There is no better incubator and home for a fetus to develop than within his/her mommy’s tummy. However, sadly for some babies who are born too early, technology needs to play a role in keeping a baby warm and creating a space to continue developing. Even full term babies born by caesarean section are placed in incubators to warm them up.
Kangaroo Mother Care (KMC) reminds us of how marsupials or kangaroos take care of their young. The infant kangaroo is always born prematurely. When the little kangaroo is born, it crawls into the maternal pouch where it receives warmth, safety and food, until maturation. Similar to the kangaroo mother, the human mother provides a safe, warm environment and frequent feeding opportunities for her premature baby, when she cares for her using the KMC method. This can be seen as the continuation of a pregnancy that has been disrupted.
KMC is an innovative method of taking care of premature babies. It can however also be used for full-term babies until they become uncomfortable in the KMC position. KMC has a list of benefits and is a relatively simple and novel method of caring for premmies.
KMC refers to the continuous nursing of a baby skin-to-skin on the mother’s or father’s chest. The baby is dressed only in a nappy and then placed on the mother’s naked chest between her breasts with the head underneath her chin.
Continuous KMC is skin-to-skin care practiced for 24 hours, day and night. The baby is removed from the position, only when the mother takes a bath. Alternatively, intermittent KMC can be practiced. The baby is held skin-to-skin for a shorter period of time when the mother or father is unable to be with their infant for 24 hours. In this case parents can practice KMC for a few hours per day and still experience the benefits of skin-to-skin contact.
KMC and birth
A mother’s temperature rises by one degree Celsius during pregnancy. If her baby is cold when placed onto her mother’s chest, mom’s temperature will rise by another two degrees Celsius, and if the baby is too warm her temperature will drop by one degree Celsius, to help cool her baby.
Amazingly, this is even evident in twins – when twins are placed in skin-to-skin, each breast will change temperature to suit the temperature needs of the baby on that breast. Unfortunately, dads do not have this temperature regulating ability, but the baby on dad’s chest will help regulate her own temperature by extending a limb to cool herself. For dad’s skin-to-skin care is a great way of bonding.
Other effects of KMC
Benefits to the baby include maintenance of adequate body temperature, less crying, more quiet sleep periods, less energy consuming movements resulting in satisfactory weight gain, better milk supply and sleep synchrony, as well as less infection. KMC babies can also be discharged to home sooner. Babies born by caesarean section or who came too early may suffer from breathing difficulties and skin-to-skin care is the most effective technique used to decrease the baby’s oxygen needs, stabilises heart rate and breathing and even blood pressure.
Benefits to the parents include an increased sense of bonding with their baby, an increased confidence in caring for their baby, continuation of the interrupted nurturing role as a mother and the empowerment to become the primary caregiver again. Skin–to-skin care also enables both fathers and mothers to participate in their infants’ care; the closeness improves bonding between parents and their infants.
Kangaroo discharge refers to the fact that many low birth-weight babies can be discharged earlier. Discharge irrespective of weight is possible once the infant is feeding satisfactorily and weight gain is maintained. KMC is continued at home until the baby reaches a weight of 2 - 3 kg or when the baby becomes restless and protests when tied in the KMC position.
KMC at home
Even older babies can be cared for in skin-to-skin as long as she finds it comfortable. This is especially helpful if you take your baby home during the winter and need to help her control her temperature. Try to KMC your baby for 90 minutes at a time, allowing her to cycle through the sleep states and enjoy a longer period of sleep. In preemie babies, to have the most benefit from skin-to-skin care, it should be practiced as often as possible for as long a period as possible. If you could not start at birth, start as soon as possible thereafter – it is never too late.
Some parents continue with skin-to-skin care even until toddler age, which is great for parent and child.
By Welma Lubbe; Nursing sister specialised in Neonatal ICU care