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Kangaroo Mother Care: KMC is an acknowledged medical practice, the standards for which were laid down by WHO in 2003, though it was already practised in hospitals and described as early as the 1970s (in Sweden in 1976, in Colombia in 1978, in the USA in 1979). The method is most often associated with dr. Edgar Rey Sanabria, a Colombian professor of neonatology (sub-specialty of paediatrics that deals with the medical care of neonates, especially ill ones). He applied it to preterm neonates in a hospital in Bogota, for whom there were not enough incubators. As a result, many lives were saved (mortality rate dropped by 50%). Little patients were recovering much faster, and were able to leave the hospital much sooner. Dr Rey published the results of his studies, popularising the term “skin to skin”.
Kangaroo Mother Care originally referred only to care of low birth weight and preterm neonates. The term was later broadened to include all infants. At present, action is being taken all over the world to popularize the method among medical staff and parents. Detailed criteria for KMC – weight at birth, general condition (stable breathing is required), as well as the kangaroo technique – are regulated by the WHO guidelines. The method is even practised in hospitals which are equipped with modern infrastructure, regardless of medical procedures they offer. Every two years The International Network of KMC hosts an international conference. Moreover, May 15th was officially named the International Kangaroo Care Awareness Day.
The most important aspect of KMC is placing the newborn on the mother’s bare stomach or chest – providing him or her with skin to skin contact. (There are other aspects to be considered: WHO acknowledges breastfeeding as part of Kangaroo Care.) According to WHO, Kangaroo Care should commence as soon as possible – right after the infant has been wiped try and swaddled – and last until the first nursing. All other activities – like measuring or weighing – should be performed afterwards.
Standards for maternity care practised in Poland since 2012 (introduced by the Minister of Health’s Regulation) state that the first skin to skin contact between the mother and the newborn should last 2 hours. Unfortunately, in spite of our laws being mother-friendly and baby-friendly, reality proves to be disappointing. According to the 2016 report issued by the Supreme Audit Office, only about 11% of mothers maintained the first skin to skin contact with their newborns for at least 2 hours. 63% of mothers claimed that their first skin to skin contact with the baby lasted less than 30 minutes. Yet more gave evidence for symbolical treatment of KMC guidelines – they were allowed to “hold” the baby for the whole of… 5 minutes.
This is way too short for KMC to work its magic. When KMC is provided in the first minutes following the delivery, it helps the baby stabilize his or her breathing and heart rate, as well as body temperature. What happens next is the exchange of microbiota between the mother and the baby, which is crucial for the development of the baby’s resistance to illnesses and allergies. Most typically, a newborn starts looking for breasts 30-40 minutes after birth. This initial period is also important for the health of the mother. Kangaroo Care mothers produce more milk and are less prone to the so-called baby blues and postpartum depression.
In case of preterm births, kangaroo care is dependent of the baby’s condition. Skin to skin contact may be delayed by a couple of hours or a couple of days, even a couple of weeks. Even so, KMC is extremely important for the infant and the mother, who is likely to blame herself for the premature birth and the baby’s health problems. Kangaroo care relieves her stress and improves her mood.
Every medical facility has its own rules and regulations surrounding kangaroo care. Doctors, nurses and midwives are obliged to provide the mother with information and support. A special kangaroo care shirt should be present in every expectant mother’s bag (a wide strip of stretchy knitted fabric will also work, but it’s the less comfortable and less safe option). The investment will pay off, since kangaroo care is not a one-time activity. Healthy babies, carried to term, should receive kangaroo care for at least an hour each day, at least until they’re 3 months old. Some paediatricians claim kangaroo care should be provided until the baby decides he or she no longer needs it and refuses to stay still in the position.