Kangaroo Mother Care

02-12-2020

For better health outcomes for premature infants

“Kangaroo Mother Care is a comprehensive intervention recommended for all newborns especially those born too soon or too small. It is the most feasible and preferred intervention for decreasing neonatal morbidity and mortality” – Healthy Newborn Network, 2020

Babymoon care

Most babies born too soon or too small are prone to a range of diseases, learning disabilities and in some cases, death. According to UNICEF, complications from preterm birth,account for nearly 1 million deaths each year. Social, economic, gender and geographic disparities can exacerbate the circumstance.

Achieving physiological independence during the transition from intra- to extrauterine life reflects the the infant’s ability to maintain homeostatic control. This is a time of high risk, and specifically preterm infants are at higher risk of mortality and morbidity because of underdeveloped physiological functions such as, cardiac, respiratory, neurophysiology, gastrointestinal, musculoskeletal, renal, metabolic, and immunity.

“Every year, 15 million babies are born prematurely – more than 1 in 10 of all babies around the world.” – UNICEF

In most countries, the use of incubators is the standard for thermal care of babies born too soon or too small. However, incubator care is not widely available especially in developing countries. Problems such as cost burden, maintenance and power outage reduces the availability of functional incubators. Furthermore, babies in incubators are separated from their mothers which strains the attachment between mother and baby. Fortunately, there’s an alternative approach for improving the survival of premature babies- namely Kangaroo Mother Care (KMC).

The key elements of kmc are:

  • Position: early, continuous and prolonged skin-to-skin contact between the mother and the baby
  • Nutrition: exclusive breastfeeding
  • Discharge: with adequate support and follow up
  • Support: supportive environment in the health care facility and at home.

KMC is a method of care of preterm infants introduced more than 40 years ago in Bogota, Colombia, as an alternative approach to traditional neonatal intensive care unit (NICU) care for low-birth weight infants. The method involves a diaper-clad infant being carried in an upright prone position skin-to-skin with the parent (most often the mother) and covered with clothing, to regulate temperature and breathing, enable breast feeding and promote mother and baby bonding. The duration of skin-to-skin contact varies but usually lasts 1 – 3hours per session with cardiorespiratory and temperature monitoring of the infant during this time. It is a cost-effective and easy-to-use method to promote the health and well-being of infants born preterm as well as full-term. KMC has since been adopted in countries around the world.

Implementation and research have made it clear that engaging parents in extended skin-to-skin front-to-front contact with their infants during prematurity and in the hour following birth are by now medically recognized and evidence-based interventions.

“Babies born too soon refers to babies born before 37 weeks of pregnancy are completed. Rates of preterm birth are rising in the majority of countries with adequate data. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born.” – World Health Organization, 2018

Physiology of premature infants

Ideally, the physiological birth of a human baby takes place at the end of 37–42 weeks in the uterus, where the environment is characterized by stable temperature and cushioning with amniotic fluid.

Afterward, development would normally progress with the mother providing most sensory care for the baby such as skin-to-skin contact, rhythmic movements and breastfeeding. When new experience is mismatched to the developmental stage, neurodevelopment is likely to be disturbed resulting in a neurobiological stress response, intensified by separation from the mother and removal of her capacity to promote regulation of her baby’s physiological status.

Several circulatory, cardiac, and pulmonary adaptations are required at birth for the lungs to successfully replace the placenta as the site of respiratory gas exchange. Preterm birth often challenges the immature cardiorespiratory functionality, resulting in a need for medical intervention and ongoing support. Neurophysiological aspects of premature baby are disturbed by preterm birth, resulting in the likelihood of long-lasting anatomical, and physiological neuropathology. Premature babies are at greater risk for developing various sensory defects, including sensory integrative disorders, than full-term babies. Affected sensory systems include tactile, vestibular, olfactory, auditory, and visual pathways.

Benefits of KMC to preterm infants

There are several evidence-based benefits of KMC as an aid to the mitigation of prematurity complications. Extended skin-to-skin contact in the hour following birth is now a medically recognized and evidence-based intervention that can save the lives of babies born too soon. The hour following birth has been found to be a delicate moment for the maturation of specific developmental skills, and the kind of care they receive has major and lasting effects on the infant. However, the time span where an infant is highly susceptible to the stimuli of infant carrying extends at minimum to 1000 days postpartum and beyond until an infant has achieved major motor milestones, such as sitting and crawling. Hence, infant carrying beyond prematurity and the postpartum hour supports the achievement of better neonatal health outcomes.

“Kangaroo Mother Care is recommended for the routine care of newborns weighing 2000 g or less at birth, and should be initiated in health-care facilities as soon as the newborns are clinically stable.” – World Health Organization, 2015

Benefits of infant carrying beyond prematurity and the postpartum hour

  • Improved nutritional outcomes through breastfeeding
  • ThermoregulationImproved gastrointestinal function
  • Decreased energy expenditure & satisfactory weight gain
  • Infants are much less stressed and this provides neurological protection to the infant and the result is:
  • Improved neurodevelopment
  • Better organized sleep patterns
  • More mature and organized electrical brain activity
  • Insecure early parent-infant relations predict a four-fold increase in adult illness. Infant carrying promotes attachment quality and represents a scalable and economically efficient intervention;.
  • Infant carrying modulates paternal hormones for strengthened family cohesion and dedication. Paternal child care involvement is associated with better social, emotional, and physical health for children. Early socio-emotional adversity is a strong predictor of substance abuse;
  • Infant carrying enables women to combine optimum motherhood during early infancy with socio-economic activities
  • Improved bonding between mother and infant
  • Significant cost-savings as well as better outcomes
  • Less dependence on incubators
  • Less nursing staff necessary
  • Shorter hospital stay
  • Improved morale & quality of careBetter infant survival with decreased morbidity and mortality rates

What Does Kangaroo Mother Care Look like in the 21st Century?

Every year on the 17 November is World Prematurity Day. With this year’s theme, Together for Babies Born too Soon – Caring for the Future; Babymoon Care plays an important role by supporting families with premature infants by promoting attachment therapy, ensuring parents who are actively involved in the care of their newborn are in close physical and emotional contact with their baby as early after birth as possible, during hospitalization and at home. This active involvement decreases parental stress, enabling parents to better care for their baby, positively affecting on the parent-child bond and family life in general.

Babymoon Care’s Solutions combine health, fashion and tech for parents in the 21st century and beyond enabling them to practice KMC safely and efficiently in hospitals and/or at home. Our solution today supports the World Health Organization’s recommendation to move from using simple carriers to using solutions which support infant-attachment. We leverage millennia of effective parenting, by replacing common baby carriers with engineered babywearing solutions to achieve better infant & toddler healthcare outcomes. With easy adjustability, excellent weight distribution, the upright position is maintained through out the carrying period while supporting the parent’s shoulders and back.

World Health Organization (WHO) recommends that during COVID-19 pandemic, healthcare providers should “enable mothers and infants to remain together and practice skin-to-skin contact, and rooming-in throughout the day and night, especially straight after birth during the establishment of breastfeeding, whether or not the mother or child has suspected, probable, or confirmed COVID-19”.
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