Kangaroo Mother Care (KMC)

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premature baby, breastfeeding a preemie

Kangaroo Care, more accurately referred to as Kangaroo Mother Care (KMC) essentially involves:

You can start with kangaroo mother care right after giving birth or a few hours, days or weeks later. It all depends on your unique situation. 

Is it your preference? Is your baby premature or ill? These are some of the factors that will determine when you start with kangaroo mother care.


Wondering How To Do It?

kangaroo care, kc, skin to skin contact
  • Your baby will only be wearing a nappy and if needed a beanie or hat. Some new studies recommend that mothers not use a beanie, as the smell of the baby's head plays a role in releasing hormones for bonding and breastfeeding. Yet others suggest that babies lose a lot of their body heat through their heads, making a hat essential. My opinion is that during the first few days after birth, it's important to establish breastfeeding, so keep the room comfortably warm and don't use a hat until then.
  • You will be wearing a shirt that opens up in the front or maybe even go topless for the time that you are doing this with your baby.
  • Then you'll place your baby onto your naked chest (no bra) in an upright position. The upright position is considered best, as it helps the baby "crawl" and self-attach to the breast. Watch the breast crawl video here in which a baby 'crawls' and attaches to the breast on his own, directly after birth.
  • Next, you'll cover both your baby and yourself with some sort of cover. You could use a light blanket or a special wrap/shirt specifically designed for kangaroo care. If the room is warm and you feel comfortable to sit with your baby without a cover, go for it!
  • Your baby's head should be turned to the side and slightly extended so that their airway is open and you can have eye contact with your baby.
  • Their legs should be in a "froggy" position as this is important for hip and joint development. It's also closer to the way they were lying inside of the womb.
  • Having their hands close to their face will allow them to self-soothe.

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Types Of  Kangaroo Mother Care

attachment parenting, skin to skin benefits, skin to skin and breastfeeding

There are two types:

  • Intermittent: This is when kangaroo care is done for periods of time.

If your baby is still nursed in an incubator because of needing monitoring, or if you have been released from the hospital and can not stay with your baby 24/7, you can do intermittent kangaroo mother care.

Even if it's just a matter of preference on your side, it is fine. The important thing to remember is that you need do this for at least one full sleep cycle, to maximize the benefits.

  • Continuous: This is when the baby stays on your chest day and night.

It could either be because there aren't any incubators available for your baby, or it could be your preference. This is the optimal option. If your doctor gives you the go ahead, you and your baby will benefit most from continuous care, even more so, if your baby is premature.

Up to what age should KMC be done? 

This is up to your baby and yourself. As your baby grows and thrives, you can follow his/her cues and then decrease the periods of time spent in the kangaroo position accordingly.

It will be a natural progression if you are in tune with your baby's needs, which is something you pick up when you spend so much time with your baby so close to you. And chances are, you will feel a bit disappointed once it's over.

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What Exactly Is So Neat 
About Kangaroo Mother Care?

breastfeeding twins, kangaroo care, kangaroo mother careTwin Fact: When mom holds both babies, each breast will regulate each baby according to their own needs.

The most amazing fact to me is that the mother's breast temperature can rise and fall to warm or cool her baby down as needed.

Your breasts will keep your baby at the ideal temperature for sleeping, breathing and using the least amount of energy necessary, so that your little one can instead focus on growing and thriving.

It has been proven, that a mother can better control her baby's temperature than a servo-controlled incubator!

Then there's the movement of the mother's chest from her breathing. This stimulates the baby to keep breathing and keeps their heart rate stable. In fancier medical terms, it prevents and/or decreases Apnea and Bradycardia. (Apnea ~ when baby stops breathing. Bradycardia ~ when baby's heart rate slows down)

This, in turn, keeps the baby's oxygen levels where they should be (Oxygen Saturation), and it also assists the baby to sleep for more extended periods. And we've all learned that children grow when they are sleeping. If your baby is premature, very small, has low muscle tone or didn't grow optimally in the womb, this is especially important for you.

And... medical interventions like drips, ventilation, monitors and so on, do not affect kangaroo care. The baby can still have all those "gadgets" attached while lying on your chest. Many have found that these things are not as needed when KMC is practiced. So all the more reason to take advantage of kangaroo mother care.

If your baby needs to be transported to another hospital or clinic, you can use kangaroo care as a safe and effective means to keep your baby stable. And if you can not do it yourself, ambulance staff can keep your baby in the kangaroo position.

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Breastfeeding and Kangaroo Mother Care

skin to skin twins, twins breastfeeding

Marsupials like kangaroos carry their babies in their pouches, giving them full access to their source of nourishment. The word "Mother" was added into the term to emphasize the importance of the mother and her breast milk.

Exclusively breastfeeding your baby on demand is the ideal. Whether your baby breastfeeds directly from your breast or gets your breastmilk via a nasogastric tube (the little tube that goes through the nose into the tummy), a cup or other method is not the point. The point is that your baby should get YOUR milk, that is specifically designed for YOUR baby, at that stage.

Interesting tidbit: Your breast milk composition will be different if your baby is premature than if they are full term.

Skin to skin contact helps to establish breastfeeding, so don't feel discouraged if your baby can't suck on your breast right away. The fact that they are close to their source of nourishment and are stimulated by the smell of your milk and skin will help towards breastfeeding successfully, eventually.

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The History of Kangaroo Care

In 1978 Dr. Edgar Rey Sanabria in Bogota, Colombia, began the practice of Kangaroo Care out of necessity. There weren’t enough resources and incubators to care for all the premature babies in the hospital and this made the death rate very high. Since then though, studies have been done on this practice, and they found a decrease in the number of babies that are dying, with the introduction of KMC. Not only were more babies surviving, but they were even thriving!

It has turned out to be more than just an alternative to incubator care.


Premature and Low Birth Weight Babies

skin to skin with dad, dad skin to skin

Just because your baby was born too soon, doesn't mean that you can't continue the gestation period.

KMC provides the perfect opportunity for you to help your baby grow, in an environment similar to the womb, until they are full term. Think of it as a womb with a view. ;-)

Many mothers of premature babies and low birth weight babies end up feeling anxious because they have to watch the medical staff care for their babies and don't get to do much for their babies themselves. It is stressful and exhausting. But with kangaroo mother care, the mother does most of the caring. This builds her self-confidence and reduces anxiety. It empowers her to step into the role she looked forward to during her pregnancy. She can be a mother in the full sense, without having to wait until her baby is 'strong' or 'big' enough.

Not only that, research shows over and over again that babies who receive KMC thrive far better than those who are given traditional medical incubator care. The smaller the baby, the more vital kangaroo care becomes.

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How Does It Reduce Infections?

When your baby is placed on your skin, they become colonized with your bacteria. This causes your body to produce antibodies in response; they are specifically protective against harmful bacteria.

Now, when your baby is placed in an incubator, he/she become colonized with hospital bacteria, which might infect the baby. We've all heard how hospital bacteria tend to become resistant to many antibiotics... It's not good.

This is especially not good in poor countries where resources and access to antibiotics are very limited. And where incubators are not always in optimal working condition, or adequately cleaned or have reliable power supplies. That is if they even have money for an incubator.

Kangaroo care can overcome all these obstacles, by providing babies with the perfect immunity and nutrition, the perfect temperature regulation and safety.


Kangaroo Mother Care Wards

Some hospitals/clinics have special wards where mothers and babies can practice kangaroo mother care all the time, while the nursing staff supervises them.

This allows mothers to take on the responsibility of caring for their own babies and it lightens the load on the nursing personnel. Everybody wins!

Another benefit of KMC wards is that mothers get to support and encourage each other. They are going through similar experiences and being able to talk to someone who's actually been there and done that, is invaluable.


Clothing and Wraps

Any shirt or dress that opens up in front will do for the mother. There are a few items of clothing, specially designed for this purpose, which you may wish to purchase.

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Support for Mom

This goes beyond just having emotional support. It involves physical and educational support as well.

  • First of all, mom needs to understand the whole process of kangaroo mother care. She needs to know what the benefits are and why it is essential for her and her baby. This should ideally be incorporated in antenatal care, while she is still pregnant so that she can do more research herself and prepare herself for it once her baby is born.
  • Second, she needs lots and lots of emotional support and encouragement from her family and from the nursing and medical staff. Providing this kind of care to a baby is a huge commitment, even though it is well worth it.
  • Third, she needs physical support. This could either mean dad and other family members or friends help or at least lighten the burden, of household chores. They can also take over kangaroo care for short periods of time.


Kangaroo Mother Care Video

    Here is a video explaining kangaroo care and showing you what it looks like in practice.


Finally... Going Home

Once your baby is healthy, gaining weight (at least 20g per day), is able to breast or cup feed well and you are confident to manage your baby on your own, you can finally go home.

Usually, you will leave the hospital with your baby in the kangaroo position and continue the practice at home for as long as you and your baby desire.

For premature and low birth weight babies, this very well may mean that you are able to join your family sooner than with traditional medical care.

Be sure to have regular follow up visits with your health care professional to make sure that your baby is gaining weight, growing and thriving as expected.

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Dads & Kangaroo care 

dads and kangaroo care, skin to skin father

This will be a great help to the mother, especially after a cesarean section, or when she has multiple babies (twinstriplets or more) and it strengthens the family bond.

Also, dads who spend time skin to skin with their babies are less likely to abuse their children or become violent towards them. This is what studies are showing.

It's a great way to bond with your baby!


Kangaroo Care Benefits

father with baby, father kangaroo care

Kangaroo Mother Care Benefits for Baby

  • Baby's breathing is regular, and there is a reduced chance of apnea.
  • A stable heart rate. The movement of the mother's chest as she breathes stimulates her baby to keep breathing normally.
  • It could possibly also reduce the risk for SIDS (sudden infant death syndrome), also known as cot death.
  • The baby has better oxygen levels.
  • Better blood sugar levels.
  • The baby has long, deep stretches of sleep.
  • When they are awake, they are more alert.
  • They gain weight better and faster because they don't have to use their energy to try to keep warm.
  • They also have better control of body temperature.
  • It has been proven that a mother is better able to control her baby's temperature than a servo-controlled incubator. Which leads to lower chances of cold stress (hypothermia)
  • These babies cry significantly less and have much lower stress levels.
  • There is less chance of infection. This is by far one of the main kangaroo care benefits in both poor and wealthy countries alike.
  • Motor and brain development is positively affected because these babies have more energy to use for developing and growing.
  • They have a higher pain threshold than babies who do not receive kangaroo care.
  • It is a safe and convenient way of transport your baby between hospitals and clinics, especially when there are no transporting incubators available.
  • The baby is sent home earlier than if they had receive standard care, as kangaroo mother care can be continued at home.

Kangaroo Care Benefits for Parents

  • First of all kangaroo mother care creates a sense of competence and confidence in the mother. She feels like she is able to do something for her baby, especially when baby is tiny, premature or ill.
  • Mom also gets the feeling that she is completing the gestation period. Dr. Ashley Montagu calls this the exterogestation period or external gestation period. Kangaroo care is the closest recreation of the womb.
  • If the birth was traumatic and the mother and her baby had to be separated, kangaroo mother care can help restore the bond between them.
  • Decreases the occurrence of postnatal depression in the mother.
  • Violence, abuse and abandonment rate is decreased.  

Kangaroo Care Benefits Related to Breastfeeding

  • Skin to skin contact promotes the release of oxytocin. This hormone not only has a calming effect on the mother and her baby, but it also regulates milk production. Mothers who practice kangaroo care are more likely to have a good milk supply.
  • The mother's milk adjusts to the nutritional and immunological needs of her baby, hence the term "designer milk."
  • The chances of successfully breastfeeding and continuing to breastfeed for longer is much higher when KMC is practiced. 
  • Babies as premature as 30 weeks can begin breastfeeding when receiving kangaroo mother care. But there are alternative feeding methods for those who are not yet able to suck directly on the breast. 
  • The mother and baby's sleep cycles synchronize, which means they will sleep and wake together, helping both get the rest they need.
  • The mother's uterus contracts and returns back to its average size sooner and this also helps to limit her blood loss.

Other Kangaroo Care Benefits

  • Where there are Kangaroo Mother Care Wards available, mothers have the benefit of learning from and supporting each other.
  • Morbidity and mortality rates are lower, as babies are more likely to survive. Even very small babies who were not thought to be viable have beaten the odds and survived as a result of kangaroo care.
  • For hospitals, the benefits are reduced costs. Less expensive technology and fewer staff members are needed. Other hospital costs are also reduced.
  • Because fewer babies get infections, the need for intensive or special care also decreases.


Dr. Susan Ludington sums up Kangaroo Mother Care in saying:

"Separation is not biologically normal."

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