Kangaroo Mother Care – what it is and why it matters

Kangaroo Mother Care (KMC) is a care technique for preterm infants below 2,000 grams birth weight, first presented by Rey and Martinez, in Bogotá, Colombia in 1978. The World Health Organisation published official guidelines for worldwide application in 2003 and the practice is one of the strands of Vietnam’s newborns health policy.

KMC is one of the low-cost interventions used in many developing and poor countries faced with the problems of high neonatal mortality and high incidence of low birth weight without appropriate neonatal facilities. It is an alternative to minimal care after the baby has overcome any initial life threatening conditions and in situations where facilities are of good standard, but insufficient to cope with the demand. It is also used in places with access to all levels of neonatal care, as KMC offers early mother-baby, skin-to-skin contact, enhancing the quality of mother-infant bonding and successful breastfeeding.

Research has established that KMC is more than an alternative to incubator care. It has been shown to be effective for thermal control, breastfeeding and bonding in all infants.

It is a powerful, easy-to-use method to promote the health and well-being of infants born preterm as well as full-term. Its key features are:
• early, continuous and prolonged skin-to-skin contact between the mother and the baby,
• exclusive breastfeeding (ideally),
• it is initiated in hospital and can be continued at home,
• small babies can be discharged early,
• mothers at home require adequate support and follow-up,
• it is a gentle, effective method that avoids the agitation routinely experienced in a busy ward with preterm infants.

Most published experience and research concerning KMC comes from health facilities, where care was initiated with the help of skilled health workers. Once a mother was confident in the care she gave her baby, she continued it at home under guidance and with visits for specialised follow-up.

Evidence of the effectiveness and safety of KMC is available only for preterm infants without medical problems, the so-called stabilised newborn. Research and experience show that:
• KMC is at least equivalent to conventional care (incubators), in terms of safety and thermal protection, if measured by mortality,
• KMC, by facilitating breastfeeding, offers noticeable advantages in cases of severe morbidity,
• KMC contributes to the humanisation of neonatal care and to better bonding between mother and baby in both low and high-income countries,
• KMC is, in this respect, a modern method of care in any setting, even where expensive technology and adequate care are available.

Ongoing research and observational studies are assessing the effective use of this method in situations where neonatal intensive care or referral is not available, and where health workers are properly trained. In those settings KMC before stabilization may represent the best chance of healthy survival.

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