Manama story – skin-to-skin must start at birth

Manama is a small mission hospital in the remote south-west corner of Zimbabwe.

Sr Agneta Jurisoo studied what little literature was available on KMC during 1987. The following year she and Dr Bergman arrived at Manama Mission Hospital in Zimbabwe, where premature births were common. There were no incubators, poor transport over great distances, and overloaded referral centres: only one of ten premature babies survived.

In the absence of incubators, they started a care plan in which the mother became the incubator. Instead of waiting for the baby to “stabilise”, the mother was used to stabilise premature infants immediately after birth. It was immediately clear this was highly effective, no matter how small or how premature, stabilisation took a mere six hours. With this care, now five of ten very low birth weight babies survived. (Read more details here.)

This work has been published:

The “kangaroo-method” for treating low birth weight babies in a developing country
Tropical Doctor, April 1994, 24: 57-60.

	This baby is being “scored” to see how premature it is, by Sr Agneta.
	Babies need feeding: when very premature this was usually given through a nasogastric tube, but always mothers own milk was given. Intravenous lines were only used for resuscitation.
	Babies were kept skin-to-skin 24 hours a day. Here a grandmother is helping by carrying one twin.
	By putting the head-end of the bed at 30 degrees, the baby is the best angle, and mother can’t overlay the baby.
	Mothers and babies are comfortable and secure in KMC. But the mother needs psychological support to keep it up!
	DEFINITION of KMC (as used 1989) Skin-to-skin contact from birth, continuous Breastmilk & breastfeeding from birth, exclusive Psychological support to mother KMC as above used regardless of weight and gestation. KMC provides the baby with very intensive care. KC (in the USA) – In-hospital skin-to-skin contact, any duration, primarily adjunct to CMC (Conventional Method of Care).
	Babies sleep much better in skin-to-skin contact. They must however wake frequently to feed.
	This baby is (pretending to be) jaundiced, just showing off that technology is easily added to KMC. In fact, in Birth KMC, jaundice is extremely rare! Almost any modern technology can be added to the care of the baby without depriving it of skin-to-skin contact.
	KMC babies are different! They breastfeed earlier, and more frequently. They grow faster and a ready to go home sooner. They have round heads, round wide awake eyes and know what is going on! Skin-to-skin contact from birth is biologically necessary for all newborns, and life-saving for prematures. It is the fundamental human right! Read more
	KMC is now widely practised in Africa: “The impact of Kangaroo Mother Care, in terms of infant survival in this unit, has been equivalent to that of penicillin.” — Prof Bob Pattinson, Kalofong Hospital, South Africa.