Kangaroo Mother Care For Newborn Babies – Everything You Need To Know About by Dr Lathiesh Kumar Kambham

10 min read

Written by Dr Lathiesh Kumar Kambham

Dr Lathiesh Kumar Kambham

Dr. Lathiesh Kumar Kambham is a Neonatologist and Paediatrician with over 12 years of experience. He has a special interest in the management of birth asphyxiated babies and extreme preterms and ha More

Kangaroo Mother Care For Newborn Babies

A baby requires about 37 – 40 weeks inside the mother’s womb to develop and get ready to meet the outside world. It is during this time that the baby develops from an embryo, grows various parts of the body, and develops various senses and other skills required to cope-up once they reach the outside world.

According to WHO, a baby born after the completion of 37 weeks is known as a full-term baby. Any time before that is known as a preterm baby. When a baby is born before they are ready to face the world, they can suffer, and require more support to sustain themselves. Thus, the concept of “Kangaroo Mother Care” was born, to help these premature babies get stronger and healthy enough to sustain themselves on their own.

In This Article

What is Kangaroo Mother Care?

Kangaroo care was first developed in Columbia in the late 1970s as a solution to reduce the death rate of pre-term babies. It is the method of having continuous skin-to-skin contact with the baby.

When you see the baby wrapped around the mother’s chest, it will look very similar to a kangaroo holding its baby in its pouch. Hence the name kangaroo mother care. Though the name says “mother” both mother and father can provide this skin-to-skin contact for the baby.

It is usually done for a few hours a day until the doctors feel the baby is stable and healthy enough to sustain on their own. Many studies show this method of caring for a preterm baby will not only help keep the baby safe but also help the baby thrive.

Top Three Key Components of Kangaroo Mother Care

new born baby smiling

Kangaroo mother care consists of the following 3 main components:

1. Kangaroo Position

The mother will have to hold the naked baby in an upright position against her bare chest, between her breasts. The nurse will turn the baby’s head to one side and keep it in a slightly elongated position to facilitate breathing and eye contact. The baby’s legs should be opened at the hips and made to sit in a frog position. The baby’s stomach should rest over the mother’s epigastrium so that the mother’s breathing will stimulate the baby’s breathing.

The nurse or the doctor might use a blanket, a towel, or a hospital gown to wrap around the baby and the mother. There should be some support under the baby’s bottom to prevent slipping out of position.

2. Kangaroo Nutrition

Here the baby will receive nutrition by exclusive breastfeeding on demand. The mother can feed directly or express the milk and feed it through a nasogastric tube, or from a cup. The general recommendation is to feed a newborn every two hours. Since the baby is in close quarters with the mother’s breasts, they have easy access to breastmilk and can feed on demand.

Kangaroo mother care has also shown improvement in the breastmilk supply for the mother. If the mother wants to express the breastmilk and feed the baby, she can do so while the baby is still attached to her.

[Read : Feeding and Nutrition for a Premature Baby]

3. Kangaroo Discharge

Kangaroo mother care starts in the hospital under the guidance and supervision of well-trained medical professionals. Once the mother is comfortable and confident about providing KMC for her baby, the doctor might discharge them.

The mother will continue to provide KMC even after discharge. The biggest advantage of kangaroo care is – even premature babies can go home early. They don’t have to stay in the hospital for weeks like in the earlier days. The mother has to learn the technique, should have enough support back home, and make arrangements to carry on with life while having the baby attached to her.

What is the Purpose of Kangaroo Mother Care?

Kangaroo mother care is a powerful and easy method to care for a pre-term or a full-term baby with low birth weight or other complications that require constant monitoring and close care. It is also gentler than an incubator or preterm ward care as the baby gets to be with the mother, getting full individual attention at all times.

It helps improve the health of the baby by promoting breastfeeding, thermal control as well as bonding with the parent. Factors like the weight of the baby, gestation period, or clinical settings do not interfere with this method of care.

When to Start Kangaroo Mother Care?

Kangaroo mother care is usually started immediately after the birth of the baby when the doctors realise the baby is either underweight, pre-mature, or needs more care to improve health. As soon as the nurse cleans and dries the baby, the doctor will examine the baby, cut the cord and attach the baby to the mother’s body to start KMC.

Let’s break it up based on birth weight for better understanding.

1. Below 1200g

If the baby is preterm or full-term but weighs less than 1200g, they are bound to suffer from many health issues and sometimes serious morbidities. In such a case, the doctors will want to closely monitor the baby and check their weight gain, progress, and development. So, it may take days, sometimes even weeks before they initiate KMC.

2.  1200g – 1800g

If the baby weighs anywhere between 1800g and 1500g, there is still a chance of developing health issues or severe morbidities. The doctor might want to transfer the baby to a special care unit if feasible. It might be days before they initiate the KMC.

3. Above 1800g

The baby will be fairly stable without many risks. Once the doctor is convinced of the same, they can initiate the KMC right away.

However, KMC is not just for preterm or low birth weight babies. Even if the infant is full-term and meets the ideal weight requirements, they can receive KMC for a few hours after delivery, to promote bonding and the baby’s health.

In the case of preterm babies who are ill at birth or require medical attention, KMC can start after the baby is better.

[Read : Cup Feeding a Baby]

Who Can Provide Kangaroo Mother Care?

father giving Kangaroo Mother Care

The name includes the word mother because the entire setup looks like it mimics what a kangaroo mother does with its young one. The Kangaroo Mother Care is however not restricted to just the mother.

If the mother is unwell and is not in a position to provide KMC, the father can provide it. It gives the father a chance to help out with the baby and form a strong bond. The mother also gets a break and some much-needed rest after delivery. Even other family members can provide KMC.

Some of the points to keep in mind for anyone offering KMC are

  • The caregiver must be willing to provide KMC.
  • They should be healthy and free of any illness as the baby’s immunity is very low and can catch infection very easily.
  • The caregiver must maintain proper hygiene at all times and ensure they keep their surroundings clean and safe for the baby too.
  • They must follow all instructions at all times irrespective of whether they feel it is necessary or not.
  • When someone apart from the mother is performing KMC, the baby does not have easy access to the breasts. The mother can express her breastmilk and feed it to the baby using a cup, spoon or a tube.

How to Start Kangaroo Mother Care?

Now that we know when doctors will recommend KMC for a baby, how do you provide it? Before initiating KMC, there are a few factors to address first:

1. Counselling the Family

The first step is to brief the mother about the procedure, and the needs and benefits of KMC. After the baby’s birth, the nurses can fix a convenient time for the mother and the baby, for the doctor to brief and counsel them and the family.

It is important to involve the family in this as the mother cannot do this alone. She might have to continue KMC after discharge, for which she needs help and support at home. So, the father, and the grandparents can also be a part of the counselling to understand everything about KMC.

The doctor and the nurse can show the family how to perform KMC, answer all their queries and even let them interact with another parent performing KMC. This will reassure them and put them at ease to do something uncommon with a newborn baby.

2. Mother’s Clothes

The next issue to address here is clothing. Since it has to be skin-to-skin contact, the mother’s or father’s clothing should be openable in the front. There is special apparel for KMC too. The parents can gather all this information from the medical staff and make an informed decision.

3. Baby’s Clothes

The baby does not need any clothes. The doctors have to ensure the family understands this. The baby is bound to pass urine and stool, so a diaper or a cloth nappy will suffice. The mother’s body heat is enough to keep the baby warm. They can even use a cap to cover the baby’s head.

How Does Kangaroo Mother Care Work?

The kangaroo mother care keeps the baby and mother close, practically still attached even after birth. The mother’s body temperature helps to keep the baby warm. If the baby is too cold, the mother’s body temperature will increase to keep the baby warmer and if the baby’s skin gets too warm, the mother’s body will cool down, leading to effective thermoregulation without any intervention.

When the baby is in close proximity to the breasts, it stimulates breastmilk production, thus providing sufficient nutrition for the baby on demand. This in turn helps increase the baby’s weight and improve health and immunity.

Many studies show that KMC works wonders for many premature or low birth weight babies. The benefits are so many that many hospitals are adopting this method of care for the first few days, irrespective of the health conditions of the baby.

[Read : Helping A Low Birth Weight Baby]

Top Benefits of Kangaroo Mother Care

Benefits of Kangaroo Mother Care

Over time, doctors have come to agree that kangaroo mother care is very beneficial for not just the preterm babies but even full-term babies who have low birth weight, respiratory issues, and few other complications.

The benefits of kangaroo mother care are

  • Keeps the baby cozy and warm.
  • Prevents infections and helps develop the baby’s immunity.
  • Improves the bond between the caregiver and the baby.
  • Promotes breastfeeding.
  • Increases the parents’ confidence that they can care for the baby.
  • Mother can care for the baby rather than place the baby in the incubator, out of her reach.
  • Babies with low birth weight, who receive kangaroo mother care can go home earlier than babies who do not receive this care (this also reduces your hospital expenses).
  • Even fathers can offer KMC and improve their bonding with the baby while giving the mother her much-deserved break.

What Are the Disadvantages of Kangaroo Mother Care?

Some of the disadvantages of the KMC method can be

  1. Since the baby is attached to the mother or the father at all times, it restricts their movements and requires great care from their end to ensure they do not hurt the baby (bumping, dropping food/drink, suffocating).
  2. Skin-to-skin contact requires the mother to expose parts of her body, which requires privacy. She may not be comfortable doing KMC in a crowded hospital ward or back home with many people living in it.

How Long Should Kangaroo Mother Care Be Given to a Baby?

The kangaroo mother care can start right after birth and go on till the baby is strong enough to survive without KMC. Ideally, KMC should end around 12 weeks after birth.

WHO Guidelines of Kangaroo Mother Care

WHO Guidelines of Kangaroo Mother Care

According to WHO, successful implementation of KMC will require the following

Supportive health care staff who are trained in KMC.

  • The hospital must have a written policy and guidelines customized to the local culture and situation.
  • Continuous monitoring and evaluation by the medical care professionals as per criteria already established.
  • The doctors must inform the mother about KMC soon after the preterm baby’s birth. They must brief her about the requirements and the advantages of this method over the traditional caring method and give her the option to choose the method suitable for her.
  • The hospital must provide a comfortable room with beds, chairs, enough pillows, curtains for privacy, and a bathroom with all facilities. The hospital should also provide them with nutritious meals throughout their stay.
  • The institution should provide a support binder to help the mother carry the baby or help her learn to tie a piece of cloth to provide the right type of support.
    They should provide proper clothing for the baby if the temperature drops below 22oC.
  • Record daily readings of information regarding the baby’s weight, observations, feeding, and instructions for the mother and medical staff around.
  • A record book to file all the data collected daily, to facilitate comparison and understanding of the baby’s development.
  • The baby should be exclusively breastfed. It can be directly from the mother or expressed. In case breastmilk is unavailable, milk from another mother or the breastmilk bank can be pasteurized and given to the baby (this is not included in the guidelines).
  • Health workers must educate the mother and avoid harmful cultural practices that can harm the baby (refusal to give colostrum, negative reception of a preterm or a low-birth-weight baby).
  • On discharge, provide the mother with access to medical care and support groups as and when needed.

KMC For Premature Babies

KMC for premature baby

Kangaroo mother care is a prominent method of caring for premature or preterm babies. In places like third-world countries where the number of preterm births was high and medical care or incubators were low, the doctors had to find ways to support and sustain these preterm babies.

It provides the perfect solution as the mother can care for her baby without an incubator or other medical interventions. This method also improves the survival rate of preterm babies. It stimulates breastmilk production more, which could otherwise be low owing to the poor nutrition and health conditions of the mother.

What is the Role of KMC in Low Birth Weight Babies?

LBW (Low Birth Weight) has lower immunity when compared to babies in the ideal weight range. Skin-to-skin contact not only provides the opportunity for the babies to feed on demand but also keeps them warm and safe from infections around them.

As these babies are not handled by others, the chances of infection or discomfort decrease drastically. KMC proves to be an effective move against death in infants with LBW.

The kangaroo baby care is similar to how kangaroos and many other animals care for their little ones. They do not depend on external support and are self-sufficient when it comes to protecting and nurturing their own young ones. The KMC method allows humans to do the same for their babies and improves the survival rate of preterm and LBW babies.

FAQ’s

1. Does Kangaroo Mother Care Increase Milk Supply?

Yes, it does. Having the baby in close proximity to the breasts stimulates breastmilk production and increases supply.

2. Can Mother Give KMC in a Sleeping Position?

The mother can lie down and sleep as long as the baby’s airway is stable, and the baby is safe and snug in the wrap. The mother can lie on her back or even her side with the head slightly raised. It is safer for the mother to sleep in a reclined position.

Read Also: Taking Your Premature Baby Home

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Dr Lathiesh Kumar Kambham,MBBS, MD (Pediatrics)
DM (Neonatology), Lead Neonatology and NICU Services
Aster Women & Children's Hospital
17 years of experience

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