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.
This document discusses immediate newborn care including establishing respiration, cutting the umbilical cord, preventing heat loss, assessing the baby's condition through Apgar scoring, identifying the baby, weighing the baby, positioning the baby, and encouraging bonding between mother and baby. It then discusses subsequent newborn care including maintaining a clear airway, keeping the baby warm to prevent hypothermia, and preventing hypoglycemia.
This document discusses the nursing management of high risk newborns, specifically post-mature infants. It defines high risk newborns as those with greater than average chances of morbidity within the first 28 days. It identifies characteristics like low birth weight, twins, and infection as risk factors. The goals of management are outlined as perinatal prevention, resuscitation, evaluation, monitoring, and family care. Assessment includes initial apgar scoring and ongoing clinical, transitional, behavioral, and physical assessments. Post-mature infants are those born after 42 weeks of gestation, and may show signs like loose skin and lack of vernix or lanugo. Management focuses on immediate care, temperature regulation, infection prevention, feeding support, and
The document discusses Apgar scoring, which evaluates newborns on factors like heart rate, breathing effort, muscle tone, and skin color to assess their transition from fetus to newborn. It notes that various medical factors can affect Apgar scores, either raising or lowering them despite the infant's actual condition. It also presents data showing greatly increased risk of neonatal death for infants with very low 5-minute Apgar scores. Additional sections cover definitions of preterm and postterm birth, risk factors for jaundice, signs that jaundice requires further evaluation, and graphs on neonatal mortality rates and average daily weight gain by postnatal age.
The document provides information on the immediate and essential care of newborn babies. It discusses the characteristics, reflexes, and measurements of newborns. It also outlines the steps for immediate basic care including maintaining temperature, establishing breathing, vitamin K injection, and initiating breastfeeding. The document summarizes assessment methods for gestational age and provides details on the Ballard scoring system.
Gestational age assessment and Neonatal reflexesThe Medical Post
This document provides information on assessing gestational age in neonates through calculation of dates, evaluation of obstetrical factors, physical examination of the neonate, and assessment of neonatal reflexes. It describes various neuromuscular and physical criteria used in the Ballard exam to determine gestational age, such as posture, arm recoil, and genital development. It also outlines several neonatal reflexes that are present at birth and typically disappear by 3-12 months, including Moro, rooting, stepping, and asymmetric tonic neck reflex.
The document discusses the care of hospitalized children. It emphasizes that children require specialized pediatric care due to anatomical, physiological, immunological, psychosocial and cognitive differences compared to adults. The hospital environment can impact children in various ways depending on their developmental stage. Nursing care aims to minimize stressors like separation from parents, loss of control, and pain/injury through measures like parental involvement, developmentally-appropriate activities, and clear communication. The goal is to help children benefit from hospitalization and cope with the experience in a healthy manner.
This document discusses the neurological assessment of a newborn baby. It begins by outlining the current practice of neurological examinations in hospitals, noting that full examinations are often not possible due to large patient volumes and staffing shortages. The document then provides details on various components of a comprehensive neurological assessment, including gestational age assessment, examination of the head and fontanelles, assessment of tone, posture and reflexes, and cranial nerve evaluation. It discusses the typical timing of appearance and disappearance of various reflexes. The document concludes by discussing the use of rapid neurodevelopmental assessments at discharge to screen for developmental issues.
This document discusses immediate newborn care including establishing respiration, cutting the umbilical cord, preventing heat loss, assessing the baby's condition through Apgar scoring, identifying the baby, weighing the baby, positioning the baby, and encouraging bonding between mother and baby. It then discusses subsequent newborn care including maintaining a clear airway, keeping the baby warm to prevent hypothermia, and preventing hypoglycemia.
This document discusses the nursing management of high risk newborns, specifically post-mature infants. It defines high risk newborns as those with greater than average chances of morbidity within the first 28 days. It identifies characteristics like low birth weight, twins, and infection as risk factors. The goals of management are outlined as perinatal prevention, resuscitation, evaluation, monitoring, and family care. Assessment includes initial apgar scoring and ongoing clinical, transitional, behavioral, and physical assessments. Post-mature infants are those born after 42 weeks of gestation, and may show signs like loose skin and lack of vernix or lanugo. Management focuses on immediate care, temperature regulation, infection prevention, feeding support, and
The document discusses Apgar scoring, which evaluates newborns on factors like heart rate, breathing effort, muscle tone, and skin color to assess their transition from fetus to newborn. It notes that various medical factors can affect Apgar scores, either raising or lowering them despite the infant's actual condition. It also presents data showing greatly increased risk of neonatal death for infants with very low 5-minute Apgar scores. Additional sections cover definitions of preterm and postterm birth, risk factors for jaundice, signs that jaundice requires further evaluation, and graphs on neonatal mortality rates and average daily weight gain by postnatal age.
The document provides information on the immediate and essential care of newborn babies. It discusses the characteristics, reflexes, and measurements of newborns. It also outlines the steps for immediate basic care including maintaining temperature, establishing breathing, vitamin K injection, and initiating breastfeeding. The document summarizes assessment methods for gestational age and provides details on the Ballard scoring system.
Gestational age assessment and Neonatal reflexesThe Medical Post
This document provides information on assessing gestational age in neonates through calculation of dates, evaluation of obstetrical factors, physical examination of the neonate, and assessment of neonatal reflexes. It describes various neuromuscular and physical criteria used in the Ballard exam to determine gestational age, such as posture, arm recoil, and genital development. It also outlines several neonatal reflexes that are present at birth and typically disappear by 3-12 months, including Moro, rooting, stepping, and asymmetric tonic neck reflex.
The document discusses the care of hospitalized children. It emphasizes that children require specialized pediatric care due to anatomical, physiological, immunological, psychosocial and cognitive differences compared to adults. The hospital environment can impact children in various ways depending on their developmental stage. Nursing care aims to minimize stressors like separation from parents, loss of control, and pain/injury through measures like parental involvement, developmentally-appropriate activities, and clear communication. The goal is to help children benefit from hospitalization and cope with the experience in a healthy manner.
This document discusses the neurological assessment of a newborn baby. It begins by outlining the current practice of neurological examinations in hospitals, noting that full examinations are often not possible due to large patient volumes and staffing shortages. The document then provides details on various components of a comprehensive neurological assessment, including gestational age assessment, examination of the head and fontanelles, assessment of tone, posture and reflexes, and cranial nerve evaluation. It discusses the typical timing of appearance and disappearance of various reflexes. The document concludes by discussing the use of rapid neurodevelopmental assessments at discharge to screen for developmental issues.
Kangaroo Mother Care (KMC) involves securing low birth weight or preterm infants skin-to-skin to the mother's chest. It promotes the health and development of these infants through improved temperature regulation, breastfeeding, and bonding with the mother. The key components of KMC are maintaining the infant in the kangaroo position, keeping them skin-to-skin on the mother's chest, securing them with a wrap, exclusive breastfeeding when possible, continuing KMC after hospital discharge with support, and benefits both the infant and mother.
Contracted pelvis, also known as pelvic disproportion, occurs when the essential diameters of the pelvis are shortened, altering the normal mechanism of labor. It can be caused by developmental, metabolic, traumatic or other factors. Pelvises are classified based on degree of contraction and pelvic architecture. Diagnosis involves history, physical exam including internal and external pelvimetry, and sometimes radiological imaging. An internal pelvimetry exam evaluates the inlet, cavity, and outlet to determine pelvic adequacy for vaginal delivery.
This document outlines the components and process of neonatal assessment. It discusses the aims of assessment including identifying prenatal influences, potential problems, and needs for intervention. The components include history of the mother and baby, physical examination from head to toe, and potential investigations. The physical examination involves assessing vital signs, appearance, measurements, and neurological and physical systems. The goal is to detect any issues that may impact health and develop appropriate care plans.
The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth
This document discusses various types of malpresentations that can occur during labor, including face presentation, brow presentation, breech presentation, shoulder presentation, and unstable lie. It provides details on the diagnosis, management, and potential complications of each presentation. Face presentation is the most common type of malpresentation and can be diagnosed based on abdominal and vaginal exams. Brow presentation carries a high risk of obstructed labor requiring c-section. Shoulder presentation requires c-section delivery due to the inability to deliver the shoulders. Unstable lie increases the risk of cord prolapse so careful monitoring is needed.
The document discusses the Apgar score, which is a quick assessment of a newborn's health. It was developed in 1952 by Dr. Virginia Apgar and is measured at one and five minutes after birth. The Apgar score rates five signs - appearance, pulse, grimace, activity, and respiration. Each sign is given a score of 0, 1, or 2. A higher total score indicates better adaptation to extrauterine life without requiring resuscitation. Factors like drugs given to the mother during labor can affect the Apgar score. The assessment helps identify babies needing immediate resuscitation and predicts survival in the neonatal period.
This document discusses the care of preterm babies. Key points include:
- Preterm babies are born before 37 weeks gestation and have low birth weight, immature organ systems, and are susceptible to complications.
- Care involves temperature regulation, appropriate feeding, monitoring for complications like respiratory distress and infections.
- Feeding may begin with intravenous fluids or a nasogastric tube and progress to breastfeeding. Nutritional needs for protein, carbohydrates, fats, vitamins and minerals must be met.
- Ongoing monitoring of vital signs and development is needed to detect any issues and provide appropriate treatment and care. Immunizations should also be given according to schedule.
This document discusses postpartum complications, beginning with an introduction to the postpartum period and its significance. It then covers non-bleeding complications that can occur, including pain, breast engorgement, urinary retention, preeclampsia/eclampsia, and postpartum fever. Two case studies are presented involving a patient with postpartum fever and another with symptoms of postpartum thyroiditis. Management options are provided for various complications like endometritis, mastitis, septic thrombophlebitis, and postpartum thyroiditis.
Presentation on Baby friendly hospital initiativeSimran Dhiman
The presentation provides an overview of the Baby-Friendly Hospital Initiative (BFHI), which was launched in 1991 by UNICEF and WHO to promote breastfeeding. The goals of BFHI are to transform hospitals through implementing the Ten Steps to Successful Breastfeeding and end distribution of breastmilk substitutes. The Ten Steps include establishing breastfeeding policies, training staff, educating mothers, and encouraging breastfeeding within 30 minutes of birth, on demand, and without pacifiers. Hospitals must foster breastfeeding support groups prior to discharge to be Baby-Friendly certified. The document reviews the Ten Steps and medical reasons substitutes may be needed, and the role of administrators in upholding the International Code of Marketing of Breastmilk
The APGAR score is a system used to assess newborns one and five minutes after birth. It evaluates the baby's activity, pulse, grimace, appearance, and respiration on a scale of 0-2 for each category. A score of 7-10 is considered normal, 4-6 moderately abnormal, and 0-3 concerning as it requires increased intervention. The APGAR score provides a quick way for medical staff to communicate the condition of the newborn and determine if additional care is needed.
Phototherapy uses fluorescent light to break down bilirubin in an infant's skin to treat jaundice. It works by converting bilirubin into water soluble forms that can be excreted from the body. Nursing care for infants receiving phototherapy includes properly positioning the infant under the lights, monitoring their temperature and bilirubin levels daily, providing eye protection and extra fluids, and allowing for feeding and parental interaction while limiting light exposure.
The document summarizes physiological changes that occur during the postpartum period known as the puerperium. It lasts approximately 6 weeks as the body reverts back to its pre-pregnant state. This includes involution of the uterus, vagina, and other pelvic structures. Other changes include lochia discharge, temperature regulation returning to normal, changes in blood pressure and pulse, weight loss, fluid balance changes, and the return of menstruation being delayed in women who breastfeed.
This document outlines the tools and procedures used to assess a newborn infant, including measurements of growth, reflex and nutritional evaluations, and observation of sleep patterns and parent-infant interactions. Key areas of assessment include head circumference, weight, length, reflexes, formula intake, stooling, skin turgor, and parental bonding. The assessment also addresses educating new parents on safety, feeding, hygiene and other infant care topics. Finally, the maternal postpartum recovery is evaluated.
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.
This document discusses factors that define high risk newborns and their management and follow up. It identifies demographic, medical history, pregnancy, delivery, and neonatal factors that increase morbidity and mortality risks. It outlines assessments and interventions needed for different at-risk groups, including extra care to prevent hypothermia, hypoglycemia, and infection. High risk newborns require intensive care and multidisciplinary follow up after discharge to screen for developmental delays and other issues. The goal is early identification and intervention to optimize outcomes.
During the first year of life, infants experience significant physical, cognitive, linguistic, and emotional growth and development. Caregivers monitor an infant's physical growth through regular checkups and maintaining a growth chart. Infants develop motor skills and learn to grasp objects and sit up on their own. Establishing routines for sleeping, eating, and playtime is important for development. Infants begin to understand language and may say their first words by the end of the year. Their brains grow rapidly, so interaction and reading are encouraged over excessive TV time. Caregivers should ensure infant safety by maintaining a secure environment, using approved car seats correctly, and preventing hazards like choking, burns, and falls. When infants are sick or hospitalized
Stages of normal labor- easy explanation for Nursing Students(B.Sc & GNM)...
Introduction, definition of normal labor, definition of normal labor by WHO, Mechanism of labor, stages of labor, Intrapartum management of Labor, pain control.
The document summarizes the normal mechanism of labor with an occiput anterior position of the fetal head. It describes the key stages of engagement, descent, flexion, internal rotation, crowning and extension of the head. Internal rotation occurs as the presenting part rotates anteriorly upon meeting resistance from the sloped pelvic floor. This allows the anteroposterior diameter of the head to align with the widest diameter of the pelvic outlet to facilitate delivery. The stages ensure the fetus progresses safely through the birth canal during a vaginal delivery.
Nursing management of low birth weight(lbw) babiesRose Vadakkut
This document provides information on the management of low birth weight babies. It defines different categories of low birth weight, describes optimal care at birth including warming and feeding practices. It outlines monitoring requirements and discusses positioning, thermal comfort, oxygen therapy, phototherapy and infection control. The document also covers nutrition, stimulation, immunization and family support needs for low birth weight infants.
The document outlines a presentation on Kangaroo Mother Care (KMC). KMC involves prolonged skin-to-skin contact between a mother and her premature or low birth weight infant. The presentation covers causes of newborn deaths, the contribution of prematurity to deaths, elements of KMC including positioning and breastfeeding, evidence that KMC reduces mortality and improves outcomes, and country experiences implementing KMC.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help alleviate symptoms of mental illness and boost overall mental well-being.
Kangaroo Mother Care (KMC) involves securing low birth weight or preterm infants skin-to-skin to the mother's chest. It promotes the health and development of these infants through improved temperature regulation, breastfeeding, and bonding with the mother. The key components of KMC are maintaining the infant in the kangaroo position, keeping them skin-to-skin on the mother's chest, securing them with a wrap, exclusive breastfeeding when possible, continuing KMC after hospital discharge with support, and benefits both the infant and mother.
Contracted pelvis, also known as pelvic disproportion, occurs when the essential diameters of the pelvis are shortened, altering the normal mechanism of labor. It can be caused by developmental, metabolic, traumatic or other factors. Pelvises are classified based on degree of contraction and pelvic architecture. Diagnosis involves history, physical exam including internal and external pelvimetry, and sometimes radiological imaging. An internal pelvimetry exam evaluates the inlet, cavity, and outlet to determine pelvic adequacy for vaginal delivery.
This document outlines the components and process of neonatal assessment. It discusses the aims of assessment including identifying prenatal influences, potential problems, and needs for intervention. The components include history of the mother and baby, physical examination from head to toe, and potential investigations. The physical examination involves assessing vital signs, appearance, measurements, and neurological and physical systems. The goal is to detect any issues that may impact health and develop appropriate care plans.
The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth
This document discusses various types of malpresentations that can occur during labor, including face presentation, brow presentation, breech presentation, shoulder presentation, and unstable lie. It provides details on the diagnosis, management, and potential complications of each presentation. Face presentation is the most common type of malpresentation and can be diagnosed based on abdominal and vaginal exams. Brow presentation carries a high risk of obstructed labor requiring c-section. Shoulder presentation requires c-section delivery due to the inability to deliver the shoulders. Unstable lie increases the risk of cord prolapse so careful monitoring is needed.
The document discusses the Apgar score, which is a quick assessment of a newborn's health. It was developed in 1952 by Dr. Virginia Apgar and is measured at one and five minutes after birth. The Apgar score rates five signs - appearance, pulse, grimace, activity, and respiration. Each sign is given a score of 0, 1, or 2. A higher total score indicates better adaptation to extrauterine life without requiring resuscitation. Factors like drugs given to the mother during labor can affect the Apgar score. The assessment helps identify babies needing immediate resuscitation and predicts survival in the neonatal period.
This document discusses the care of preterm babies. Key points include:
- Preterm babies are born before 37 weeks gestation and have low birth weight, immature organ systems, and are susceptible to complications.
- Care involves temperature regulation, appropriate feeding, monitoring for complications like respiratory distress and infections.
- Feeding may begin with intravenous fluids or a nasogastric tube and progress to breastfeeding. Nutritional needs for protein, carbohydrates, fats, vitamins and minerals must be met.
- Ongoing monitoring of vital signs and development is needed to detect any issues and provide appropriate treatment and care. Immunizations should also be given according to schedule.
This document discusses postpartum complications, beginning with an introduction to the postpartum period and its significance. It then covers non-bleeding complications that can occur, including pain, breast engorgement, urinary retention, preeclampsia/eclampsia, and postpartum fever. Two case studies are presented involving a patient with postpartum fever and another with symptoms of postpartum thyroiditis. Management options are provided for various complications like endometritis, mastitis, septic thrombophlebitis, and postpartum thyroiditis.
Presentation on Baby friendly hospital initiativeSimran Dhiman
The presentation provides an overview of the Baby-Friendly Hospital Initiative (BFHI), which was launched in 1991 by UNICEF and WHO to promote breastfeeding. The goals of BFHI are to transform hospitals through implementing the Ten Steps to Successful Breastfeeding and end distribution of breastmilk substitutes. The Ten Steps include establishing breastfeeding policies, training staff, educating mothers, and encouraging breastfeeding within 30 minutes of birth, on demand, and without pacifiers. Hospitals must foster breastfeeding support groups prior to discharge to be Baby-Friendly certified. The document reviews the Ten Steps and medical reasons substitutes may be needed, and the role of administrators in upholding the International Code of Marketing of Breastmilk
The APGAR score is a system used to assess newborns one and five minutes after birth. It evaluates the baby's activity, pulse, grimace, appearance, and respiration on a scale of 0-2 for each category. A score of 7-10 is considered normal, 4-6 moderately abnormal, and 0-3 concerning as it requires increased intervention. The APGAR score provides a quick way for medical staff to communicate the condition of the newborn and determine if additional care is needed.
Phototherapy uses fluorescent light to break down bilirubin in an infant's skin to treat jaundice. It works by converting bilirubin into water soluble forms that can be excreted from the body. Nursing care for infants receiving phototherapy includes properly positioning the infant under the lights, monitoring their temperature and bilirubin levels daily, providing eye protection and extra fluids, and allowing for feeding and parental interaction while limiting light exposure.
The document summarizes physiological changes that occur during the postpartum period known as the puerperium. It lasts approximately 6 weeks as the body reverts back to its pre-pregnant state. This includes involution of the uterus, vagina, and other pelvic structures. Other changes include lochia discharge, temperature regulation returning to normal, changes in blood pressure and pulse, weight loss, fluid balance changes, and the return of menstruation being delayed in women who breastfeed.
This document outlines the tools and procedures used to assess a newborn infant, including measurements of growth, reflex and nutritional evaluations, and observation of sleep patterns and parent-infant interactions. Key areas of assessment include head circumference, weight, length, reflexes, formula intake, stooling, skin turgor, and parental bonding. The assessment also addresses educating new parents on safety, feeding, hygiene and other infant care topics. Finally, the maternal postpartum recovery is evaluated.
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.
This document discusses factors that define high risk newborns and their management and follow up. It identifies demographic, medical history, pregnancy, delivery, and neonatal factors that increase morbidity and mortality risks. It outlines assessments and interventions needed for different at-risk groups, including extra care to prevent hypothermia, hypoglycemia, and infection. High risk newborns require intensive care and multidisciplinary follow up after discharge to screen for developmental delays and other issues. The goal is early identification and intervention to optimize outcomes.
During the first year of life, infants experience significant physical, cognitive, linguistic, and emotional growth and development. Caregivers monitor an infant's physical growth through regular checkups and maintaining a growth chart. Infants develop motor skills and learn to grasp objects and sit up on their own. Establishing routines for sleeping, eating, and playtime is important for development. Infants begin to understand language and may say their first words by the end of the year. Their brains grow rapidly, so interaction and reading are encouraged over excessive TV time. Caregivers should ensure infant safety by maintaining a secure environment, using approved car seats correctly, and preventing hazards like choking, burns, and falls. When infants are sick or hospitalized
Stages of normal labor- easy explanation for Nursing Students(B.Sc & GNM)...
Introduction, definition of normal labor, definition of normal labor by WHO, Mechanism of labor, stages of labor, Intrapartum management of Labor, pain control.
The document summarizes the normal mechanism of labor with an occiput anterior position of the fetal head. It describes the key stages of engagement, descent, flexion, internal rotation, crowning and extension of the head. Internal rotation occurs as the presenting part rotates anteriorly upon meeting resistance from the sloped pelvic floor. This allows the anteroposterior diameter of the head to align with the widest diameter of the pelvic outlet to facilitate delivery. The stages ensure the fetus progresses safely through the birth canal during a vaginal delivery.
Nursing management of low birth weight(lbw) babiesRose Vadakkut
This document provides information on the management of low birth weight babies. It defines different categories of low birth weight, describes optimal care at birth including warming and feeding practices. It outlines monitoring requirements and discusses positioning, thermal comfort, oxygen therapy, phototherapy and infection control. The document also covers nutrition, stimulation, immunization and family support needs for low birth weight infants.
The document outlines a presentation on Kangaroo Mother Care (KMC). KMC involves prolonged skin-to-skin contact between a mother and her premature or low birth weight infant. The presentation covers causes of newborn deaths, the contribution of prematurity to deaths, elements of KMC including positioning and breastfeeding, evidence that KMC reduces mortality and improves outcomes, and country experiences implementing KMC.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help alleviate symptoms of mental illness and boost overall mental well-being.
Kangaroo care involves extended skin-to-skin contact between a parent and their baby. It has benefits for both babies and parents such as easier breathing and sleep for babies, improved brain development, and increased milk production and bonding for mothers. Kangaroo care is done by placing the baby in an upright position against the parent's chest so as much skin is in contact as possible. It should be done for at least 30 minutes to 2 hours at a time to receive the full benefits.
Child Healthcare addresses all the common and important clinical problems in children, including:immunisation history and examination growth and nutrition acute and chronic infections parasites skin conditions difficulties in the home and society.
The document discusses growth and development in children. It defines growth as a quantitative increase in size through cell multiplication, while development refers to functional and physiological maturation. Some key principles discussed include cephalocaudal and proximodistal directions of development. Factors that can influence growth include genetic, prenatal, and postnatal factors. The document also describes methods to assess growth such as weight, length, head circumference, chest circumference, and skin fold thickness. Growth charts are discussed as tools to monitor growth over time.
Mother and Baby Friendly Care: Baby friendly 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 – Miriam Adhikari, South African Journal of Child Health, Primary Newborn Care 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.
Mother and Baby Friendly Care: Principles 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 – Miriam Adhikari, South African Journal of Child Health, Primary Newborn Care 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.
There are several methods for determining body composition and measuring obesity levels:
1) Body mass index (BMI) calculates weight relative to height and can indicate overweight or obesity levels.
2) Waist-to-hip ratio measures abdominal fat by comparing waist and hip circumference. Higher ratios mean more abdominal fat and greater health risks.
3) Skinfold thickness uses calipers to measure subcutaneous fat layers at various body sites and estimate body fat percentage.
This document summarizes recent research on mother-infant bonding. It discusses the importance of early contact like skin-to-skin contact and breastfeeding in establishing a strong bond. Studies have found effects of early separation on the mother-infant relationship a year later. The research also examines epigenetics and how a mother's behaviors and mental health can impact bonding through sensitive periods of development. The document stresses the importance of community support to help nurture bonding and facilitate positive change when needed.
This document discusses kangaroo mother care (KMC), an intervention where low birthweight infants have skin-to-skin contact with their mothers. It provides background on the origins and history of KMC, as well as statistics on neonatal and infant mortality globally and in Malawi. Current KMC practices at Zomba Central Hospital in Malawi are described. Challenges to implementing KMC include poor monitoring, lack of resources and follow-up after discharge. Evidence shows KMC reduces infection risk, promotes growth and development, and is more effective than conventional care. Recommendations include improving follow-up systems and prioritizing KMC as a basic neonatal health service.
Kangaroos are found in the grasslands and woodlands of Australia where they live in large groups called mobs. They have soft gray or brown fur, muscular hind legs and a strong tail that allow them to hop at speeds up to 70 mph. Kangaroos are herbivores that eat grass and leaves and have adaptations like the ability to go without water for long periods and use their claws to dig for water when needed. They carry their young in pouches and have become endangered due to habitat loss.
Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteria in the blood occurring in the first month of life. It can be early-onset within the first week of life, usually acquired during birth from the mother, or late-onset between 1 week to 1 month of life, often from hospital-acquired infections. Symptoms are non-specific but can include temperature irregularities, poor feeding, or respiratory distress. Treatment involves blood cultures, antibiotics like ampicillin and gentamicin, and supportive care for complications involving various organ systems. Ongoing research focuses on immunotherapies and blocking inflammatory responses.
This document contains 50 multiple choice questions about various topics in neonatology. The questions cover areas such as newborn assessment, common conditions in newborns, neonatal resuscitation, prematurity, and more. The questions are intended to test a physician's knowledge of clinical presentations, diagnoses, management strategies, and underlying pathophysiology across a range of neonatal conditions and scenarios.
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 (KMC) is a technique for caring for low birth weight babies that involves continuous skin-to-skin contact between the mother and baby, exclusive breastfeeding, and early discharge from the hospital. The three main components of KMC are keeping the baby in direct skin-to-skin contact with the mother in a "kangaroo position", exclusive breastfeeding to provide "kangaroo nutrition", and early discharge from and regular follow-up after the hospital to allow for "kangaroo early discharge". KMC provides benefits to both the baby and mother such as improved physiological stability, bonding, and reduced stress for the mother.
Kangaroo mother care (KMC) is a technique for caring for low birth weight babies that involves continuous skin-to-skin contact between the mother and baby, exclusive breastfeeding, and early discharge from the hospital. The three main components of KMC are keeping the baby in direct skin-to-skin contact with the mother in a "kangaroo position", exclusive breastfeeding to provide "kangaroo nutrition", and early discharge from and regular follow-up after the hospital to allow for "kangaroo early discharge". KMC provides benefits to both the baby and mother such as improved physiological stability, bonding, and reduced stress for the mother.
Guess the topic on KMC (Sanket vispute).pptxSanket Vispute
This document provides an overview of kangaroo mother care (KMC), which involves skin-to-skin contact between a mother and her low birth weight baby. KMC has numerous benefits, including improved thermal regulation and breastfeeding rates for the baby. It can also allow for earlier hospital discharge. The document defines KMC, lists its components and eligibility criteria, and outlines the steps for providing KMC and the necessary post-discharge follow-up care.
Kangaroo mother care (KMC) involves skin-to-skin contact between a mother and her low birth weight baby, exclusive breastfeeding, and early discharge from the hospital. It was developed as an alternative to incubator care for preterm infants in Colombia. The WHO recommends KMC for newborns weighing 2000g or less, as it improves health outcomes for babies and bonding between mother and child. KMC benefits include reduced risk of infection, apnea, and oxygen requirements for babies, as well as lower stress levels, bonding, and economic benefits for families and health systems.
This document provides information on Kangaroo Mother Care (KMC), which involves continuous skin-to-skin contact between a mother and her low birth weight baby, exclusive breastfeeding, and early discharge from the hospital. KMC has numerous benefits for both babies and mothers such as improved health outcomes for babies, better bonding, and lower costs. The document outlines the history, components, procedures, advantages, and recommendations for KMC as well as requirements for facilities, mothers, babies, and record keeping to properly implement KMC.
This document discusses Kangaroo Mother Care (KMC), an approach where preterm or low birth weight infants are held skin-to-skin against the mother's chest. KMC aims to provide warmth, safety, nutrition and support to immature newborns, similar to how a kangaroo carries its joey. The document outlines the origins of KMC, components like positioning and breastfeeding, benefits like improved health outcomes and bonding, and calls for KMC to be integrated globally based on its effectiveness.
Kangaroo mother care is a method of caring for low birth weight babies that provides skin-to-skin contact between the mother and baby. It improves health outcomes by promoting breastfeeding, temperature regulation, and bonding. Key components of kangaroo mother care include skin-to-skin contact in an upright position, exclusive breastfeeding, and early discharge from the hospital with regular follow ups. It has numerous benefits for both babies and mothers such as improved physiological stability, reduced infection risk, enhanced bonding, and promotion of breastfeeding.
Kangaroo Mother Care (KMC) involves skin-to-skin contact between a mother and her newborn, especially low birth weight or preterm infants. It originated in Colombia in the 1970s as a way to improve outcomes for fragile infants born in hospitals with limited resources. KMC provides benefits to both infants and mothers, such as improved infant health, growth, and development as well as increased maternal confidence. It also benefits hospitals by reducing costs and improving quality of care. KMC is now recognized as an effective practice worldwide for newborn 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.
Kangaroo Mother Care (KMC) is a method of caring for low birth weight and preterm infants that involves continuous skin-to-skin contact between the mother and infant. It was developed in Colombia in the 1970s as a way to improve outcomes for vulnerable infants born in hospitals that lacked incubators and resources. KMC has significant benefits for infants, including improved temperature regulation, breastfeeding and weight gain. It also benefits mothers by improving bonding and confidence in caring for their infant. For hospitals, KMC can reduce costs and length of stay by decreasing the need for incubators. On a national level, KMC decreases mortality while also improving long term outcomes for infants. The document provides detailed guidelines on eligibility,
Kangaroo mother care (KMC) is a technique where premature or low birth weight babies are kept skin-to-skin against the mother's bare chest to help regulate the baby's temperature, heart rate and breathing. KMC has several purposes such as promoting bonding and attachment between mother and baby, improving parental confidence, and increasing milk production and breastfeeding success. The main components of KMC are skin-to-skin contact in an upright position, exclusive breastfeeding on demand, and physical and emotional support for the mother from family and healthcare providers.
Kangaroo Mother Care (KMC) involves skin-to-skin contact between a mother and her low birth weight baby. It has benefits like improved breastfeeding, thermal regulation, bonding, and early discharge from the hospital. KMC begins once the baby is stable, involving positioning the naked baby chest-to-chest between the mother's breasts, secured with a binder. It facilitates breastfeeding and keeping the baby warm through skin-to-skin contact. KMC requires training staff, supporting the mother's involvement in care, and ensuring follow-up after early discharge.
(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.
This document provides an overview of Kangaroo Mother Care (KMC), which involves skin-to-skin contact between low-birth weight babies and their mothers. KMC promotes breastfeeding, thermal control, and parental bonding. It consists of prolonged, continuous skin-to-skin contact and exclusive breastfeeding. The benefits of KMC include increased breastfeeding rates, better temperature regulation, reduced infection risk, early discharge from the hospital, and stronger parental bonding. The document outlines the components, prerequisites, eligibility criteria, procedures, monitoring, and follow-up care involved in implementing KMC.
Kangaroo Mother Care . neonate. newborncarePooja Rani
Kangaroo Mother Care (KMC) is a technique for caring for low birth weight babies that provides skin-to-skin contact between the mother and baby to promote thermal control, breastfeeding, infection prevention, and bonding. Key components of KMC include prolonged, continuous skin-to-skin contact; exclusive breastfeeding; and early discharge from the hospital with regular follow-up care. KMC has benefits like increased breastfeeding rates, better temperature control for the baby, earlier discharge from the hospital, and lower morbidity for the infant.
Kangaroo mother care (KMC) involves continuous skin-to-skin contact between mother and baby, exclusive breastfeeding, and early discharge from the hospital. The document discusses the components and benefits of KMC, which include improved growth, reduced morbidity and hospital stay for low birth weight babies. A study found that babies receiving KMC had better weight gain and developmental measures than babies receiving conventional care in the hospital. KMC was also found to be acceptable, affordable and beneficial to mothers and families.
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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 – Miriam Adhikari, South African Journal of Child Health, Primary Newborn Care 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.
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Mother and Baby Friendly Care: Practice of kangaroo mother care
1. 4
Practice of
Kangaroo
Mother Care
KMC is a way of keeping mother and infant
Objectives together.
4-2 How can you get health care workers to
When you have completed this unit you accept Kangaroo Mother Care?
should be able to:
It is often not easy to get KMC started in a
• Promote Kangaroo Mother Care.
hospital or clinic as both medical and nursing
• Teach a mother how to give Kangaroo staff may think that KMC is dangerous and
Mother Care. will result in more work and expense. Any
• Use Kangaroo Mother Care in the nursery. new idea is difficult to introduce at first. A
• Establish a Kangaroo Mother Care ward. clear description of KMC, together with the
• Teach ambulatory Kangaroo Mother Care. advantages and safety must be presented to all
the staff, including the senior management.
• Use Kangaroo Mother Care for transport.
Allow time for discussion where questions and
fears can be raised. KMC will not be successful
unless the staff are convinced that it can be
done and will benefit mothers and infants.
PROMOTING KANGAROO
It is very useful if a few of the staff can
MOTHER CARE visit a hospital where KMC is being used
successfully. Here they can see KMC at first
hand. It would also help to invite a few staff
4-1 What is Kangaroo Mother Care?
members from another hospital, where KMC
Kangaroo Mother Care (or skin-to-skin care) has been established, to present a talk on
is a method of caring for newborn infants. their experience.
The infant is nursed between the mother’s
KMC is a radical change from the traditional
bare breasts in direct contact with her skin.
western model of caring for small infants. The
Kangaroo Mother Care (KMC) is particularly
main obstacles to the introduction of KMC are
useful for nursing low birth weight infants
fixed ideas and attitudes. Introducing KMC
(infants with a birth weight below 2500 g).
into a service represents a major shift in the
2. PRACTICE OF K ANGAROO MOTHER CARE 53
way infants are managed. All the staff must 4-5 What are Kangaroo Mother Care
‘buy in’ to this new method of mother and guidelines?
infant care or it will not be successful
KMC guidelines explain how KMC is
implemented. Formal written protocols
4-3 How is Kangaroo Mother Care are needed in the guidelines. Copies of the
implemented? guidelines must be freely available in hospitals
The implementation of KMC depends on the and clinics where KMC is practiced.
following: It may be useful to get copies of the KMC
1. The staff ‘s acceptance of KMC. policy and guidelines from another service
2. Adopting a KMC policy. where KMC is used successfully. These
3. Writing KMC guidelines. documents can guide the process of writing
4. Training the staff to use KMC. the KMC policy and guidelines in your
5. Teaching mothers to give KMC. service. KMC should be promoted as a safe,
6. Establishing facilities for KMC. effective and affordable method of caring for
7. Managing ambulatory KMC. newborn infants.
8. Educating the community to accept KMC. There are no fixed rules for KMC. Each
Every maternal and neonatal service should hospital and clinic has their own preferences
have both a Kangaroo Mother Care policy and while each mother has her own likes and
a clear set of guidelines. Health care workers, dislikes about KMC. However, it is important
managers, policy makers and funders need that the principles and guidelines are followed.
to be convinced that KMC offers better, more
cost effective care. 4-6 Who should promote the practice of
Kangaroo Mother Care?
All the staff must be encouraged and trained to All members of the staff, including nurses,
help mothers provide Kangaroo Mother Care to doctors and administrators. In order that
their small infants. KMC succeeds, the whole staff must support
the idea and play a roll in writing the KMC
policy and guidelines. Every mother should
4-4 What is a Kangaroo Mother Care policy? know about KMC. The general public should
also know about KMC. In particular, the
The KMC policy is a written statement which infant’s grandmothers needs to be educated to
gives the benefits of KMC and commits the support KMC both in hospital and at home.
service to implement and promote KMC. It
does not have to be a long and complicated
document. The KMC policy must be displayed The practice of Kangaroo Mother Care should be
for staff and patients to see. supported and promoted by all members of the
NOTE The Bogotá Declaration on KMC, signed at
staff.
the second International Workshop on KMC in
Colombia in 1998, declares that KMC is a ‘basic
right of the newborn’ and ‘should be an integral 4-7 How are mothers informed about
part of the management of low birth weight and Kangaroo Mother Care?
full term newborns, in all settings and at all levels
of care and in all countries’. Many mothers have never heard about KMC
and are afraid to give KMC, especially to
small infants. Often mothers feel that their
infant will receive better care in an incubator.
Therefore, the benefits, safety and method of
giving KMC must be explained to the mother.
3. 54 MOTHER AND BABY FRIENDLY CARE
Once the community learns about KMC, to give continuous KMC for a few days before
many mothers will ask if they can also give their infants are discharged home.
KMC to their infants. The method, advantages
and implications of KMC should be discussed
with the mother as soon as a low birth weight
All pregnant women should know about
infant is born. She needs to know that she Kangaroo Mother Care.
may have to stay longer in hospital, give KMC
when the infant is discharged home, and
4-10 What is a Kangaroo Mother Care
attend a follow up clinic.
support group?
4-8 How can the public be informed about This is a group of mothers who have
Kangaroo Mother Care? themselves given their infants KMC. They are
very effective in promoting KMC and helping
It is important that the general public knows other mothers to provide KMC. They can
about and understands the benefits of KMC. give KMC education at antenatal clinics or
The media has an important role to play in encourage and assist mothers to give KMC in
promoting KMC. The following can be used to the nursery or KMC ward. Members of the
inform the public about KMC: support group can also teach mothers how to
1. Teaching KMC at schools. express breast milk. This assistance can be of
2. Showing KMC in the media, especially TV enormous help to the nursing staff, especially
and the local newspaper. in hospitals and clinics where staffing is
3. Discussing the benefits of KMC in the inadequate. While some helpers are voluntary,
media, especially radio and magazines. others may need to be paid a small fee. Even
4. Using KMC posters or video presentations a few hours help each day will be very useful.
in primary health care clinics. Someone needs to be identified to start and
manage a KMC support group.
Kangaroo Mother Care should be promoted
4-11 Why should KMC be supported by
among the general public. local clinics?
Because these clinics will be involved in
4-9 When should mothers first be told providing follow up care to mothers who
about Kangaroo Mother Care? are giving KMC to their small infants after
discharge from hospital. Therefore, the clinic
From the start of antenatal care when KMC
staff will also need information and training
should be included as an important part of
in KMC.
educating pregnant women. The best method
of teaching women about KMC during the
antenatal period is for them to see other
mothers providing KMC for their infants. THE METHOD OF
Videos can be shown at antenatal clinics and KANGAROO MOTHER CARE
information sheets can be provided to inform
pregnant women about KMC.
When small infants are first admitted to a 4-12 How does a mother give Kangaroo
newborn nursery for incubator care, their Mother Care?
mothers must be told that they will need to The almost naked infant (wearing only a
provide intermittent KMC as soon as their nappy and woollen cap) is placed between the
infants are well enough. They will also need mother’s bare breasts. If the room is cold, the
infant can wear a cotton shirt, open in front.
4. PRACTICE OF K ANGAROO MOTHER CARE 55
The infant is nursed upright, facing the mother mother’s back and then tied fast in front.
with the arms and legs flexed in the frog The tails support the infant.
position, under the mother’s shirt, blouse, T- 4. In preterm infants it is important to make
shirt or dress. Keeping the infant upright helps sure that the airway is never obstructed.
to prevent vomiting. All mothers should be The infant’s head should be turned to one
taught how to nurse their infant in the KMC side and slightly extended to keep the
position. The mother does not need to shower airway open. Do not allow the infant’s neck
or wash her chest before giving KMC. to be flexed or over extended. The top edge
of the towel or binder should be just under
the infant’s ear. It is best if small infants are
kept upright between the mother’s breasts
and not allowed to slip sideways.
5. If the mother is lying down, she and her
infant should be kept at an angle of about
45° by raising the head of the hospital bed
or be using a large pillow or a number of
pillows or cushions.
Special binders or carrying pouches are
commercially available and can be helpful.
4-13 How is the infant kept in position?
It is important that the infant is kept warm
and held securely. Holding the infant skin-to-
skin, chest-to-chest against the mother will
keep the infant warm. The mother should
have her hands free and be able to walk
around. A number of methods are used to
keep the infant in place:
1. Usually the mother’s shirt or blouse is
tucked into her belt or trousers to prevent
the infant slipping out.
2. Sometimes a blanket or cotton towel can
be tied around the mother as a binder No special equipment is needed to give Kangaroo
to hold the infant firmly. The binder can Mother Care.
be tied, pinned or tucked in to keep it in
place. A shirt or blouse can be worn over
the binder. A ‘boob-tube’ is useful.
3. A special KMC top (a pouch) can be used
but this is not essential. A KMC top looks
like an open shirt with long tails. The shirt
is pulled closed in front by crossing the
tails. The tails are wrapped around the
5. 56 MOTHER AND BABY FRIENDLY CARE
KANGAROO MOTHER CARE 4-17 How should the infant be taken out of
the incubator for Kangaroo Mother Care?
IN THE NURSERY
It is important that the infant does not get
cold. Before removing the infant, make sure
4-14 Which infants can be given Kangaroo that it is wearing a woollen cap and clean
Mother Care in the nursery? nappy. If the infant is receiving an intravenous
infusion or has skin probes, be careful that
Most infants can be given KMC as long as they they are not pulled loose.
are stable with a normal skin temperature,
heart rate and breathing rate. Both infants in
4-18 Should the infant be monitored
cots and incubators can be given KMC. Even
during Kangaroo Mother Care?
infants on ventilators can sometimes be given
KMC provided that their condition allows this 1. Infants that are not being monitored in
KMC has the most benefit in low birth weight the cot or incubator do not need to be
infants. All low birth weight infants should monitored during KMC.
routinely be offered KMC once they are stable. 2. Infants who are not having apnoeic attacks,
but are being routinely monitored with
Where there are no incubators, every very
an apnoea monitor, can be disconnected
small infant can be given KMC. In these
from the monitor during KMC. Switch off
circumstances, KMC can dramatically reduce
the apnoea alarm when the infant is taken
the mortality of low birth weight infants.
out of the incubator and placed in the
Severely ill infants who are going to die can also KMC position. Do not forget to switch the
be given KMC (compassionate KMC). Many apnoea monitor back on again when the
parents want to hug or hold their dying infant. infant is placed back in the incubator.
3. However, if the infant is being monitored
4-15 When should Kangaroo Mother Care for heart and respiratory rate or oxygen
be given in the nursery? saturation, this should be continued while
the infant is receiving KMC.
KMC should be given every time the parents 4. If the infant is having apnoea attacks, the
visit (intermittent KMC). The mother should infant is unstable and should either not
be encouraged to give KMC throughout the receive KMC or be monitored during KMC.
visit. Even if the visit is short, the infant will
benefit from KMC. Some mothers spend most NOTE If the infant is receiving continuous positive
of the day in the nursery and can give KMC airway pressure, be very careful that the tubing
is not disconnected. With care the infant can be
for hours at a time. Usually KMC is given for
moved from the incubator into the KMC position
a short period to start with and then the time without disturbing the ventilatory support.
of the KMC becomes longer as the mother Switch the incubator to non-servocontrol
becomes more confident. mode when the infant is taken out for KMC or
the incubator may overheat. Switch back to
4-16 Who should take the infant out of the servocontrol mode when the infant is replaced
incubator for Kangaroo Mother Care? into the incubator.
The mother needs to be shown how to remove 4-19 Where should the mother sit to give
the infant and how to put the infant back into Kangaroo Mother Care?
the incubator safely. Once the mother is able
to do this correctly, she can take the infant out It is best if the mother sits next to the cot or
and put it back by herself. It is important that incubator in a comfortable chair. Once the
the mother informs the nursing staff when she infant is well and no longer needs ventilatory
wants to give KMC. She must always wash her support, intravenous infusions (drips) and
hands well before touching her infant. skin probes or electrodes, the mother may
6. PRACTICE OF K ANGAROO MOTHER CARE 57
give KMC while walking about with the infant 4. Put the infant to the nipple every time she
in the nursery. gives KMC. It does not matter if the infant
only suckles for a few minutes.
4-20 What special facilities are needed in With encouragement, many small infants
the nursery for Kangaroo Mother Care? will take part or all of their feed from the
No special facilities are needed. Comfortable breast. The mother should start to express
chairs for the mother and partner are her breasts from the day the infant is born.
required. Simple plastic chairs are adequate. A Until breastfeeding is established, the infant
refrigerator is helpful to store expressed breast should be fed expressed breast milk by cup or
milk. In a very crowded nursery, space must nasogastric tube.
be created for parents to visit and give KMC.
4-24 What is a lodging ward?
4-21 Should the infant’s skin temperature be Often mothers have difficulty visiting their
monitored during Kangaroo Mother Care? infants every day as they live far away and
This is usually not necessary if the infant’s transport is expensive and infrequent. It is
temperature has been stable in the incubator. very helpful if these mothers can stay in or
near the hospital on a 24 hour basis so that
4-22 What feeds should be given in the they can give intermittent KMC to their
nursery during Kangaroo Mother Care? infants in the nursery.
As far as possible, give the infant its mother’s This facility is often called a lodging ward.
own milk. Exclusive breast feeding is by far the However, it is not a typical hospital ward as
best for low birth weight infants. Some small these mothers are well. It is one or more rooms
infants will breastfeed while others will have where mothers can be given accommodation.
to be fed expressed breast milk by nasogastric Often the lodging ward is next to the nursery
tube until they are mature enough to suck and and KMC ward so that they can share facilities.
swallow. Some mothers will choose to give The lodging ward needs to be supervised to
formula feeds. Theses infants should be fed by ensure cleanliness and security but nursing is
cup rather than bottle. not required. Mothers in a lodging ward need
a bed, somewhere to sit and relax, and a place
to keep their clothes and belongings safely.
Exclusive breast feeding is by far the best for low
birth weight infants.
A lodging ward provides a mother with a place
to stay so that she can be near her infant in the
4-23 How can a mother encourage a small nursery at all times.
infant to breast feed during Kangaroo
Mother Care?
It is not expensive to accommodate mothers
1. Hold the infant correctly to place the in a lodging ward. By providing breast milk
infant’s mouth over her areola (latch and giving KMC, they reduce the hospital cost
properly). Often the ‘foot ball’ position of caring for small infants. Without a lodger
is easiest. Infants can breastfeed while ward, many mothers would be discharged
receiving KMC. home and would not be able to afford the
2. Express a little milk onto the nipple before transport to visit their infants regularly.
latching the infant.
3. Place the nipple into the infant’s mouth
even if the infant does not suckle well.
7. 58 MOTHER AND BABY FRIENDLY CARE
A KANGAROO MOTHER 4-27 What facilities are needed in the
Kangaroo Mother Care ward?
CARE WARD
1. A space for the mothers to sleep. One to
four rooms with four beds per room is ideal.
4-25 What is a Kangaroo Mother Care ward? 2. A living space where the mothers can eat
and relax.
This is a special room where mothers can 3. Toilets, showers and hand basins
room-in for a few days so that they can give
continuous KMC to their infants under Cribs are not needed in a KMC ward as the
supervision both day and night. Most of these infants are continuously with their mothers.
mothers are well and do not need nursing However, plastic bassinettes are sometimes
care or routine observations. Every effort used to bath infants. The room temperature
must be made to make the KMC ward as should be 22–24 °C.
homely as possible and not look like a typical Mothers should be able to give KMC during
hospital ward. Mothers are encouraged to meals. Daily showering or washing is
wear their own clothes and walk around. The adequate. Mothers must wash their hands
KMC ward should be close to the nursery if after going to the toilet. Facilities for washing
possible. Ideally, a door should link the KMC clothes are needed.
ward with the nursery so that help can be
obtained if needed. Limited visiting is allowed Some facilities can be shared with the
in the KMC ward but the mothers’ privacy lodging ward. Mothers in the lodger ward
must be respected. can be encouraged and supported by meeting
mothers in the KMC ward. In future all
neonatal nurseries should be designed with
A ‘KMC ward’ enables the mother to give her both a KMC ward and a lodging ward nearby.
infant Kangaroo Mother Care both day and night
while being supervised by the staff. 4-28 What furniture is needed in the
Kangaroo Mother Care ward?
At night most mothers prefer to sleep on their
The following is recommended:
backs with the infant on their chest and their
head and shoulders propped up with pillows 1. Basic beds. Special hospital beds are not
into a semi-sitting position. Other mothers needed but enough pillows are necessary.
sleep on their side with the infant still in the 2. Small lockers where the mothers’ clothes
KMC position. and personal items can be safely kept.
3. Comfortable chairs where mothers can sit
4-26 What is the importance of a Kangaroo to breast feed and give KMC. Light plastic
Mother Care ward? chairs are cheap and practical.
4. Tables and chairs for meals.
A dedicated KMC ward provides a very 5. Desk, chair and basic office equipment for
valuable step between giving intermittent the staff. A telephone is useful.
KMC in the nursery and giving continuous 6. Cupboards for storing extra blankets.
KMC at home. In a KMC ward mothers gain 7. Curtains to allow some privacy are useful.
experience and confidence before going home
with their infants. Mothers support, teach and There should be no cots in the KMC ward. The
encourage each other. mother can wrap up her infant and leave it on
the bed when she goes to the toilet. If there is
not enough space for chairs, mothers will have
to sit on their beds, and have their meals in
another room nearby.
8. PRACTICE OF K ANGAROO MOTHER CARE 59
It makes an enormous difference if the KMC KMC but also about other aspects of health.
ward is attractively painted, new curtains and Talks, discussion groups, demonstrations and
bed covers are made, and posters or murals educational videos are used. Topics, which
of KMC are put on the walls. Funding can should be taught in the KMC ward, include:
usually be obtained from local charities.
1. How to give KMC correctly and provide
exclusive breastfeeding.
4-29 What nursing is needed in the 2. How to give KMC after discharge home.
Kangaroo Mother Care ward? 3. The importance of regular attendance at
A nurse is needed to supervise the mothers the follow up clinic.
in the KMC ward. It helps that most mothers 4. The importance of the Road-to-Health card.
have already been trained in KMC before they 5. The importance of immunisations for the
reach the KMC ward. It is important to have infant.
a nurse who is experienced and enthusiastic 6. How to cup feed an older child.
about KMC. A professional nurse is preferable. 7. The giving of daily vitamins and iron to
However, a non-professional nurse can be preterm infants.
used as the KMC ward supervisor. It is helpful 8. A healthy diet and lifestyle for the mother.
but not essential to have a nurse in the KMC 9. How to avoid infection with HIV.
ward at night. If a nurse is not available, the 10. Family planning.
KMC ward must be close to the nursery so The main problems in a KMC ward are
that the mothers can call for help if needed. boredom and frustration. Other than
Usually a team of two or three nurses is education, activities such as knitting woollen
needed to provide adequate day cover in a caps, reading magazines and arts or crafts
KMC ward. The nurse should have experience should be encouraged. A radio and television
in caring for low birth weight infants and be set with a video or CD player are useful as
able to recognise an ill infant. are a kettle, toaster and microwave oven.
Volunteers (lay helpers) are of great help in a Community groups can be invited to help
KMC ward. They can encourage mothers, help with some of these activities. Smoking must
them give KMC and teach them to express not be allowed.
their breast milk if necessary. A kind, motherly
person who has breast fed and given KMC to 4-31 Why may teenagers not want to stay
her own infant is an ideal helper. Many helpers in a Kangaroo Mother Care ward?
only work one or two days a week, often in the
Teenagers are naturally rebellious and often
mornings. Some helpers may need funds for
do not easily accept any form of authority.
transport or a small payment for their time.
An unhappy teenager may disrupt the
Usually only well, thriving infants are admitted normal routine in a KMC ward and they may
to the KMC ward. However, if infants below require support and understanding from
1500 g or infants still being fed by nasogastric the staff. Weekends are often most difficult
tube are admitted, then an experienced nurse for teenagers who want to be with their
is needed both day and night. Good cord care friends. They may also be anxious about their
must not be forgotten. boyfriend or partner.
Many mothers in both the lodger and KMC
4-30 What education opportunities can be wards may need ‘time out’ to go home for a
offered in a Kangaroo Mother Care ward? few days. This is important for women who
The mother’s stay in a KMC ward provides an have other children at home. Some may have
ideal opportunity for education. It is important spent weeks or months in hospital. While she
that the nurses in the KMC ward are able is away, her infant will have to go back into an
to provide education, not only about giving incubator in the nursery. Mothers rarely stay
9. 60 MOTHER AND BABY FRIENDLY CARE
away for more than a few days as most have hospital for running a KMC ward, as the
already formed a strong bond with their infant mothers need food and bedding. Sometimes
during intermittent KMC. It gives them time mothers may have to bring their own food
to prepare for the infant’s arrival at home. and bedding. The KMC ward has to be
cleaned and staff are needed to supervise the
4-32 When should mothers and infants be mothers. However, there is a great financial
discharged from a Kangaroo Mother Care saving because:
ward? 1. The mothers provide all the care for their
When the mother is able and confident to infants.
care for her infant at home. The weight and 2. Less formula is needed, as most of the
gestational age of the infant are less important infants are being breast fed.
than its maturity. Usually the infant is 3. The infants are discharged home earlier
discharged from the KMC ward when both from the nursery.
mother and infant are ready. 4. There is also less infection in the nursery.
5. Less staffing is needed than with
The following criteria should be met before conventional incubator care.
the mother and infant are discharged from the
KMC ward:
A Kangaroo Care Mother ward makes a great
1. The mother must be able to provide KMC
financial saving for the hospital.
correctly and should be confident to look
after her infant. Usually the infant is fully
breast fed. The infant must be taking all Similarly, it is cost efficient to run a lodging
feeds by mouth. ward.
2. The infant and mother should be clinically
healthy and the infant should be gaining 4-34 How can funding be obtained for a
weight at a rate of 20 g or more a day).. Kangaroo Mother Care ward?
3. The home and family must be prepared for Many hospitals have obtained funding for
the mother and her infant. their KMC ward from private institutions,
4. Arrangements must be made for regular charity groups and service organisations.
follow up at a local clinic.
Care in the KMC ward should be seen as a
step between discharge from the nursery and AMBULATORY KANGAROO
discharge home. Most mothers only need to
spend a few days in the KMC ward unless
MOTHER CARE AT HOME
their infant is very small. Infants are usually
discharged home when they are 1500 g or
4-35 What is ambulatory Kangaroo Mother
more. Many KMC wards discharge their
Care?
mothers when the infants reach 1800 g.
Infants receiving KMC are often discharged The word ambulatory means to ‘walk around’.
a little later in the cold season. The better the Ambulatory KMC usually refers to the KMC
follow up facilities, the sooner infants can be which is given after the infant has been
discharged home. discharged home from the hospital or clinic.
These mothers give home (or ambulatory)
4-33 How expensive is a Kangaroo Mother KMC throughout the day. Most work in the
Care ward? house (e.g. washing up) can be done while
giving KMC. Mothers can give KMC while
Some funding is needed to establish a KMC walking around in or near their homes.
ward. Thereafter, there is a small cost to the Ambulatory KMC should also be given when
10. PRACTICE OF K ANGAROO MOTHER CARE 61
attending the clinic, visiting friends, on the 4-38 How should you follow up infants
bus or going shopping. Many low birth weight receiving ambulatory Kangaroo Mother
infants need KMC for days or weeks after Care at home?
they are discharged home. Mothers must
As many of these infants are still small when
be convinced of the benefits of KMC and
they are discharged home, they should be seen
committed to give KMC at home.
regularly at the hospital or community based
local clinic to check that the infant is well and
Ambulatory Kangaroo Mother Care is given when the mother is managing. The infant’s weight
the mother and infant are both well and the must be measured to ensure that the infant is
mother is able to walk around with her infant. receiving adequate feeds and gaining weight.
Failure to gain weight must always be carefully
assessed. The clinic visit gives an opportunity
4-36 Which infants would benefit from to discuss KMC with the mother. Any
ambulatory Kangaroo Mother Care at problems can be identified and corrected.
home?
4-39 How often should infants, receiving
Infants that still weigh less than 2000 g would
ambulatory Kangaroo Mother Care at
benefit greatly from KMC at home. Some
home, come for a check up?
infants between 2000 g and 2500 g would also
benefit from KMC, especially when it is cold. The smaller the infant, the more frequently
the infant should visit a clinic. Below 1500 g,
daily checkups are needed. From 1500 g and
Low birth weight infants can benefit from above, three to four visits a week until 1800 g.
ambulatory Kangaroo Mother Care at home after Thereafter, weekly visits until the infant
discharge from hospital. reaches 2500 g. These recommendations
should be seen only as a guide, and will
NOTE KMC has not been well researched in depend on the mother, on her family and
the home setting. However, wide experience support systems, on distances and ease of
suggests that it is both safe and very effective in access to the clinic, and on how the infant
allowing early discharge from hospital, promoting
is growing. More frequent follow up may be
breastfeeding and encouraging bonding. Mothers
are more relaxed and better rested at home. needed in the cold season.
Many mothers giving ambulatory KMC to
4-37 When should a mother give small infants at home spend most of their day
ambulatory Kangaroo Mother Care? in the KMC room at the local clinic. Here the
staff can support and supervise the mothers.
It is best to give ambulatory KMC all the time.
Some facilities have a special KMC clinic. This
It can be given while the mother performs
may be a better option than keeping mothers
most household duties. When she is not able
and their infants in an overcrowded hospital.
to give ambulatory KMC, the infant should be
given KMC by another responsible member of
the household. KMC can be given outside the Frequent follow up visits at a Kangaroo Mother
home when the mother goes shopping, catches Care clinic are essential for low birth weight
a bus or train, or attends the local clinic. infants getting Kangaroo Mother Care at home.
11. 62 MOTHER AND BABY FRIENDLY CARE
4-40 When can ambulatory Kangaroo during transport. Every effort must be made
Mother Care be stopped? to keep the mother and infant together. Some
KMC training is needed by the transport staff.
Infants usually decide for themselves when
KMC can be stopped. As infants get older and
their weight increases with more subcutaneous 4-43 What are the advantages of using
fat, they become hot and restless during Kangaroo Mother Care for transport?
KMC and try to climb out of the mother’s Delays are avoided, as there is no need to wait
dress. Mothers of low birth weight infants for a transport incubator. This is particularly
should try to continue KMC until at least important when moving low birth weight
2000 g is reached. By 2500 g, most infants no infants to a level 2 or 3 hospital. It is also very
longer need KMC. However, these infants useful when moving well low birth weight
still need close contact with the mother, and infants back to the referral hospital. This
breastfeeding. Keeping older infants on their avoids many of the problems that commonly
mother’s back or in a sling is recommended. occur when arranging transport. KMC in a
motor car or van is ideal for transferring well,
low birth weight infants.
KANGAROO MOTHER CARE
FOR TRANSPORT Kangaroo Mother Care can be used to transport
infants.
4-41 Can Kangaroo Mother Care be used to
transport infants? 4-44 What staff are needed to supervise
Yes. Many stable newborn infants can be safely Kangaroo Mother Care during transport?
transported with KMC. This is a cheap and KMC is usually given by the mother when
very effective method, as a transport incubator transporting infants. She needs to be
is not needed. If the infant is sick or unstable, supervised by a member of the ambulance
it is still safer to use a transport incubator. staff or an accompanying nurse. Usually the
NOTE The use of KMC during transport has not ambulance staff alone are able to supervise
been fully researched. If a sick infant needs to be KMC during transport.
transferred urgently, and a transport incubator
is not immediately available, the use of KMC by 4-45 Can Kangaroo Mother Care be safely
trained staff who can monitor the infant and
used in a private car?
give oxygen or even mask ventilation may be
preferable to a long wait for a transport incubator. Yes. It is best if the mother sits in the back
It is unacceptable for a small infant to seat and wears a seat belt. Only the hip belt
arrive cold at a hospital because a transport should be used. The seat belt should not be
incubator was not available when KMC could placed over the infant but between the mother
have been used. KMC can also be used to and her infant. The infant can be tied to the
warm cold infants. mother’s chest with a towel. Make sure that the
infant’s neck is not flexed as this may interfere
with breathing.
4-42 How is Kangaroo Mother Care given
during transport?
Usually the mother gives KMC. However, CASE STUDY 1
a nurse or member of the transport team
can also give KMC if the mother is not well A mother attending antenatal care says that
enough or is not moved with the infant. Even she has read about KMC in a magazine and
the father or grandmother could provide KMC
12. PRACTICE OF K ANGAROO MOTHER CARE 63
wants to know how this is done. The clinic 1. Is this infant not too small to be given
staff are unable to help her as they have no KMC?
experience of KMC.
No. Most small infants can be given KMC,
especially if they are healthy and stable.
1. Who should be able to advise her about
KMC?
2. For how long should the mother give
All the staff members at the clinic should KMC during her visits?
know about KMC. The staff who care for
For the whole of the time that she visits her
her at the antenatal clinic must give her
infant. The more time she spends giving KMC
the information that she needs. Giving
the better.
information on KMC is an important part of
antenatal care. Videos or CDs are a very useful
way of teaching pregnant women about KMC. 3. Could her partner also give KMC?
It is important to encourage bonding between
2. How can the public be informed about the infant and both parents. Therefore, the
KMC? father should also have an opportunity to give
KMC. This will also help him understand and
Through the schools, radio and TV, newspapers
support the mother when she gives KMC.
and magazines, and health care facilities.
4. What special facilities are needed to give
3. Which family member often influences a
KMC in the nursery?
woman’s decision to use KMC or not?
All that is needed is a comfortable chair. It is
The grandmother. The whole family should
best if the mother is able to give KMC beside
support a mother giving KMC.
the incubator.
4. When should a pregnant woman first be
5. Why is it important that the mother
told about KMC?
learns how to express her breasts?
At the beginning of her pregnancy as soon as
Because the infant needs expressed breast milk
she starts antenatal care. There is a possibility
feeds as it is still too immature to suck. One
that any pregnant woman might deliver
of the most important skills that all mothers
preterm and need to give KMC to a small
should learn is how to express their milk.
infant.
CASE STUDY 2 CASE STUDY 3
The matron of a maternity hospital calls a
The mother of a 1500 g newborn infant visits
meeting of her staff. She is keen to start a
the nursery. Her infant appears healthy and
KMC ward as the well baby nursery is grossly
is being nursed in an incubator. The infant
overcrowded. She asks how KMC can be
is still being fed by nasogastric tube. The
given by mothers who are already living at the
nursery staff ask the mother whether she is
hospital to be near their infants. She also needs
willing to give KMC during the times that
to know what equipment will be required and
she visits her infant. They show her how to
whether this will be very expensive.
express her breast milk.
13. 64 MOTHER AND BABY FRIENDLY CARE
1. Will a KMC ward help to solve the CASE STUDY 4
problem in this nursery?
Overcrowding is a very common problem in The young mother of a low birth weight infant
hospital nurseries. The overcrowding, with the gave intermittent KMC while visiting her
resultant stress on the staff and high rate of infant in the nursery. Later she stayed with her
infection, will be greatly improved if a KMC infant for 5 days in a KMC ward. At discharge
ward is started. the infant was healthy, breast feeding well and
gaining weight. The infant’s discharge weight
2. What space will be needed for a KMC was 1750 g. On the day after discharge she was
ward? asked to attend the local well baby clinic.
A space for the mothers to sleep, a living area
1. Is it wise to discharge an infant with such
where they can eat and relax, and toilets and
a low weight?
showers.
It is safe to discharge this infant provided that
3. Will a special area have to be built for a it is healthy, feeding well, gaining weight and
KMC ward? receiving KMC.
A room will be needed where mothers and
2. How often should the infant receive KMC
their infants can stay together. One of the
at home?
rooms previously used for mothers of infants
in the nursery could probably be converted All the time, both day and night. Someone
into a KMC ward. else reliable can give KMC if the mother
needs a break.
4. What furnishing is required?
3. When should the infant be taken to the
Simple beds, comfortable chairs, lockers for
clinic?
clothes, and tables and chair for meals.
On the day after discharge and then three or
5. What nurses will be needed for the KMC four times a week until a weight of 1800 g is
ward? reached. Thereafter, weekly visits are usually
adequate. With very small infants receiving
An experienced and enthusiastic nurse will be ambulatory KMC at home, it is best for the
needed to supervise the mothers. Staffing is far mother and infant to visit the clinic every day
less than that required in a well baby nursery. so that the infant’s weight gain can be checked
However, staff need to have the skills necessary and the mother supported.
to teach and support KMC. Volunteers are also
very useful to assist in a KMC ward.
4. When can ambulatory KMC be stopped?
6. Will establishing a KMC ward not be very When the infant reaches 2500 g.
expensive?
Some funding will be required to start the
KMC ward. Thereafter, the savings to the
CASE STUDY 5
hospital will be greater than the running costs.
A mother is transferred to a level 2 hospital on
the day after delivery for investigation of a heart
murmur noted during labour. Her well 1700 g
infant is not moved with her as the transport
incubator is broken. She is very upset about
being separated from her newborn infant.
14. PRACTICE OF K ANGAROO MOTHER CARE 65
1. What is incorrect about the management 3. What could have been done to keep this
of this mother and infant? infant warm if the mother was too ill to
give KMC?
They should not have been separated. The infant
should have been moved with the mother. A nurse or ambulance driver or her partner or
the grandmother could have given KMC on
2. How could the infant have been kept the way to hospital.
warm during transport?
The mother could have given KMC.