05 January 2014


Newborn deaths account for 44% of the mortality in children under the age of five.  Most of these deaths occur in premature or low birth rate infants, and the majority of them occur in developing countries.  Kangaroo mother care (KMC) has definitively been shown to reduce newborn mortality.  Unfortunately, this simple intervention has been severely underutilized.  According to a recent meeting of stakeholders in newborn health(1), although the global implementation of KMC could substantially reduce newborn mortality, only a small proportion of newborns who could benefit from KMC actually receive it.
The concept of kangaroo mother care had its beginnings in Bogota, Columbia in the 1980s, when two physicians became concerned about the high rate of death and failure to thrive among premature infants in their overcrowded hospitals.  They conceived of the idea of placing the infant in continuous skin to skin contact between the mother’s breasts.  In addition they encouraged exclusive breast feeding, and early discharge in the kangaroo position.  KMC is initiated in hospital.  The baby and mother are introduced gradually to the position as soon as the baby has overcome initial problems and is ready to feed and grow.
It should be emphasized that KMC is more than an alternative to incubator care.  It is effective for long term thermal control.  The success rate of breast feeding is increased, as is the degree of maternal-child bonding.  It is also a gentle, effective way to avoid the stress and agitation routinely experienced in a busy hospital.  In addition studies show a consistent improvement in body temperature control and weight gain over infants kept in hospital.  Of greatest importance, the rate of infection and the mortality rate are both markedly reduced.  Studies are ongoing to assess whether KMC is effective where neonatal intensive care or referral is not available.  An excellent comprehensive practical guide to kangaroo mother care is published by the World Health organization, and is available for download (2)
In conclusion, kangaroo mother care is a relatively simple, cost-saving and very effective intervention for premature and other newborn infants that is currently greatly underutilized, and has the potential to greatly reduce newborn morbidity and mortality.  Although the chief current application will be in countries with limited resources, the benefits in bonding and improved breast feeding warrant its further consideration for all settings involved in the care of newborns.
REF:  1.  Engmann, C. et al  Consensus on kangaroo mother care acceleration.  Lancet 382, 9907 pp e26-27, Nov 30, 2013.
2.  WHO. Kangaroo mother care, a practical guide
Submitted by Roger Boe MD


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