PRESENTATION ON
KMC
Prepared By: Vipin Vageriya
Asst. Professor,
Dept of Nursing
CHARUSAT University, Changa-
Anand-Gujarat(India)
Kangaroo MotherCare
What is KMC ???What is KMC ???
A special way of caring for
Low birth weight (LBW) babies
It promotes,
Effective thermal control
Breast feeding
Prevention of infection
Parental bonding
Components of KMCComponents of KMC
Skin-to-skin contact Skin-to-skin contact
Early, continuous and prolonged Early, continuous and prolonged
skin-to- skin contactskin-to- skin contact
Exclusive breast feeding Exclusive breast feeding
Promotes lactation and Promotes lactation and
facilitates feedingfacilitates feeding
Pre-requisites of KMCPre-requisites of KMC
Support to the motherSupport to the mother
In hospital &In hospital &
At homeAt home
Post-discharge follow upPost-discharge follow up
Benefits of KMCBenefits of KMC
Breast feedingBreast feeding
Increased breast feeding ratesIncreased breast feeding rates
Increased duration of breast Increased duration of breast
feedingfeeding
Thermal controlThermal control
Effective thermal controlEffective thermal control
Equivalent to conventional Equivalent to conventional
incubator careincubator care
Benefits of KMC (cont..)Benefits of KMC (cont..)
Early dischargeEarly discharge
Better weight gainBetter weight gain-- Early Early
dischargedischarge
Lesser morbidityLesser morbidity
Regular breathingRegular breathing
Decreased episodes of apneaDecreased episodes of apnea
Protection from nosocomial Protection from nosocomial
infectionsinfections
Benefits of KMC (cont..)Benefits of KMC (cont..)
Other benefitsOther benefits
Less stress to the infantLess stress to the infant
Stronger bondingStronger bonding
Deep satisfaction for mother Deep satisfaction for mother
More confident parentsMore confident parents
Requirements for KMC Requirements for KMC
implementationimplementation
Training Training
Nurses, physicians and other staffNurses, physicians and other staff
Educational material Educational material
Information sheets, posters and Information sheets, posters and
video films on KMCvideo films on KMC
Eligibility criteria: BabyEligibility criteria: Baby
Birth weight >1800 gm: Birth weight >1800 gm:
Start at birthStart at birth
Hemodynamic stability is a Hemodynamic stability is a
MUSTMUST
Eligibility criteria: MotherEligibility criteria: Mother
WillingnessWillingness
General health & nutritionGeneral health & nutrition
HygieneHygiene
Supportive familySupportive family
Supportive communitySupportive community
Preparing for KMCPreparing for KMC
CounselingCounseling
Demonstrate procedureDemonstrate procedure
Ensure family supportEnsure family support
KMC support groupKMC support group
Mother’s clothingMother’s clothing
Front-open, light dress as per the local Front-open, light dress as per the local
cultureculture
Baby’s clothingBaby’s clothing
Cap, socks, nappy and front-open Cap, socks, nappy and front-open
sleeveless shirt or ‘jhabala’sleeveless shirt or ‘jhabala’
KMC procedure: Kangaroo KMC procedure: Kangaroo
positioningpositioning
Place baby between the mother’s Place baby between the mother’s
breasts in an upright positionbreasts in an upright position
Head turned to one side and Head turned to one side and
slightly extendedslightly extended
Hips flexed and abducted in a Hips flexed and abducted in a
“frog” position; arms flexed“frog” position; arms flexed
Baby’s abdomen at mother’s Baby’s abdomen at mother’s
epigastriumepigastrium
Support baby’s bottomSupport baby’s bottom
KMC procedure: Kangaroo KMC procedure: Kangaroo
positioning (cont..)positioning (cont..)
Head turned
to one side
Frog-leg
position
Baby between
mother’s breasts
Support baby’s
bottom
Monitoring during KMC Monitoring during KMC
Check ifCheck if
Neck position is neutralNeck position is neutral
Airway is clearAirway is clear
Breathing is regularBreathing is regular
Color is pink Color is pink
Temperature is being Temperature is being
maintainedmaintained
initiation of KMCinitiation of KMC
Baby should be stableBaby should be stable
Short KMC sessions can be Short KMC sessions can be
initiated even if the baby is initiated even if the baby is
receiving receiving
Duration of Kangaroo Duration of Kangaroo
Mother CareMother Care
Start KMC sessions in the nurseryStart KMC sessions in the nursery
Practice one hour sessions initiallyPractice one hour sessions initially
Transit from conventional care to Transit from conventional care to
longer KMClonger KMC
Transfer baby to post-natal ward Transfer baby to post-natal ward
and continue KMCand continue KMC
Increase duration up to 10-12 Increase duration up to 10-12
hours a dayhours a day
KMC during sleep and restingKMC during sleep and resting
RestingResting
Reclining or semi-recumbent Reclining or semi-recumbent
positionposition
Adjustable bedAdjustable bed
Several pillows on an ordinary bedSeveral pillows on an ordinary bed
Easy reclining chairEasy reclining chair
SleepSleep
Supporting garment restraint for Supporting garment restraint for
baby baby
KMC during sleepKMC during sleep
KMC during restingKMC during resting
Any family member can do it !Any family member can do it !
Father & other family Father & other family
members can members can
also provide skin-to-skin carealso provide skin-to-skin care
FatherFather
GrandmotherGrandmother
Criteria for transferCriteria for transfer
From nursery to wardFrom nursery to ward
Stable babyStable baby
Gaining weightGaining weight
Mother confident of looking Mother confident of looking
after the babyafter the baby
Discharge criteriaDischarge criteria
Baby is well with no evidence Baby is well with no evidence
of infectionof infection
Feeding well (predominant Feeding well (predominant
breast milk)breast milk)
Gaining weight (15-20 Gaining weight (15-20
gm/kg/day)gm/kg/day)
Maintaining body temperature Maintaining body temperature
(in room temperature)(in room temperature)
Mother confident of taking care Mother confident of taking care
of the babyof the baby
Follow-up visits ensuredFollow-up visits ensured
Discontinuation of KMCDiscontinuation of KMC
Term gestationTerm gestation
Weight ~ 2500 gm or moreWeight ~ 2500 gm or more
Baby uncomfortableBaby uncomfortable
Pulls limbs outPulls limbs out
Cries and fogs from mouth Cries and fogs from mouth
Mother can continue KMC after Mother can continue KMC after
giving the baby a bath and during giving the baby a bath and during
cold nightscold nights
Post-discharge follow upPost-discharge follow up
Once or twice a week till 20 wks / Once or twice a week till 20 wks /
2.5-3 kg2.5-3 kg
Thereafter, once in 2-4 wks till 3 Thereafter, once in 2-4 wks till 3
monthsmonths
Subsequently, every 1-2 months Subsequently, every 1-2 months
during first yearduring first year
More frequent visits if baby is not More frequent visits if baby is not
growing well. growing well.