Pregnancy is a beautiful journey for a mother as with each day she witnesses the life’s miracle of a lovely little human growing inside her. Although normally growth of a baby takes a minimum of 37 weeks of pregnancy but at times the baby is born sooner and needs special care and attention. This is where KANGAROO-MOTHER-CARE comes up. As you can understand from the term, Kangaroos have pouches that provide nourishment and protection for their undeveloped young. In the same way human mothers carry their babies in close contact with their skin.
Kangaroo Mother Care, commonly referred to as KMC has three important components namely Skin-to-skin contact, Exclusive or Predominant Breastfeeding (direct or expressed) and Continuous Medical, Emotional, Physical and Psychological care for the mother and the baby.
KMC is practiced for all infants especially in the initial days of their life with emphasis on Low-Birth-Weight babies (less than 2.5 kg) who are smaller in size for their gestational age or born premature (less than 37 weeks) or both.
For many years, KMC is evidently known to reduce neonatal mortality by 40% approx. Presently WHO guideline is to start KMC once the neonate is stable, which can take anywhere between 3 to 7 days post birth. However, a recent large-scale study published in May 2021 clearly states that immediate KMC (17-18 hrs/day) has reduced neonatal deaths by additional 25% as compared to conventional KMC (1-2 hrs/day gradually increasing to 15-17 hrs/day). Immediate KMC was done in special Mother-NICUs where mother and baby both were under special care immediately after birth and started KMC. Conventional KMC was done in NICUs where KMC was started as soon as the baby and mother were stable.
KMC has numerous benefits for the mother and the baby. It has been reported that the mother of a preterm baby has depression and stress and dis-satisfaction with her baby’s care. If the mother is with her baby, providing skin to skin care and breastfeeding, her stress reduces, she gains confidence in herself and the care team of her baby in NICU.
The preterm baby has an increased risk of mortality, reduced body temperature, low blood sugar, high rate of infections, poor weight gain and inability to suckle well at breast. With KMC, babies tend to be happier and self-regulatory. They have better body temperature through their mother’s skin compared to a warmer one. Their stress levels and glucose levels are normalized. Mother’s skin gives them a sterile environment and protection against infection, same as a womb. Since they cry less and burn less calories with KMC, they gain weight faster. Skin to skin contact promotes breast crawl and helps in establishing breastfeeding sooner. With these amazing benefits and fast recovery, it is possible to discharge the babies sooner.
An important aspect of KMC is exclusive breastfeeding, which is essential for all babies up to 6 months irrespective of their gestational age and birth weight. As soon as the baby is born and placed on the mother’s bare chest, it exhibits 9 stages of adaptation to life outside the womb. After the first cry, with movements of its body, the baby reaches to the breast, starts sucking and sleeps when done. This magical hour of uninterrupted skin to skin contact embarks the beginning of a baby’s life in this world. It helps in relaxation, uterus contraction, hormone regulation and breast milk production in mothers. Babies cry less, suck effectively and bond better with their mothers.
For KMC, the baby is placed naked in an upright position on mother’s bare chest, he is then secured with a binder or a special KMC garment with the head slightly extended and turned to one side for easy breathing. Arms and legs are slightly bent, which promotes optimal baby position for muscle growth. Baby can be placed in a semi reclined position for breastfeeding, tube feeding or cup feeding.
KMC should be uninterrupted except for regular checkups in each shift or if the baby shows signs of distress (abnormal breathing, low body temperature, convulsions, lethargy, fever or any other worry sign). KMC should be started in the hospital and continued at home, usually until the baby has reached the term gestation of 40 weeks or weight of 2500 grams. It is evidence based and highly recommended for babies especially pre-terms and mothers must opt for KMC immediately after birthing.
Antenatal preparation, knowledge and implementation of KMC is the key to a healthy and happy motherhood. Every mother has the power to do this. It is rightly said “The bond between a mother and her baby is the only real and purest bond in the world, the only true love we can ever find in our lifetime.” This bond starts when the baby is not even born and continues for the whole life. The magic of this bond and the mother’s touch heals a baby’s soul and makes him/her a beautiful human being.
Dr Ananya Didwan
Physiotherapist (MPT Pediatrics & Women’s Health)
Lamaze Certified Childbirth Educator
Female Pelvic Floor Rehab Specialist
Antenatal and Postnatal Exercise Specialist
Lactation Consultant
Vishesh Jupiter Hospital, Indore
References:
1.Kangaroo mother care : A practical guide
2. Immediate “Kangaroo Mother Care” and Survival of Infants with Low Birth Weight
3. What is kangaroo mother care? Systematic review of the literature
4. The wonders of mother’s skin to skin care
5. Healthy Birth Practice #6 – Keeping mother and baby together – Its best for mother, baby and breastfeeding
