Kangaroo Mother Care

Jodibala Haobijam *

The people belonging to the north eastern states such as, Manipur, Mizoram, Nagaland, Tripura, Arunachal Pradesh, practice it as a normal routine to carry their babies at the back as well as in front from time immemorial ignorant of its therapeutic benefits.

The significance of Kangaroo Mother Care (KMC) was widely accepted and practiced in the medical field, but the concept was existing from the ancient time. The mothers were practicing it, without knowledge of what it is, as the medical world named it as kangaroo mother care.

Kangaroo Mother Care (KMC) is a special way of caring of low birth weight babies. It as first presented by Rey and Martinez, in Bogotá, Colombia, where it was developed as an alternative to inadequate and insufficient incubator care for the preterm newborn .It is a powerful, easy-to-use method to promote the health and well-being of infants born preterm as well as full-term.

Its key features are:

• early, continuous and prolonged skin-to-skin contact between the mother and the baby;
• exclusive breastfeeding (ideally);
• it is initiated in hospital and can be continued at home;
• contributes to the humanization of neonatal care
• promotes better bonding between mother and baby

The Process of KMC

Kangaroo positioning

• The baby should be placed between the mothers' Breasts in an upright position.
• The head should be turned to one side and in a slightly extended position. It keeps the airway open and allows eye to eye contact between the mother and her baby.
• Mothers should make sure that baby's neck position is neither too flexed nor too extended, airway is clear, breathing is regular, color is pink and baby is maintaining temperature
• The hips should be flexed and abducted in a "frog" position; the arms should also be flexed.
• Baby's abdomen should be at the level of the mother's epigastrium. Mother's breathing stimulates the baby, thus reducing the occurrence of apnea.
• Support the baby's bottom with a sling/binder.

Privacy

KMC unavoidably requires some exposure on the part of the mother so, privacy must be maintained. The length of skin-to-skin contacts should be gradually increased up to 24 hours a day interrupted only for changing diapers.

• The mother should maintain good hygiene: daily bath/sponge, change of clothes, hand washing, short and clean finger nails.

Clothing

KMC can be provided using any front-open, light dress as per the local culture. KMC works well with blouse, gown or shawl. Suitable apparel that can retain the baby for extended period of time can be adapted locally. Baby is dressed with cap, socks, nappy, and front-open sleeveless shirt.

Feeding

Holding the baby near the breast stimulates milk production. Mother may express the breast milk while the baby is still in the KMC position. The baby could be feed with spoon or tube depending on the condition of the baby.

Counseling

When baby is ready for KMC, arrange a time that is convenient to the mother and her baby. Teach the KMC Process in a caring, gentle manner and with patience. Answer queries and allay Mother Anxieties. Encourage her to bring her mother/mother in law, husband or any other member of the family. It helps in building positive attitude of the family and ensuring family support to the mother which is particularly crucial for home-based KMC. It is helpful that the mother starting KMC interacts with someone already practicing KMC for her baby.

Benefits of KMC

• KMC has been shown to exert a beneficial effect on breastfeeding.
• Prolonged skin-to-skin contact between the mother and her preterm/ LBW infant provides effective thermal control, reduces the risk of hypothermia
• The babies gained more weight on KMC than on conventional care.
• KMC protects against nosocomial infections
• Mothers are less stressed during kangaroo care as compared with a baby kept in incubator
• Mothers report a stronger bonding with the baby, increased confidence, and a deep satisfaction that they were able to do something special for their babies.
• Fathers felt more relaxed, comfortable and better bonded while providing kangaroo care.

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* Jodibala Haobijam contributes to e-pao.net regularly. The writer is a Lecturer in Department of Maternal and Child Health at M M College of Nursing, HARYANA. The writer can be contacted at jodibalahaobijam(at)yahoo(dot)co(dot)in
This article was webcasted on January 28, 2009.

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