(Kangaroo Mother Care) Kangaroo Mother Care is an affordable alternative technology that addresses the needs of low birth weight infants. The kangaroo Mother Care position where in the baby is held against the mother's chest on skin to skin contact provides all the basic requirements for newborn survival.
the most effective method in maintaining temperature and also ensure thriving of low birth weight babies. this method can be used both at hospital and home setting.
Kangaroo mother care is generally given to low birth weight babies. it is very essential for baby's health. there are many benefits of KMC as it provides warmth to he child, helps in breast feeding and helps in maintaining good attachment. please read this and get knowledge. this information will help young mothers more. stay tuned.
(Kangaroo Mother Care) Kangaroo Mother Care is an affordable alternative technology that addresses the needs of low birth weight infants. The kangaroo Mother Care position where in the baby is held against the mother's chest on skin to skin contact provides all the basic requirements for newborn survival.
the most effective method in maintaining temperature and also ensure thriving of low birth weight babies. this method can be used both at hospital and home setting.
Kangaroo mother care is generally given to low birth weight babies. it is very essential for baby's health. there are many benefits of KMC as it provides warmth to he child, helps in breast feeding and helps in maintaining good attachment. please read this and get knowledge. this information will help young mothers more. stay tuned.
Health education on Antenatal care include definition,aim, objectives, registration, antenatal check up, immunization, iron & folic acid, diet, bowel care, cleanliness, clothing, shoes, dental care, care of breast, sleep, exercise, coitus, travel, smoking & alcohol, family support & dangers signs during pregnancy.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
Antenatal exercises aim at improving the physical and psychological well-being of an expected mother for labor and preventing pregnancy-induced pathologies by various physical means. It generally includes low impact aerobic exercises and stretching exercises.
Important points in the organization of a NICU. The Aims and Objectives, Main components of NICU eg., physical facilities, personnel, equipment, laboratory facilities, procedure manual, transport of sick child and levels or grades of neonatal care.
Health education on Antenatal care include definition,aim, objectives, registration, antenatal check up, immunization, iron & folic acid, diet, bowel care, cleanliness, clothing, shoes, dental care, care of breast, sleep, exercise, coitus, travel, smoking & alcohol, family support & dangers signs during pregnancy.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
Antenatal exercises aim at improving the physical and psychological well-being of an expected mother for labor and preventing pregnancy-induced pathologies by various physical means. It generally includes low impact aerobic exercises and stretching exercises.
Important points in the organization of a NICU. The Aims and Objectives, Main components of NICU eg., physical facilities, personnel, equipment, laboratory facilities, procedure manual, transport of sick child and levels or grades of neonatal care.
angaroo mother care (KMC) is a nursing method that involves skin-to-skin contact between a mother and her newborn to help establish bonding and meet the baby's biological and emotional needs. It's a simple way to care for low birth weight infants (LBWIs), who are born with a weight below 2500 grams, and is especially important because 20 million LBWIs are born worldwide each year.
Mother and Baby Friendly Care: Practice of kangaroo mother careSaide OER Africa
Newborn Care was written for healthcare workers providing special care for newborn infants in level 2 hospitals. It covers: An essential tool in the initial and ongoing training and teaching of any healthcare worker. This was written specifically for nurses, midwives and doctors who provide primary care for newborn infants in level 1 clinics and hospitals. It covers: Mother and Baby Friendly Care describes gentler, kinder, evidence-based ways of caring for women during pregnancy, labour and delivery. It also presents improved methods of providing infant care with an emphasis on kangaroo mother care and exclusive breastfeeding. It covers: mother-friendly care in pregnancy, a modern approach to normal labour, skin-to-skin care of infants, encouraging breastfeeding, a baby-friendly nursery.
Introduction to the "Bridge" - a new breastfeeding support tool Leith Greenslade
Learn more about the Bridge, a new tool designed to help babies latch to the breast, increase breast stimulation to improve milk supply, and promote skin-to-skin time. The Bridge has been developed by US-based breastfeeding start-up Laally, founded by breastfeeding parents, Kate and Max Spivak. Laally’s mission is to, "improve breastfeeding rates worldwide by educating parents about the importance of breastfeeding and providing them with the right tools and guidance”.
Presentation on kangaroo mother care by Devi pravallika pharm D.
A small presentation which lets you understand kangaroo mother care a very useful but underrated and not so well known method.
O cuidado “Mãe Canguru” é uma metodologia inovadora para o tratamento e atendimento ambulatorial (não hospitalar) de crianças prematuras e com baixo peso ao nascer.
Calor, Amamentação e posição do canguru são os fundamentos básicos dessa tecnologia. Mais do que tudo, porém, é o relacionamento amoroso e íntimo estabelecido entre mãe e filho que permite que os pequenos sobrevivam.
O estímulo importante e contínuo, afetuoso tanto quanto físico, melhora e garante os ritmos respiratório e cardíaco dos prematurinhos.
A voz da mãe, seu arrulhar e a família ao redor servem como gatilhos enriquecedores das perspectivas neurológica e cognitiva. É a mãe, e não os médicos ou o hospital, quem é responsável e protagonista pelo cuidado do bebê precoce.
Texto escrito pelo Dr. Hector Martinez.
Tradução livre por Marcus Renato de Carvalho
#NovembroRoxo
Mesa redonda em homenagem aos 40 anos dessa Metodologia no #XVENAM 3thWBC no dia 14 de novembro as 14h no Centro de Convenções Sul América – Rio de Janeiro / RJ Brasil com a presença do Dr. Hector Martinez
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
How to Give Better Lectures: Some Tips for Doctors
Booklet on kmc
1. INFORMATION BOOKLET ON KANGAROO MOTHER CARE
FOR LOW BIRTH WEIGHT BABIES
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PREPARED BY:
Ms. Sunita Thakur
Master of nursing student
Rajkumari Amrit Kaur College of Nursing
Lajpat nagar, New Delhi
2. TABLE OF CONTENT
S. NO. CONTENTS PAGE NO.
1 Acknowledgement
2 Preface
3 Objectives
4 Introduction
5 Historical back ground of kangaroo mother care
6 What is kangaroo mother care?
7 Benefits of kangaroo mother care
8 Component of kangaroo mother care
9 Prerequisite for kangaroo mother care
10 Eligibility criteria for kangaroo mother care
11 Preparing for kangaroo mother care
12 Kangaroo mother care procedure
13 Time of initiation
14 Duration of kangaroo mother care
15 Kangaroo mother care during sleep and rest
16 From hospital to home
17 When should kangaroo mother care be discontinued?
18 Record keeping
19 Post discharge follow-up
20 Implementation of kangaroo mother care in the unit
21. Conclusion
3. ACKNOWLEDGEMENT
I , Ms. Sunita Thakur, Master of Nursing final year student greatly acknowledge expert guidance
of respected Madam, Mrs. O. K. Kathuria, guest faculty and Mrs. Sunita Patney senior lecturer
Rajkumari Amrit Kaur College of Nursing, New Delhi, for their continued, enthusiastic and
valuable direction in developing this information booklet.
I also greatly acknowledge the WHO, KMC India network, AIIMS, National Neonatology
Forum as a source of content and picture for preparation of this booklet.
I would also like to thank the teaching faculty of RAK College of Nursing, New Delhi. They
provided the timely support, encouragement and comprehensive and valuable comments on
different aspects of this booklet.
For any queries and/or suggestion regarding this information booklet please contact: ---
Ms. Sunita Thakur
Master of Nursing Student
Rajkumari Amrit Kaur
College Of Nursing,
Lajpat Nagar, New Delhi
4. PREFACE
“Children are the wealth of tomorrow. Take care of them if you
wish to have a strong India, ever ready to meet various challenges”
– Pandit Jawaharlal Nehru
This information booklet on kangaroo mother care for low birth weight babies is a
humble attempt to educate the nursing personnel and increase their competency and efficiency so
that, they can provide better quality KMC to LBW babies. This information booklet has been
developed taking into consideration the important roles which nursing personnel play during the
care of LBW babies in their recovery.
It has been proven by many researches related to KMC that it is very effective, simple,
low cost method for caring LBW babies. It helps in decreasing morbidity and mortality of LBW
babies especially where good care for such babies is scarce. Problems like this exists more in the
developing countries like India where such care is rarely available. The nurse‟s expertise in the
initiation of KMC is important to enable them to practice it for saving of life of LBW babies.
Nursing personnel are working in variety of settings i.e. obstetrics, pediatric, homes or
in the community and contribute in decreasing the morbidity and mortality of the LBW babies .It
is necessary that every nursing personnel gains knowledge and skill in implementing kangaroo
mother care. I have made an attempt to compile the important information regarding KMC in this
booklet. This booklet is a small effort to increase the knowledge and improve the skill of nursing
personnel. I hope that this information booklet will be helpful to all the nursing personnel and
they will utilize this knowledge while providing KMC for LBW babies.
5. OBJECTIVES
GENERAL OBJECTIVES:
After going through this information booklet you will be able to improve your knowledge and
practice about kangaroo mother care.
SPECIFIC OBJECTIVES:
After going through this booklet you will be able to:
Describe the concept of Kangaroo Mother Care.
Enumerate benefits of kangaroo mother care.
Enlist components of kangaroo mother care.
Discuss pre-requisites of kangaroo mother care.
Identify the eligibility criteria for kangaroo mother care.
Describe preparation for kangaroo mother care.
Explain procedure of kangaroo mother care.
Discuss time of initiation and duration of kangaroo mother care.
Explain discharge and follow up of kangaroo mother care.
Describe implementation of kangaroo mother care in the unit.
6. INTRODUCTION
Each year about 20 million low birth weight babies are born worldwide. In India every 4th
baby born is low birth weight, which imposes a heavy burden on healthcare and social systems.
Medical care of low birth weight infants is complex, demands an expensive infrastructure and
highly skilled staff, and is often a very disruptive experience for families. LBW babies in poorly
resourced settings often end up in understaffed and ill equipped neonatal care units, which may
be turned into potentially deadly traps by a range of factors, for example, malfunctioning
incubators, broken monitors, overcrowding, nosocomial infections, etc resulting in number of
complications and also mortality of these babies.
Kangaroo Mother Care is a promising method which has the potential to solve these
problems as it does not need expensive and sophisticated equipment, and is simple enough to be
applied almost everywhere. It is a powerful, easy-to-use method to promote the health and well-
being of infants born premature and low birth weight. Despite of so many advantages, it is still
not a widely practiced method especially in India. So it is essential that it should be promoted
and implemented by nursing personnel on a wider scale in developed and developing countries.
HISTORICAL BACKGROUND OF K M C
Kangaroo mother care was first suggested in 1978 by Dr Edgar Rey in Bogotá, Colombia.
KMC was started in response to overcrowding and insufficient resources in neonatal intensive
care units associated with high morbidity and mortality among low-birth weight infants. The
term KMC is derived from practice similarities to marsupial care giving, i.e., the premature
infant are kept warm in the maternal pouch and close to the breasts for unlimited feeding.
WHAT IS KANGAROO MOTHER CARE?
“A form of parental care giving where the newborn low birth weight is intermittently nursed
skin-to-skin in a vertical position between the mother‟s breasts or against the father‟s chest for a
non-specific period of time.”
(Kenner & Lott, 2003)
7. According to W.H.O. The low birth
weight babies are the newborn babies
weighing less than 2500 gm at birth are
classified as low birth weight (LBW)
irrespective of the periods of gestation. Any
neonate born before 37 weeks (<259 days)
of pregnancy irrespective of the birth weight
is classified as Preterm baby.
So, Kangaroo Mother Care is a special way of caring of low birth weight babies.
KMC satisfies all five senses of the baby. In KMC, the baby is continuously kept in skin-to-skin
contact by the mother and breastfed exclusively to the utmost extent. The baby feels warmth of
mother through skin-to-skin contact (touch), she listens to mother‟s voice & heart beat (hearing),
sucks on breast (taste), has eye contact with mother (vision) and smells mother‟s odor
(olfaction). It fosters their health and well being by promoting effective thermal control,
breastfeeding, infection prevention and bonding.
BENEFITS OF KMC
For parents:
Enhanced attachment and bonding.
Increased milk volume, increased rates and duration of breastfeeding.
Feeling of confidence, competence, satisfaction and empowerment regarding baby care.
Decreased separation anxiety of parents.
Parent‟s participation and acceptance increases.
Cost effective care.
For low birth weight baby:
Normalizes temperature, heart rate and respiratory rate.
Decrease in apnea.
Breast milk is readily available and accessible.
Increased weight gain.
Normalized infant growth and development of premature infants.
Enhanced mother-infant bonding.
Less crying and distress.
8. Restful sleep.
Less nosocomial infection.
Less time in incubators.
KMC satisfies baby‟s five senses.
Reduced risk of sudden infant death.
KMC useful in transferring the LBW babies to higher centre.
Improved health status and survival.
Earlier discharge.
Decreased readmission.
For institutions:
Shorter hospital stay.
Decreased overcrowding.
No need of additional staff.
Reduced use of advanced health care technology only used in addition to KMC.
Increased survival of premature and LBW babies.
More parental involvement, with greater opportunities for teaching and assessing.
Fewer readmissions in the hospital.
For the community:
Less morbidity and mortality of LBW babies.
Decreased use of financial resources
Promotion of total family health.
Decreased health care cost.
COMPONENTS OF KANGAROO MOTHER CARE
A. SKIN-TO-SKIN CONTACT: Early,
continuous and prolonged skin-to-skin
contact between the mother and her baby is
the basic component of KMC. The infant is
placed on her mother's chest between the
breasts.
9. B. EXCLUSIVE BREASTFEEDING: The baby on KMC is breastfed exclusively. Skin-to-
skin contact promotes lactation and facilitates the feeding interaction.
PRE-REQUISITES OF KMC
1. SUPPORTING MOTHER IN HOSPITAL AND AT HOME
A mother cannot successfully provide KMC all alone. She would require counseling
along with supervision from care-providers, and assistance and cooperation from her family
members.
2. POST-DISCHARGE FOLLOW UP
KMC is continued at home after early discharge from the hospital. A regular follow up
and access to health providers for solving problems is crucial to ensure safe and successful KMC
at home.
ELIGIBILITY CRITERIA
Eligibility criteria for baby
All stable LBW babies are eligible for KMC. It can also be given to babies who are on
intravenous fluids, tube feeding or oxygen but are otherwise stable. Very sick babies needing
special care should be cared under radiant warmer initially and KMC should be started after they
become stable. Some guidelines for practicing KMC include:
I. Birth weight >1800 gm: These babies are generally stable at birth. Therefore, in most of them
KMC can be initiated soon after birth.
II. Birth weight 1200-1799 gm: Many babies of this group have significant problems in
neonatal period. It might take a few days before KMC can be initiated. If such a baby is born in a
place where neonatal care services are inadequate, the baby should be transferred to a proper
facility after initial stabilization and appropriate management, by keeping the baby in continuous
skin-to skin contact with the mother / family member during transport.
III. Birth weight <1200 gm: Frequently, these babies develop serious prematurity-related
morbidity often starting soon after birth. It may take days to weeks before baby's condition
allows initiation of KMC.
10. Eligibility criteria for mother
All mothers can provide KMC, irrespective
of age, parity, education, culture and
religion. The following points must be taken
into consideration:
WILLINGNESS: The mother must be willing and realize the benefits of KMC.
Healthcare providers should motivate her to learn and undertake KMC.
GENERAL HEALTH AND NUTRITION: The mother should be free from serious
illness, take adequate diet and supplements recommended by her physician.
HYGIENE: The mother should maintain good hygiene: daily bath/sponge, change of
clothes, hand washing, short and clean finger nails.
FAMILY SUPPORT: Apart from supporting the mother, family members should also
be encouraged to provide KMC when mother wishes to take rest or deal with
conventional responsibilities of household chores.
COMMUNITY SUPPORT: Community awareness about the benefits should be
created. This is particularly important when there are social, economic or family
constraints.
PREPARING FOR KMC
COUNSELING
When baby is ready for KMC, arrange a
time that is convenient to the mother and her
baby. The first few sessions are important
and require extended interaction.
Demonstrate to her the KMC procedure in
caring, gentle manner and with patience.
Answer her queries and allay her anxieties. Encourage her to bring her mother/mother in law,
husband or any other member of the family. It helps in building positive attitude of the family
11. and ensuring family support to the mother which is particularly crucial for post-discharge home-
based KMC. It is helpful that the mother starting KMC interacts with someone already practicing
KMC for her baby.
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. Suitable apparel that can retain the
baby for extended period of time can be
adapted locally.
BABY'S CLOTHING
Baby is dressed with cap, socks, nappy, and
front-open sleeveless shirt or 'jhabala'.
12. PLACE FOR PROVIDING KMC
KMC is feasible everywhere, because it is
not based on equipments. So it can be
provided in the:
Nursery.
Post-natal ward.
Home settings.
KANGAROO MOTHER CARE PROCEDURE
KANGAROO POSITIONING
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 extended
position.
This slightly extended head position
keeps the airway open and allows eye
to eye contact between the mother
and her baby.
The hips should be flexed and abducted in a "frog" position; the arms
should also be flexed.
Baby's abdomen should be at the level of the mother's epigastrium.
Mother‟s breathing stimulates the baby, thus reducing the occurrence of
apnea.
Support the baby in bottom with a sling/binder. (Special binders or carrying pouches are
also commercially available and can be helpful.)
13. MONITORING
Babies receiving KMC should be monitored carefully especially during the initial stages.
Nursing staff should ensure that baby's:
Neck is not too flexed or to extended
Breathing is normal and regular
Feet and hands are warm
Baby is upright between mother‟s
breasts
Airway is clear
Color is pink
Baby is maintaining temperature
Mother should be involved in observing the
baby during KMC so that she herself can
continue monitoring at home.
FEEDING
The mother should be explained how to breastfeed while the baby is in KMC position.
Holding the baby near the breast stimulates milk production. She may express milk while the
baby is still in KMC position.
PRIVACY
KMC unavoidably requires some exposure on the part of the mother. This can make her
nervous and could be de-motivating. The staff must respect mother's sensitivities in this regard
and ensure culturally acceptable privacy standards in the nursery and in the wards where KMC is
practiced.
14. TIME OF INITIATION
KMC can be started as soon as the baby is stable. Babies with severe illnesses or requiring
special treatment should be managed according to the unit protocol. Short KMC sessions can be
initiated during recovery with ongoing medical treatment (IV fluids, oxygen therapy). KMC can
be provided while the baby is being fed via orogastric tube or on oxygen therapy. Once the baby
begins to recover, family members should be motivated to practice KMC.
DURATION OF KMC
Skin-to-skin contact should start gradually in the nursery, with a smooth transition from
conventional care to continuous KMC.
Sessions that last less than one hour should be avoided because frequent handling may be
stressful for the baby.
The length of skin-to-skin contacts should be gradually increased up to 24 hours a day,
interrupted only for changing diapers, especially where no other means of thermal control
are available.
It may not be possible for mother to provide KMC for prolonged period in the beginning.
Encourage her to increase the duration each time. The aim should be to provide KMC as
long as possible.
KMC DURING SLEEP AND REST
A comfortable chair with adjustable back
may be useful to provide KMC during sleep
and rest. In the KMC ward or at home, the
mother can sleep with the baby in kangaroo
position in a reclined or semi recumbent
position, about 15 -30 degrees above the
ground.
15. When mother is not available, other family
members such as grandmother, father or
other relatives can provide Kangaroo
Mother Care.
FROM HOSPITAL TO HOME
Standard criteria to be made to transfer the
baby from nursery to the post natal ward
which should be as follows:-
Stable baby
Gaining weight
Mother confident to look after the
baby
DISCHARGE CRITERIA
The standard policy of the unit for discharge from the hospital should be followed. Generally
the following criteria are accepted at most centers:
• Baby's general health is good with no evidence of infection
• Feeding well and receiving exclusively or predominantly breast milk.
• Gaining weight (at least 15-20 gm/kg/day for at least three days)
• Maintaining body temperature satisfactorily for at least three consecutive days in room
temperature.
• The mother and family members are confident to take care of the baby in KMC and should
be asked to come for follow-up visits regularly.
These criteria are usually met by the time baby weighs around 1500gm. The home
environment is also very important for the successful outcome of KMC. The mother should go
16. back to a warm, smoke-free home. She should have support for everyday household tasks.
WHEN SHOULD KMC BE DISCONTINUED?
When the mother and baby are comfortable, KMC is continued for as long as possible, at
the institution & then at home. Often this is desirable until the baby's gestation reaches term or
the weight is around 2500 g. The baby starts wriggling to show discomfort, pull limbs out, cries
and fusses every time the mother tries to initiate skin to skin contact. This is the time to wean the
baby from KMC. Mothers can provide skin to skin contact occasionally after giving the baby a
bath and during cold nights.
RECORD KEEPING
Adequate record keeping is important for babies, especially LBW babies receiving KMC
accurate record keeping help in programme evaluation. The records kept are as follows:
Date when KMC began.
Age of baby when KMC was started.
Weight of baby when KMC was started.
Condition of the baby.
Feeding method for the baby.
Duration and frequency of skin to skin contact.
Daily weight gain by the baby.
The drugs received by baby.
Any complications.
Information about admission and discharge of the mother.
POST-DISCHARGE FOLLOW UP
Close follow up is a fundamental pre-requisite of KMC practice. It is important that each
unit should formulate its own policy of follow up.
In general, a baby is followed once or twice a week till 37-40 weeks of gestation or till the
bay reaches 2.5-3 kg of weight. (Smaller the baby at discharge, the earlier and more frequent
follow-up visits should be made). Thereafter, a follow up once in 2-4 weeks may be enough till 3
months of post-conceptional age.
17. Later, the baby should be seen at an interval of 1-2 months during first year of life.
The baby should gain adequate weight i.e.15-20 gm/kg/day up to 40 weeks of post-conceptional
age and 10 gm/kg/ day subsequently. More frequent visits should be made if the baby is not
growing well or if his condition demands.
IMPLEMENTATION OF KANGAROO MOTHER CARE IN THE UNIT
The implementation of KMC depends on the following:
1. The staff„s acceptance of KMC.
2. Adopting a KMC policy.
3. Writing KMC guidelines.
4. Training and promoting the staff to use KMC.
5. Teaching mothers to give KMC.
6. Establishing facilities or requirements for KMC.
7. Managing ambulatory KMC.
1. STAFF„S ACCEPTANCE OF KMC:
Health care workers, managers, policy
makers and funders need to be convinced
that KMC offers better, more cost effective
care. All the staff must be encouraged and
trained to help mothers provide kangaroo
mother care to their LBW babies.
2. ADOPTING A KANGAROO MOTHER CARE POLICY: The KMC policy is a written
statement which commits to implement and promote benefits of KMC. It does not have to be a
long and complicated document. The KMC policy must be displayed for staff and parents to see
so, that they are oriented and follow it easily.
3. WRITING KANGAROO MOTHER CARE GUIDELINES: KMC guidelines explain how
KMC is to be implemented. Formal written protocols are needed in the guidelines. Copies of the
guidelines must be freely available in hospitals and clinics where KMC is practiced.
There are no fixed rules for KMC. Each hospital and clinic has their own preferences, while each
mother has her own likes and dislikes about KMC. However, it is important that the principles
and guidelines are followed to maintain that standard care is given and received. In order that
18. KMC succeeds, the whole staff must support the idea and play a role in writing the KMC policy
and guidelines.
4. TRAINING AND PROMOTING THE STAFF TO PRACTICE KMC: All members of
the staff, including nurses, doctors and administrators need to promote the KMC. Training of all
involved personnel must take place at regular intervals so that they can provide physical,
emotional and educational support to the mother and the family. Every mother/ father/ babies
grandparents/ general public should know about KMC and should be educated by nursing
personnel to support KMC both in hospital and at home.
5. TEACHING MOTHERS TO GIVE
KMC: Many mothers have never heard
about KMC and are afraid to give KMC,
especially to LBW babies. From the start of
antenatal care, KMC should be included as
an important part of educating pregnant
women.
Often mothers feel that their LBW infants will receive better care in an incubator which is a
wrong idea. The method, advantages and implications of KMC should be discussed with the
mother as soon as a low birth weight infant is born. Planned teaching programme, educational
material such as information booklet, pamphlets, posters, and video films on KMC in local
language should be available to the mothers, families and community.
6. ESTABLISHING FACILITIES OR
REQUIREMENTS FOR KMC: No
special equipments are needed to give
kangaroo mother care. If possible, reclining
chairs in the nursery and postnatal wards,
and beds with adjustable back rest should be
arranged. Mother can provide KMC sitting
on an ordinary chair or in a semi-reclining
posture on a bed with the help of pillows.
19. 7. MANAGING AMBULATORY KMC:
The word ambulatory means to “walk
around”. Ambulatory KMC usually refers to
the KMC which is given after the infant has
been discharged to home from the hospital
or clinic.
The mothers can give home (or ambulatory) KMC throughout the day. Most work in the house
can be done while giving KMC.
Mothers can give KMC while walking around in or near their homes. Ambulatory KMC can
also be given when attending the clinic, visiting friends, on the bus or going shopping.
Once Kangaroo Mother Care is
implemented, nurses and other staff
appreciate KMC because of health benefits
to the babies, the satisfaction of the mothers
and decrease the workload of staff.
Practicing of the KMC does not require
extra staff in ward compared to incubator
care.
CONCLUSION
Conventional neonatal care of LBW babies is expensive and needs both trained personnel and
permanent logistic support. In developing countries like, financial and human resources for
neonatal care are limited and hospital ward for LBW babies are often over crowded. In this
situation only ray of hope is the kangaroo mother care and the nurses have a major role to play to
initiate and motivate mothers to practice kangaroo mother care as they conduct deliveries in
various health settings and function as independent practitioners or as members of health team.
So KMC is definitely humane, simple and feasible method of care that is important to be
practiced and encouraged by the nurses for the care of LBW babies.