Kangaroo Mother Care

What is Kangaroo Mother Care (KMC)

Kangaroo Mother Care (KMC) is a special method of care of low birth weight (<2500gm) babies. As the name suggests Kangaroo Mother Care consists of keeping the baby in close skin-to-skin contact with his/her mother as practiced by female kangaroo animal for their babies.

It benefits the baby by

• Keeping the baby warm
• Promoting and sustaining breastfeeding
• Decreasing risk of infection
• Promoting bonding between baby and mother

Parts of KMC

KMC has two essential components

• Skin to skin contact: Early, continuous and prolonged skin-to-skin contact between the mother and the baby is the basic feature of KMC. The infant is placed on her mother’s chest between the breasts.
• Exclusive breast feeding : The baby on KMC is breastfed exclusively. Skin-to-skin contact promotes breast milk production and enables the small baby to learn sucking quickly. Intimate physical contact during KMC strengthens the emotional bonding between the mother and the baby.

Which babies should get KMC?

All small babies less than 2.5 kg are eligible for KMC. Lower the birth weight, more beneficial is KMC to the baby. Sick babies may need special care initially. Therefore KMC should be started after consultation with the doctor caring for the baby.

Benefits of KMC

• Breastfeeding - Studies have reported that KMC results in increased breastfeeding rates as well as increased duration of breastfeeding.
• Thermal control - Prolonged skin-to-skin contact between the mother and her LBW infant maintains temperature of baby in normal range. This is as good as keeping the baby in an incubator.
• Early discharge - Studies show that KMC cared LBW infants can be discharged from the hospital earlier than the conventionally managed babies. The babies gain more weight on KMC than on conventional care.
• Less sickness - Babies who receive KMC remain healthier during infancy than those without KMC. KMC protects babies against infections.
• Other effects - KMC helps both infants and parents. Mothers are less stressed during kangaroo care than when the baby is receiving incubator care. They also experience a stronger bonding with the baby, increased confidence, and a sense of deep satisfaction that they are able to do something special for their babies. Fathers feel more relaxed, comfortable and better bonded while providing kangaroo care.

How to start practicing KMC

A mother cannot successfully provide KMC to her baby all alone. She requires counseling and supervision from health care-providers.

• After learning from doctor/nurse KMC is initiated in the nursery. After discharge KMC is continued at home. A regular follow up program is crucial to ensure safe and successful KMC at home.
• Assistance and cooperation from family members helps the mother to give more attention to her low birth weight baby.

What mothers need to do while starting KMC?

• All mothers can provide KMC, irrespective of age, education, culture and religion.
• Willingness: The mother must be willing to provide KMC. All mothers wish to do their best for their babies and once initiated, mothers get a great sense of emotional satisfaction of doing something special and life-nourishing for their babies.
• General health and nutrition: The mother should be free from major illness to be able to provide KMC. She should receive good diet and supplements recommended by her doctor.
• Hygiene: The mother should maintain good hygiene: daily bath/sponge, change of clothes, hand washing, short and clean finger nails.
• Supportive family: Apart from supporting the mother, family members should also be encouraged to provide KMC when the mother takes rest. Mother would need family’s cooperation to deal with her conventional responsibilities of household chores till the baby requires KMC.
• Mother’s clothing: KMC can be provided using any front-open, light dress as per the local culture. KMC works well with blouse and sari, gown or shawl.
• Baby’s clothing: Baby is dressed with cap, socks, nappy, and front-open sleeveless shirt or ‘jhabala’.

KMC procedure

The baby should be placed between the mother’s breasts in an upright position.

• The head should be turned to one side and in a slightly upturned position. This position helps in breathing of and allows eye-to-eye contact between the mother and her baby.
• The legs and arms should be folded. Baby’s abdomen should be at the level of the mother’s upper abdomen.
• Support the baby bottom with a sling/binder.

Feeding

• Holding the baby near the breast stimulates milk production.
• Mother should express milk while the baby is still in KMC position.
• The baby could be fed with paladai, cup, spoon or tube, depending on the condition of the baby.

Privacy

KMC requires some exposure on the part of the mother. This can make her nervous and could be de-motivating. So mother should be provided some privacy for practicing KMC.

Duration for which KMC should be practiced

To begin with, it may not be possible for the mother to provide KMC for a prolonged period of time. But each session of KMC should last at least an hour. The aim should be to provide KMC as long as possible preferably 24 hours a day.

Can the mother continue KMC during sleep and resting?

Using a comfortable chair or several pillows on an ordinary bed KMC can be provided during sleep and rest.

When should KMC be discontinued?

Babies love receiving KMC after going home. When the mother and baby are comfortable, KMC continues for as long as possible, first at the hospital then at home until the weight is 2500 g. By this time, the baby starts wriggling to show that she is uncomfortable, pulls her limbs out, cries and fusses every time the mother tries to put her back skin to skin.

Post-discharge follow-up

After discharge baby should be taken to the hospital as and when advised by doctor/nurse.

Source : KMC initiative

Related resources

1. KMC - a practical guide