother care
Dr Athreya explains the benefits of kangaroo mother care:
- Long hours of skin-to-skin contact with the mother early on help the baby to be colonised by healthy bacteria
- Enhances bonding between mother and child
- Promotes early and exclusive breastfeeding and enhances the rate of the same
- Helps in weight gain and growth in head circumference
- Reduces stress levels in the mother
- Reduces rates of serious infections
- Reduces body temperature fluctuations and hypothermia (dip in temperature)
- Improves neurodevelopmental outcomes
- Reduces chances of repeated handling of babies by doctors and nurses and thus contributes to reduced mortality and morbidity
Dr Athreya, adds “When KMC is used in premature babies, they require a shorter time to be discharged from NICU and come home.”
Prachi Pendurkar, a mother from Bengaluru, says “I delivered twins — my son weighed only a kilogram at birth and was extremely fragile. We never got the right support and guidance from the hospital in terms of lactation. As I was able to move around more and became more independent after the delivery, I came across this concept of KMC. It doesn’t target one particular problem. It has so many benefits and the results are magical — increasing the milk supply, maintaining the baby’s body temperature, feeling stabilized and secure and the baby’s crying reduced, too. My babies also started sleeping better.”
What are the types of kangaroo mother care?
The WHO classifies kangaroo mother care into two types:
Any KMC: KMC can be initiated in the healthcare facility or at home and should be practised for 8–24 hours per day (as many hours as possible).
Immediate KMC: KMC should be started as soon as possible after birth.
Dr Athreya says “At healthcare facilities, immediate KMC can be initiated before the infant is clinically stable unless the infant is unable to breathe spontaneously after resuscitation, is in shock or needs mechanical ventilation. The infant’s heart rate, breathing, colour, temperature and oxygen saturation should be monitored,” says Dr Athreya.
“KMC is a specific intervention that is to be practised in NICUs in hospitals and in some situations, continued at home — it is different from baby wearing,” says Dr Athreya.
Besides, doctors suggest KMC for babies born with normal gestational periods and healthy weight, too.
How KMC originated:
Speaking about the origin of the practice, Dr Kumar says “KMC first originated in low- and middle-income countries where most parents were unable to maintain the baby’s temperature and there were a lot of deaths due to various infections. So, an intervention called kangaroo mother care was started where the baby’s temperature is controlled through skin-to-skin contact.”
Kangaroo mother care is a method of care for preterm and low birth weight babies where there is prolonged skin-to-skin contact with exclusive breastfeeding. This simple technique has several advantages, including enhancing bonding, promoting exclusive breastfeeding, reducing body temperature fluctuations and hypothermia and reducing overall mortality and morbidity.