Definition
Kangaroo Mother Care (KMC) is a
special way of caring of low birth weight
babies.
It fosters their health and well being by
promoting
Effective thermal control,
Breastfeeding,
Infection prevention and
Bonding.
Components of KMC
1.Skin-to-skin contact -Early,
continuous and prolonged skin-to skin
contact
2.Exclusive breast feeding -Promotes
lactation and facilitates feeding, provides
adequate nutrition
3.Early discharge and follow up care-
desired weight gain helps in early
discharge and regular follow up care to
identify problems for early intervention
Pre-requisites of KMC
1. Support to the mother
a)In hospital &
b)At home
2. Post-discharge follow
up
Benefits of KMC
1.Breast feeding-Increased breast
feeding rates and Increased duration
of breast feeding
2.Thermal control-Effective thermal
control, Equivalent to conventional
incubator care
Cont..
3.Early discharge-
Better weight gain -
Early discharge
4.Lesser morbidity-
Regular breathing,
Decreased episodes
of apnea, Protection
from nosocomial
infections
Cont..
5. Other benefits
◦Stronger bonding
◦Deep satisfaction for mother
◦More confident parents
◦No need for special care
Eligibility criteria: Baby
1.Birth weight >1800 gm: Start at
birth
2.Birth weight 1200-1800 gm:
Hemodynamicallystable
3.Birth weight <1200 gm:
Hemodynamicallystable
4.KMC can be initiated for the stable
babies, who are on IV fluid therapy,
tube feeding or oxygen therapy.
Eligibility criteria: Mother
1.Willingness of mother
2.General health & nutrition (free from
serious illness)
3.Hygiene (daily bath, change of clothes
daily, short finger nails)
4.Supportive family and community
Preparing for KMC
1. Counseling
Explain benefits of KMC
Demonstrate procedure to mother
Ensure family support
KMC support group (interaction with
mother already practicing KMC for their
baby)
Discuss about the procedure to the
husband or any other family member
Cont..
2. Mother’s clothing
Front-open, light dress as per the local
culture
3. Baby’s clothing
Cap, socks, nappy and front-open
sleeveless shirt.
KMC Procedure
1. Kangaroo Positioning
1.Place baby between the mother’s
breasts in an upright position
2.Head turned to one side and slightly
extended
3.Hips flexed and abducted in a “frog”
position; arms flexed
4.Baby’s abdomen at mother’s epigastrium
5.Support baby’s bottom
2. Monitoring during KMC
Check for,
❑Neck position -neither too flexed nor
too extended
❑Clear airway
❑Regular breathing
❑Color and temperature of skin
❑Hands and feet for warmth
3. Feeding
Help mother to breastfeed her baby
during KMC
Holding baby near the breast, during
kangaroo positioning stimulates milk
production
4. Privacy
KMC unavoidably requires
some exposure on the
part of the mother.
Privacy should be
maintained to avoid
unnecessary exposure on
the part of the mother
which makes her nervous
or uncomfortable.
Initiation of KMC
KMC can be started as
soon as the baby is
stable.
Short KMC sessions can
be initiated even if the
baby is receiving IV
fluids, Oxygen therapy,
gavagefeeding etc.
Duration of Kangaroo Mother
Care
1.Skin-to-skin contact should start gradually
in the nursery
2.Transit from conventional care to longer
KMC
3.Sessions that last less than one hour should
be avoided because frequent handling may
be stressful for the baby.
4.Continue KMC to post-natal ward and
home
5.Increase duration up to 24 hours a day,
interrupted only for changing diapers.
KMC during sleep and resting
Resting
Reclining or semi-recumbent position
Adjustable bed
Several pillows on an ordinary bed
Easy reclining chair
Sleep
Supporting garment restraint for baby
Mother can provide KMC in reclining or semi-
recumbent position 15’-30’ from above the
ground
Criteria For Transfer
From nursery to ward
1.Stable baby
2.Gaining weight
3.Mother confident of looking after
the baby
Discharge Criteria
1.Baby is well with no evidence of infection
2.Feeding well (exclusively breast milk)
3.Gaining weight (15-20 gm/kg/day)
4.Maintaining body temperature (in room
temperature)
5.Mother confident of taking care of the
baby
6.Follow-up visits ensured
Discontinuation of KMC
1.Post-conception age reaches 40
weeks
2.Weight ~ 2500 gm
3.Baby uncomfortable
4.Wriggling out
5.Pulls limbs out
6.Cries vigrously
Post-discharge Follow Up
1.Once or twice a week till 37-40 wks
/ 2.5-3 kg
2.Thereafter, once in 2-4 wks till 3
months Post-conceptionalage
3.Subsequently, every 1-2 months
during first year
4.More frequent visits if baby is not
growing well