An introduction…

An Introduction to the Concept of Kangaroo Mother Care

What is Kangaroo Mother Care?

Definition: A universally available and biologically sound method of care for all newborns, but in particular for premature babies, with three components …

1. Skin-to-skin Contact
2. Exclusive breastfeeding
3. Support to the mother infant dyad.

Skin-to-skin contact is between the baby front and the mother’s chest. The more skin-to-skin, the better. For comfort a small nappy is fine, and for warmth a cap may be used. Skin-to-skin contact should ideally start at birth, but is helpful at any time. It should ideally be continuous day and night, but even shorter periods are still helpful.

Exclusive breastfeeding means that for an average mother, expressing from the breasts or direct suckling by the baby is all that is needed. For very premature babies, supply of some essential nutrients may be indicated.

Support to the dyad means that whatever is needed for the medical, emotional, psychological and physical well being of mother and baby is provided to them, without separating them. This might mean adding ultramodern equipment if available, or purely intense psychological support in contexts with no resources.

In Bogota, Colombia, where KMC started, “early discharge” is regarded as the third part of the definition. This is also a form of support where hospitals are overcrowded, but it also requires a good community support system. (See INK.)

In the USA, the term Kangaroo Care (KC) is generally used. This has been defined as “intra-hospital maternal-infant skin-to-skin contact”. KC is generally started later, and on stabilised prematures, and is used an adjunct to technological care.

While KC has profound effects on the baby, KMC does so much more!

The definition OF KANGAROO MOTHER CARE is based on all these arguments, and though it applies to all babies, it is particularly important for premature babies.

In summary:

• Kangaroo Position – maternal infant skin-to-skin contact
• Kangaroo Nutrition – early and exclusive breastfeeding
• Kangaroo Support – never separate mother and baby, and ADD ON available technology

Biologically, we know that the newborn is born with the skills and behaviours it needs to grow and be well, all it needs is to be undisturbed in skin-to-skin contact with mother, and it will breastfeed.

From evolutionary arguments we understand that the baby is extremely immature, and that its well-being is dependent on continuing its gestation in skin-to-skin contact with mother, and that the mothers milk is uniquely adapted to the immature gut.

Anthropology provides ample evidence that the behaviour we infer or deduce from biology and evolutionary arguments is in fact the normal behaviour for the human race: newborns and babies should be in constant contact with mother and should exclusively breastfeed.

Neurology can explain the mechanisms that we observe when baby is in skin-to-skin contact and when it is separated.

Physiology and research provides overwhelming evidence that Kangaroo Mother Care is not only safe, but superior.

For infants born too soon, being premature on top of being immature: continuing the gestation on mothers skin-to-skin contact and with breast milk is even more important than for fullterm infants.

The above contrasts starkly with twentieth century high technology practice, in which separation of mother and child is accepted as necessary and normal.

Separation is common, but abnormal and harmful