Origins of Kangaroo mother care (KMC)
In 1978, Dr. Edgar Rey Sanabria, a professor of pediatrics at the NICU of Bogotá City Hospital in Colombia, adopted the idea of having mothers of low birth weight babies come to the ward to make skin-to-skin contact, keep their babies warm and breastfeed them, in order to alleviate the lack of equipment and staff and to improve the survival rate of newborns. . The next observations found that this approach resulted in earlier discharge of preterm infants, lower rates of in-hospital infections, and increased maternal confidence and satisfaction.
KMC has now become an important approach to the care of premature babies, and in 2011, May 15 of each year was designated as International Kangaroo Mother Care Promotion Day.
Methods of KMC
It is a good idea for the mother (and father, too) to shower and change into clean clothes before arriving at the NICU. Wear a shirt, not a bra. Upon arrival at the hospital, semi-recline in a recliner (or sitting position) with the nurse’s guidance and unfasten the shirt. The baby is removed from all clothing and wears only a cap and diaper. The baby is placed facing the mother on the chest in a position similar to the fetal position, in contact with the mother’s skin. The mother’s one hand or arm holds the baby and the other hand holds the baby’s head and neck so that the baby is in a fetal-like position. A blanket may be brought to secure the infant and then enclose the infant with the blanket.
It can be started at what time
Theoretically, it can be started immediately after birth. However, because premature infants have unstable vital signs at birth, they require many medical treatments, including respiratory and circulatory support, postural support, etc. Kangaroo care can be started once the vital signs are stable, mostly 1 week after birth, when the mother has also passed through the pain and medical treatment associated with the birth.
How long each session lasts
There is no time limit, depending on the condition of the baby and the time tolerated by the mother. Of course, it can be suspended if there are fluctuations in respiration, oxygen saturation, heart rate, or if detubation occurs. Half an hour is appropriate at first, then it can be extended.
Benefits from KMC
Doctors usually confirm its effects through rigorous trials, so let’s take a look at the results published in a prestigious clinical research website (Cochrane Library). 3 studies with a total of 1362 low birth weight infants were involved and could
reduce the rate of nosocomial infections by 41 weeks
reduce the severity of illness and respiratory infections
reduce the rate of non-exclusive breastfeeding at hospital discharge
Reduce the rate of maternal dissatisfaction
Increase mothers’ confidence in competent care
Improved weight gain (exceeded control group by 3.6 g/d)
No difference in psychomotor development at 12 weeks postnatal
Increased parental contact with preterm infants, increased parental involvement and satisfaction
Reduced infection rates and shorter hospital stays
Above is another study published in Pediatrics (English) in 2002, which illustrates that infants in kangaroo care (KC) had better motor development (PDI) and mental development (MDI) than controls.
Problems we encountered performing KMC
Medical side effects: None.
KMC can significantly increase the workload of nurses.
Possible inappropriate position can lead to apnea and fluctuation of oxygen saturation, which is more worrying for medical staff and parents.
There is not enough space and privacy.
Not considered important by medical staff or parents.
Kangaroo mother care, from first contact!