Kanaroo Mother Care

1. PRESENTATION ON
KMC
Prepared By: Vipin Vageriya
Asst. Professor,
Dept of Nursing
CHARUSAT University, Changa-
Anand-Gujarat(India)

2. Kangaroo MotherCare

3. What is KMC ???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

4. Components of KMCComponents of KMC
 Skin-to-skin contactSkin-to-skin contact
 Early, continuous and prolongedEarly, continuous and prolonged
skin-to- skin contactskin-to- skin contact
 Exclusive breast feedingExclusive breast feeding
 Promotes lactation andPromotes lactation and
facilitates feedingfacilitates feeding

6. Pre-requisites of KMCPre-requisites of KMC
 Support to the motherSupport to the mother
  In hospital &In hospital &
  At homeAt home
 Post-discharge follow upPost-discharge follow up

7. Benefits of KMCBenefits of KMC
 Breast feedingBreast feeding
  Increased breast feeding ratesIncreased breast feeding rates
  Increased duration of breastIncreased duration of breast
feedingfeeding
 Thermal controlThermal control
  Effective thermal controlEffective thermal control
  Equivalent to conventionalEquivalent to conventional
incubator careincubator care

8. Benefits of KMC (cont..)Benefits of KMC (cont..)
 Early dischargeEarly discharge
  Better weight gainBetter weight gain-- EarlyEarly
dischargedischarge
 Lesser morbidityLesser morbidity
  Regular breathingRegular breathing
  Decreased episodes of apneaDecreased episodes of apnea
  Protection from nosocomialProtection from nosocomial
infectionsinfections

9. Benefits of KMC (cont..)Benefits of KMC (cont..)
 Other benefitsOther benefits
  Less stress to the infantLess stress to the infant
  Stronger bondingStronger bonding
  Deep satisfaction for motherDeep satisfaction for mother
  More confident parentsMore confident parents

10. Requirements for KMCRequirements for KMC
implementationimplementation
 TrainingTraining
 Nurses, physicians and other staffNurses, physicians and other staff
 Educational materialEducational material
 Information sheets, posters andInformation sheets, posters and
video films on KMCvideo films on KMC
 

11. Eligibility criteria: BabyEligibility criteria: Baby
 Birth weight >1800 gm:Birth weight >1800 gm:
 Start at birthStart at birth
 Hemodynamic stability is aHemodynamic stability is a
MUSTMUST

12. Eligibility criteria: MotherEligibility criteria: Mother
 WillingnessWillingness
 General health & nutritionGeneral health & nutrition
 HygieneHygiene
 Supportive familySupportive family
 Supportive communitySupportive community

13. Preparing for KMCPreparing for KMC
 CounselingCounseling
  Demonstrate procedureDemonstrate procedure
  Ensure family supportEnsure family support
  KMC support groupKMC support group
 Mother’s clothingMother’s clothing
  Front-open, light dress as per the localFront-open, light dress as per the local
cultureculture
 Baby’s clothingBaby’s clothing
  Cap, socks, nappy and front-openCap, socks, nappy and front-open
sleeveless shirt or ‘jhabala’sleeveless shirt or ‘jhabala’

14. KMC procedure: KangarooKMC procedure: Kangaroo
positioningpositioning
 Place baby between the mother’sPlace baby between the mother’s
breasts in an upright positionbreasts in an upright position
 Head turned to one side andHead turned to one side and
slightly extendedslightly extended
 Hips flexed and abducted in aHips flexed and abducted in a
“frog” position; arms flexed“frog” position; arms flexed
 Baby’s abdomen at mother’sBaby’s abdomen at mother’s
epigastriumepigastrium
 Support baby’s bottomSupport baby’s bottom

15. KMC procedure: KangarooKMC procedure: Kangaroo
positioning (cont..)positioning (cont..)
Head turned
to one side
Frog-leg
position
Baby between
mother’s breasts
Support baby’s
bottom

16. KMC procedure: KangarooKMC procedure: Kangaroo
positioningpositioning

17. Monitoring during KMCMonitoring during KMC
Check ifCheck if
 Neck position is neutralNeck position is neutral
 Airway is clearAirway is clear
 Breathing is regularBreathing is regular
 Color is pinkColor is pink
 Temperature is beingTemperature is being
maintainedmaintained

18. initiation of KMCinitiation of KMC
 Baby should be stableBaby should be stable
 Short KMC sessions can beShort KMC sessions can be
initiated even if the baby isinitiated even if the baby is
receivingreceiving

19. Duration of KangarooDuration of Kangaroo
Mother CareMother Care
 Start KMC sessions in the nurseryStart KMC sessions in the nursery
 Practice one hour sessions initiallyPractice one hour sessions initially
 Transit from conventional care toTransit from conventional care to
longer KMClonger KMC
 Transfer baby to post-natal wardTransfer baby to post-natal ward
and continue KMCand continue KMC
 Increase duration up to 10-12Increase duration up to 10-12
hours a dayhours a day

20. KMC during sleep and restingKMC during sleep and resting
RestingResting
 Reclining or semi-recumbentReclining or semi-recumbent
positionposition
 Adjustable bedAdjustable bed
 Several pillows on an ordinary bedSeveral pillows on an ordinary bed
 Easy reclining chairEasy reclining chair
 SleepSleep
 Supporting garment restraint forSupporting garment restraint for
babybaby

21. KMC during sleepKMC during sleep

22. KMC during restingKMC during resting

23. Any family member can do it !Any family member can do it !
 Father & other familyFather & other family
members canmembers can
 also provide skin-to-skin carealso provide skin-to-skin care
 FatherFather
 GrandmotherGrandmother

25. Criteria for transferCriteria for transfer
 From nursery to wardFrom nursery to ward
 Stable babyStable baby
 Gaining weightGaining weight
 Mother confident of lookingMother confident of looking
after the babyafter the baby

26. Discharge criteriaDischarge criteria
 Baby is well with no evidenceBaby is well with no evidence
of infectionof infection
 Feeding well (predominantFeeding well (predominant
breast milk)breast milk)
 Gaining weight (15-20Gaining weight (15-20
gm/kg/day)gm/kg/day)

27.  Maintaining body temperatureMaintaining body temperature
(in room temperature)(in room temperature)
 Mother confident of taking careMother confident of taking care
of the babyof the baby
 Follow-up visits ensuredFollow-up visits ensured

28. Discontinuation of KMCDiscontinuation of KMC
 Term gestationTerm gestation
 Weight ~ 2500 gm or moreWeight ~ 2500 gm or more
 Baby uncomfortableBaby uncomfortable
  Pulls limbs outPulls limbs out
  Cries and fogs from mouthCries and fogs from mouth
 Mother can continue KMC afterMother can continue KMC after
giving the baby a bath and duringgiving the baby a bath and during
cold nightscold nights

29. Post-discharge follow upPost-discharge follow up
 Once or twice a week till 20 wks /Once or twice a week till 20 wks /
2.5-3 kg2.5-3 kg
 Thereafter, once in 2-4 wks till 3Thereafter, once in 2-4 wks till 3
monthsmonths
 Subsequently, every 1-2 monthsSubsequently, every 1-2 months
during first yearduring first year
 More frequent visits if baby is notMore frequent visits if baby is not
growing well.growing well.