kangaroo mother care

1. KANGAROO MOTHER CARE
BY:
Mrs.Keerthi Samuel.K
Asst.Professor
VMCON

2. zKangaroo MotherCare

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INTRODUCTION
 Kangaroo care, named for the
similarity to how certain marsupials
carry their young, was initially
developed in the 1970s to care for
preterm infants in countries where
incubators were either unavailable or
unreliable. There is evidence that it is
effective in reducing both infant
mortality and the risk of hospital-
acquired infection, and increasing
rates of breastfeeding and weight
gain.

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DEFINITION
 Kangaroo
care or kangaroo
mother care (KMC),
sometimes called skin-
to-skin contact, is a
technique of newborn
care where babies are
kept chest-to-chest and
skin-to-skin with a parent,
typically their mother
(occasionally their
father).

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THREE MAIN PARTS OF KMC
SKIN-TO-SKIN
CONTACT
BREAST
FEEDING
SUPPORT TO
THE DYAD

6. 1.Skin-to-skin contact
The more skin-to-skin contact between the baby’s
front and the mother’s chest, the better. For comfort
a small nappy is fine, and for warmth a cap may be
used. Skin-to-skin contact should ideally start at
birth, but is helpful at any time. It should ideally be
continuous day and night, but even shorter periods
are still helpful.
2. Exclusive breastfeeding
Direct suckling by the baby from the breasts is all
that is needed for most mothers and babies. For
very premature babies, expressing milk and addition
of some essential nutrients may be needed.
3. Support to the dyad
Whatever is needed for the
medical, emotional,
psychological and physical
well being of mother and baby
is provided to them, without
separating them. This might
mean adding ultramodern
equipment if available, or
purely intense psychological
support in contexts with no
resources. It can even mean
going home very early.

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What is KMC ???
 A special way of caring for
Low birth weight (LBW) babies
 It promotes,
 Effective thermal control
 Breast feeding
 Prevention of infection
 Parental bonding

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ADVANTAGES
1. TO THE BABY:
 Effective thermal and pain
control
 Reduced infections ad
minimize the hospital stay.
 Increased weight gain
 Improved sleeping pattern.
 Relieves colic.
 Early growth
 Reduced apnea and oxygen
requirement
 Increased cognitive and
motor development.
 Physiological stability

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ADVANTAGES
2. TO THE MOTHER:
 Low parental anxiety
levels.
 Effective bonding
 Increased milk
production and success
of breast feeding
 Less neglect and
abandonment
 Able to choose breast
feed over formula feed.

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ADVANTAGES
 3. TO THE FATHER:
 Greater role in infant care
 Improves bonding
between father and child
which is very important in
countries with high rates of
violence towards children.
 If the mother is a cesarean
patient father can hold the
baby for KMC as mother
recovers from anesthesia.

11. z Pre-requisites of KMC
 Support to the mother
 In hospital &
 At home
 Post-discharge follow up

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Requirements for KMC
implementation
 Training
 Nurses, physicians and other staff
 Educational material
 Information sheets, posters and
video films on KMC


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Eligibility criteria: Baby
 Birth weight >1800 gm:
 Start at birth
 Hemodynamic stability is a
MUST

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Eligibility criteria: Mother
 Willingness
 General health & nutrition
 Hygiene
 Supportive family
 Supportive community

15. z Preparing for KMC






Counseling
Demonstrate procedure
Ensure family support
KMC support group
Mother’s clothing
Front-open, light dress as per the local
culture
Baby’s clothing
 Cap, socks, nappy and front-open
sleeveless shirt or ‘jhabala’

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KMC procedure: Kangaroo
 Place baby between the mother’s
breasts in an upright position
 Head turned to one side and
slightly extended
 Hips flexed and abducted in a
“frog” position; arms flexed
 Baby’s abdomen at mother’s
epigastrium
 Support baby’s bottom

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TECHNIQUE
 In kangaroo care, the baby wears only a small
diaper and a hat and is placed in a flexed
(fetal position) with maximum skin-to-skin
contact on parent's chest.
 The baby is secured with a wrap that goes
around the naked torso of the adult, providing
the baby with proper support and positioning
(maintain flexion), constant containment
without pressure points or creases, and
protecting from air drafts (thermoregulation).
 If it is cold, the parent may wear a shirt or
hospital gown with an opening to the front and
a blanket over the wrap for the baby.

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TECHNIQUE
 The tight bundling is enough to
stimulate the baby: vestibular
stimulation from the parent's
breathing and chest
movement, auditory stimulation
from the parent's voice and
natural sounds of breathing
and the heartbeat, touch by the
skin of the parent, the wrap,
and the natural tendency to
hold the baby. All this
stimulation is important for the
baby's development.

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20. MONITORING DURING
KMC
 Neck position is neutral
 Airway is clear
 Breathing is regular
 Color is pink
 Temperature is being
maintained

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 Practice one hour sessions
initially
 Transit from conventional
care tolonger KMC
 Transfer baby to post-natal
ward and continue KMC
 Increase duration up to
10-12 hours a day
DURATION OF KMC

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KMC during sleep and resting
Resting
 Reclining or semi-recumbent
position
 Adjustable bed
 Several pillows on an ordinary bed
 Easy reclining chair
 Sleep
 Supporting garment restraint for
baby

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KMC DURING SLEEP

24. z WHO CAN GIVE KMC?
other family
members
FatherGrandmother

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DISCHARGE CRITERIA
• Baby is well with no evidence of infection
• Feeding well (predominant breast milk)
• Gaining weight (15-20 gm/kg/day)
• Maintaining body temperature (in room
temperature)
• Mother confident of taking care of the baby
• Follow-up visits ensured

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DISCONTINUATION
Of KMC
 Term gestation
 Weight ~ 2500 gm or
more
 Baby uncomfortable
 Pulls limbs out
 Cries and fogs from
mouth
 Mother can continue
KMC after giving the
baby a bath and during
cold nights

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POST-DISCHARGE FOLLOW UP
 Once or twice a week till
20 wks 2.5-3KGS
 Once in 2-4 wks till 3
months
 Subsequently, every 1-2
months during first year
 More frequent visits if
baby is not growing well.