Kangaroo care - skin-to-skin care
Premature birth
The global incidence of premature birth is 4-10 per cent, i.e., approximately 20 million newborns annually. In the Europe and Central Asia region it is 6.5 per cent, representing 4,000-4,500 children born prematurely every year. Premature birth (prematurity) refers to children born alive before the 37th week of gestation. Depending on the gestational week in which they were born and their immaturity, premature babies are classified by:
- Moderate to late immature – born between 32 and 37 weeks of gestation.
- Very immature - born between 28 and 32 weeks of gestation.
- Extremely immature - born before 28 weeks of gestation.
Body mass at birth
Depending on the body weight at birth, newborns are classified by:
- Low birthweight - body weight less than 2,500 g.
- Very small body weight at birth - less than 1,500 g.
- Extremely small body weight at birth - less than 1,000 g.
Development of kangaroo mother care (KMC)
This form of care originated in Bogotá, Colombia, in 1978, as an alternative method to standard neonatal care. Using this method, it was shown to be possible for a newborn to maintain an optimal body temperature while the mother could monitor the baby's vital signs, breathing pattern, and colour of its skin. Breastfeeding enables feeding in that position. After several years of implementing this method, an analysis of the results was undertaken that demonstrated a reduction in the number of deaths and the number of infections in newborns. In high income countries, the many benefits of this method (e.g., promotion of breastfeeding, establishing contact between mother and newborn, and a better sensorimotor outcome) have been identified.
Classification of KMC
In relation to the starting of the method:
- KMC at birth (birth kangaroo care - initiated immediately after delivery).
- Early KMC (initiated in the first 24 hours).
- Late KMC (initiated after 24 hours).
In relation to the duration of the method:
- Continuous KMC (C KMC - during 24 hours).
- Intermittent KMC (I KMC - for a certain time period).
Method of application of KMC
KMC for preterm or low birthweight infants should be started as soon as possible after birth. Your newborn is placed naked on your skin between your breasts (chest to breast), and its head is turned to one side and slightly raised in order to clear the airways. An infant is fixed and covered with a blanket that reaches your baby's neck. Your baby can remain in this position for hours. The procedure should be interrupted only when your baby is dressed, or the navel is treated. During sleep, you should be in a semi-sitting position. Another person (your partner, family member or healthcare professional) can replace you from time to time so that you can rest. Often in hospital, continuous KMC is not possible and therefore this care is only carried out for a certain period of time. In healthcare facilities, immediate KMC can be initiated before your baby is clinically stable, unless it is unable to breathe spontaneously after resuscitation, is in shock or needs mechanical ventilation. KMC can also be undertaken at home with infants who have no danger signs. It takes at least an hour a day to see the benefits of this method.
Positive effects of the method
The positive effects of this method are numerous. There is stimulation of lactation, quicker and easier initiation of breastfeeding, better progress of your baby, organization of sleep, and early establishment of the bond between the baby and you and the father. This method has a beneficial effect on your baby's sensorimotor development as well as the stabilization of hormones after birth. KMC is also used in intensive care units while medical procedures are undertaken as it has been proved to have an analgesic effect and reduce pain and discomfort during some procedures. KMC can also involve other family members, giving them a greater role in the care of your baby and alleviating parents' anxiety and their feeling of helplessness.
