Kangaroo Mother Care: Learning from nature to maintain yourself

Every year, around 15 million babies are born prematurely around the world. More than a million of them die soon after birth and many subsequently suffer from various physical, neurological or intellectual impairments. In Bangladesh, the neonatal mortality rate is 30 per 1,000 live births, which accounts for 67% of all under-five deaths. 19% of these deaths are due to premature births.

With our societal and economic evolution, women are gradually becoming more involved in economic activities. The opportunity to live with a reunited family in large cities also decreases for its increasing expenses. Thus, working women enter a more stressful lifestyle. They also experience the stress of their workplace and household. Studies show that women who experience high levels of stress during pregnancy have a 25-60% higher risk of preterm delivery, even after accounting for the effects of other established risk factors.

During the 1970s, Colombian doctors struggled to treat premature infants with their limited resources. Two Colombian doctors, Dr Edgar Rey Sanabria and Dr Héctor Martínez Gómez, observed a similar type of preterm birth in kangaroos as a natural phenomenon. The newborn kangaroo or “joey” is usually delivered prematurely to its mother’s pouch and grows there until a certain period of life. Its mother’s pouch not only provides the necessary warmth to keep her from losing her body temperature, but also keeps the baby close to the breasts for unlimited breastfeeding. The two doctors then attempted to use this experience on human newborns to reduce overcrowded and inadequate resources in neonatal intensive care units. They began placing the premature newborn baby naked (except for a diaper, hat, mittens and socks) on their mother’s uncovered breast, ensuring skin-to-skin contact, and obtained beneficial results. This procedure enabled them to reduce the size of the incubators. They named it “Kangaroo Mother Care (KMC)”. After several scientific trials and validations, the World Health Organization has accepted KMC as the standard of care to reduce morbidity and mortality in premature infants.

Premature infants are at a higher risk of heat loss due to the lack of a protective fat layer under their sensitive skin, where temperature regulation plays an important role in their survival. The kangaroo position uses the mother’s body heat to maintain the newborn’s body temperature. Touch, gentle pressure and warmth of the newborn have also been shown to promote the release of oxytocin, a hormone with multiple benefits.

Oxytocin causes blood vessels in the mother’s chest to dilate, increasing blood supply, which helps provide more warmth to the premature newborn. Oxytocin causes redness in the mother’s breast and begins to pulse in response to skin-to-skin contact with the newborn. As a result, the temperature of the newborn’s skin rises and reduces the risk of potentially fatal hypothermia. It improves the availability of breast milk by increasing its improved ejection. Oxytocin increases the digestive hormones needed in newborns, which optimizes their digestion and metabolism for their optimal growth and, ultimately, their early discharge from the hospital. It also helps reduce postpartum bleeding, anxiety and improve wound healing, ultimately leading to a faster return to pre-pregnancy weight of the mother.

While providing kangaroo care, a mother can learn the different ways of feeding a premature baby by being close to nurses and doctors, which helps build her confidence to care for the baby at home. The process also helps to optimize a trend of “family-centered care” of a newborn baby, which is a holistic way to bring about a positive outcome in pregnancy.

To adopt a behavior and make it a practice, awareness raising with frequent reminders is necessary. Family decision makers and health care workers at all levels need to receive repeated reminders of the benefits of KMC to make it common practice. Electronic, print and mass media, development partners, etc. as part of their social responsibility, can play an important role in promoting such health awareness practices among the masses.

Dr Abdullahel Amaan is a resident in the Department of Neonatology at Bangabandhu Sheikh Mujib Medical University, Bangladesh.
Email: [email protected]

Dr Khainoor Zahan is Deputy Director, Bangladesh National Nutrition Council (BNNC), Bangladesh. Email: [email protected]

Norma A. Roth