A low birth weight baby is an infant who weighs less than 2.5 kg at the time of birth and a premature baby is one who is born at less than 37 completed weeks of gestation. Nearly 2 crore low-birth-weight infants are born worldwide every year and 40 per cent of them are born in India only. The common cause of neonatal mortality (death of a child in the first 28 days) is prematurity. To reduce the mortality rate of premature babies, Kangaroo mother care (KMC) is found to be an effective technique. How? Let’s find out.
Kangaroo always delivers a premature baby which stays in the pouch of the mother till it is mature enough to survive outside. Similarly, KMC is an easy way to care for low birth weight babies with its two components
The first is skin-to-skin contact and second is exclusive and frequent breastfeeding. KMC was first started by pediatricians in Bogota Colombia in 1978. It can be provided by the mother, father, or any other adult family member. It should be provided to all low birth weight infants as soon as they are stable.
KMC is provided with the mother sitting in a comfortable reclining chair, wearing any front open light dress. The infant should be dressed in caps, socks, diapers, and a front open sleeveless shirt. The infant is placed between the mother’s breasts with the head turned to one side and hips and legs flexed. The infant is supported from the bottom with a sling.
One session of kangaroo mother care should be at least one hour with the total duration of KMC in 24 hours as long as possible. The infant needs to be removed from KMC only for changing diapers and examination by a doctor. The short duration of KMC is defined as a daily duration of fewer than 4 hours, five to eight hours is considered prolonged, and nine to twelve hours is considered long.
KMC takes care of all 5 senses of an infant with the infant feeling the warmth of the mother (touch), listening to her voice (hearing), sucking milk (taste), eye contact with her (vision), and smelling her odor (olfaction). KMC helps to reduce deaths, decreases the risk of infection, and helps in the earlier discharge of newborn babies from hospitals with better mother and infant bonding.
Also read: World Prematurity Day: A premature baby needs extra care! Keep these 5 tips in mind
KMC is recommended by World Health Organisation for all low birth weight infants but in our country, because of an extremely large number of low birth weight (LBW) babies, KMC is recommended by the Government of India to all babies with birth weight less than 2000 grams (2kg).
Infants receiving KMC are closely watched, especially in the early phases, to make sure their airways are clean, they are breathing normally, their skin is pink, and their body temperature is maintained. In order for the mother to continue monitoring at home, she is taught to look out for danger indicators such as low body temperature, breathing challenges, colour changes, and feeding difficulties.
Feeding and nutrition are very important for ensuring the optimal growth of LBW babies. Initially, breastfeeding is given at fixed intervals of 2 hours to ensure adequate intake. The mother should be explained how to breastfeed while the infant is in the KMC position. Holding an infant near the breast stimulates milk production. The mother may express milk while the infant is in the KMC position.
When the mother is reclining or semi-reclining and about 30 degrees off the horizontal, she can sleep next to her infant in the kangaroo position. Both, an adjustable bed and pillows on a regular bed can be used for this. You can take a nap during the day in a cozy chair with an adjustable back.
KMC may be discontinued after the infant weighs above 2.5 kg or reaches 37 weeks gestation. A baby that tends to wriggle out of the KMC, pulls limbs out, cries, or fusses is no longer in need of the KMC. For all LBW babies, KMC is a very successful intervention to improve both short- and long-term outcomes.
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