Kangaroo mother care has been around for quite some time in various parts of the world. This technique for newborn care was previously recommended for babies who were born with a low birth-weight, whether premature or full-term. A study that was conducted in Colombia from 1993 to 1996 showed all the short-term benefits of kangaroo mother care, which included survival, neurodevelopment, and so on. On following up with the participants of the study 20 years later, around 2012 to 2014, it revealed that the effects of kangaroo care were still visible in most participants, including the most fragile individuals. Restrictions for kangaroo mother care are now slowly being eased, seeing that there are plenty of benefits, that babies who are exposed to skin-to-skin contact experience.
What is Kangaroo Mother Care?
The term ‘Kangaroo Mother Care’ emerged from the way certain marsupials carry their babies, such as kangaroos, who carry their babies in their pouches. Initially developed for premature babies in countries where neonatal care facilities were poor or ineffective, the technique involves the diapered baby lying on the mother’s bare chest for the first few hours after the baby’s birth, and continuing this practice for several weeks after birth as well. It was in 1978 when Dr Edgar Rey Sanabria decided to combat the situation of lack of resources and overcrowding in his hospital in Colombia. Inspired by the idea of the joey (a baby kangaroo) that feeds and forms a close bond by staying in its mother’s pouch for months together, he devised the kangaroo mother care technique, which won him the World Health Organisation’s Sasakawa Health Prize in 1991.
There are three components to kangaroo mother care or KMC. The first involves skin-to-skin contact; the other aspects are exclusive breastfeeding (kangaroo nutrition) and discharge from the hospital as soon as possible (kangaroo discharge).
Purpose of Kangaroo Mother Care
According to the World Health Organisation, KMC was recommended for newborns who weighed 2000 grams or less at birth. Currently, it is being extended to premature babies in NICU and full-term babies as well. Apart from the benefits it offers, skin-to-skin contact is believed to be the most natural step to follow after childbirth. The separation between the mother and baby right after childbirth can sometimes negatively affect both parties, anxiety being one of the noted effects. On the other hand, placing the baby in the care of the mother or other family members immediately gives him the feeling of security and comfort, and promotes bonding and attachment at the earliest. The mother should always be the primary provider of skin-to-skin contact; but in case she is unable to do so, the father of the baby or another family member can step in.
Techniques of Kangaroo Mother Care
With regard to skin-to-skin contact, which is exactly like it sounds, the baby is placed against the mother’s bare chest. The baby is diapered and a dry hat is placed on his head (if done right after birth, the baby’s head is first dried), but is naked otherwise, and is placed between his mother’s breasts. The baby is secured in a wrap that goes around the mother’s torso and a blanket is draped over both of them for providing warmth, but in the case the environment is too cold for the mother, she can wear a loose garment and leave it open near the chest area for the baby to lie on. The baby lies in an upright foetal position, in a way that his airways are not obstructed, his posture is right, and he is not exposed to sudden drafts of air. By bundling him tightly, it offers him plenty of stimulation - whether it is from the parent’s breathing and chest movements, hearing the voice of his mother that he has heard while in the womb, and the warmth of his mother’s skin.
Kangaroo mother care can be practised for almost 6 months with preemie babies, and for 3 months with full-term babies, or up until the time that the baby doesn’t pull away while placed skin-to-skin against his mother or father. A minimum of 60 minutes of kangaroo care per day is recommended for the baby to get the full benefit of skin-to-skin contact.
Kangaroo Mother Care for Premature Babies
Premature babies are those who are born before the 37th week of gestation, which means that they have not developed completely and face an increased risk of complications once they are out in the world. With low birth weight and poor organ development, premature babies spend their first few hours or days in the NICU, where they are provided with a protective environment. Research has shown that providing kangaroo care to premature babies doesn’t just help them survive their initial days after birth, but also provides them advantages in the long run. They are able to be more productive, lead a family life that is nurturing, perform better in school and so on, much better than their counterparts who were treated in an incubator after birth. While medical technology offers all the assistance and benefits to help premature babies survive, skin-to-skin contact has shown to help the babies really thrive. Another study has shown that there is no such thing as cuddling your baby too much, especially when it comes to preemies. Since preemies are exposed to more painful procedures right from birth, their responses to gentle touch (such as skin-to-skin contact) can be affected. To counteract this, it is important to provide these babies plenty of physical contact and affection, be it through breastfeeding, stroking, gentle hugs, and just touching in general.
WATCH: A Real-life Account of Kangaroo Care for Preterm Babies
Raquel and Jodee share their story of becoming parents to twins who were born at 7 months, and how kangaroo care is helping both them and their kids.
The couple believes in providing the babies with kangaroo mother and father care.
They also stress on how doctors provide all the care and assistance they can, and how parents should also do their part.
Benefits of Kangaroo Mother Care
There are several benefits offered by the ‘skin-to-skin contact’ aspect of KMC, for premature and full-term babies, and as seen in the study earlier, some can last up to over 20 years!
Better Regulation of Body Temperature
During pregnancy, the mother’s womb provides the foetus everything in terms of food, oxygen, and temperature control; when the baby is delivered, skin-to-skin contact is the closest thing that can compare to being back in the security of the womb. The mother’s skin is the same temperature as the womb, which will help the baby adapt to the outside environment faster. A study conducted with regard to how skin-to-skin contact can affect a baby’s body temperature revealed that the babies reached their normal body temperature faster with this type of contact, than when exposed to artificial warmers.
Helps to Initiate Breastfeeding Easier
Babies are born with a natural instinct to find the mother’s breast when they are born, and can latch on and feed immediately - provided that they are in close contact with the mother! When the baby receives skin-to-skin contact, he is in the ideal position to breastfeed, and can even begin nursing within an hour of birth. Babies who received kangaroo mother care could also breastfeed for longer periods than their counterparts (an average of 5 months more). Skin-to-skin contact has also shown to increase breastmilk supply for mothers, as the hormones for lactation balance out in such a way that more milk is produced.
Increased Tolerance to Pain and Stress
Studies have shown that when babies receive skin-to-skin contact, the levels of stress hormones in their body (cortisol) tend to come down, while the levels of feel-good hormones (oxytocin) go up. Such babies were also less reactive to heel pricks and injections that were administered when they were engaged in kangaroo mother care with their mother - in fact, it seemed to help the babies more than the traditional solution of sugar water for pain relief. A reduction in their stress hormone levels also led to a reduction in crying in babies.
Better Functioning of the Lung and Heart
It helps babies, both premature and full-term, achieve more normalised breathing. When the baby is out of the comfort of the womb, the first few moments are a challenge, which is where skin-to-skin contact benefits him by stabilising his heartbeat and breathing.
Transfer of Good Bacteria
When the baby passes through the birth canal, it allows the baby’s gut to be colonized by good bacteria in the mother’s vagina. The other way to expose the baby to this bacteria is by providing skin-to-skin contact with his mother. While the practice of providing babies born through C-section skin-to-skin contact is comparatively rare, it does happen in certain places and provides the baby with the benefit of transfer of good bacteria, that he misses out because he wasn’t delivered vaginally.
Promotes Weight Gain
With better breastfeeding and less energy expended to keep themselves warm, babies use that energy to grow, which helps with healthy weight gain as well. This aspect is important for premature babies who are born with low birth weight in the first place.
When babies are continually provided kangaroo mother care, it helps the quality of their sleep. They tend to sleep for longer periods of time and more deeply; this is especially helpful for preemie babies who need ample amount and good quality of sleep.
Boosts Mental Development
A study showed that the effects of kangaroo mother care on certain babies were still present in their adolescence. The reasoning is that with better and more stable breathing and heart rate, and improved sleep, babies’ brains are able to develop better.
Reduces the Effects of Postpartum Depression
Postpartum depression is a serious concern and mothers of preemie babies are seen to be highly susceptible to postpartum depression. Studies have shown that kangaroo mother care has helped to lessen the effects of depression in new mothers due to increased bonding with the baby, as well as the lack of ‘separation anxiety’, although more research is required in this area.
Promotes Better Bonding Between Mother and Baby
Kangaroo mother care helps moms understand their babies much better, when it comes to signs of hunger or discomfort, and promotes better communication between both of them. This also helps the mother gain confidence in her own abilities as she is able to take care of her child’s needs much better. The bonding isn’t just limited to mom and baby - dads too can bond with their babies by engaging in skin-to-skin contact. We have a celebrity example below!
While participating as a panelist in a discussion regarding prevention of neonatal deaths that can be prevented in the first place, actress Kareena Kapoor Khan stressed on the fact that the child is the responsibility of both parents. Since she was too exhausted after childbirth, she asked her husband to step in and provide kangaroo mother care to baby Taimur. She was quoted as saying the following: “The first thing after childbirth that you want to do is put the child on the mother’s breast. After childbirth I was tired, but that was on my mind. With my eyes half-shut, I asked Saif to give Taimur that kangaroo love. When the mother is recuperating from childbirth, the father must step in.
India reports the highest number of neonatal deaths in the world and the main causes remain the same - premature births, infection, or birth asphyxia. Poor infrastructure in the health sector can be attributed to this distressing problem as well. Kangaroo mother care, therefore, is one of the low-cost interventions that can be taken to save the lives of premature babies. While several hospitals and colleges today are encouraging KMC, there are hurdles that stop it from becoming a step for healthcare providers to follow - neither is it a technical and scientific aspect of post-delivery care, nor can hospitals ensure that kangaroo care is followed through with properly once the mother and baby are discharged from the hospital. But that said, doctors who have understood the great benefits of kangaroo care and how it can help to eliminate preventable neonatal deaths are now encouraging women from small communities to engage in skin-to-skin contact with their babies and breastfeed immediately as well. The government has also inaugurated the Kangaroo Mother Care Foundation, India in 2015 and since then, have undertaken several activities to promote awareness and implementation of KMC in hospitals across India.
Babies are delicate little things that need all the warmth and physical affection they can get right after birth, so that they can adjust and adapt to the world around them, after developing and growing in the safety of their mothers’ womb. Whisking the baby away to an incubator and keeping him away from the parents is distressing for both parties; and as seen from various accounts and studies, kangaroo mother care from the time of birth can offer benefits that even the best of scientific technology cannot!