Kangaroo mother care is a low cost approach for the care of low birthweight babies.It is a special way of caring low birthweight infants by skin to skin contact.
The two components of kangaroo mother care:-
Skin to skin contact:-Early, continued and prolonged skin contact between the mother and her baby.
Exclusive breastfeeding:- The baby on kmc is breastfed exclusively.skin to skin contact promote lactation.
ARTICLES
Mother's Clothing:-
~ Front open,light dress as per the local culture or Jhabala.
~ KMC works well with blouse and sari,gown or shawl.
Baby's Clothig
~ Baby is dressed with cap,socks, nappy and front open sleveless shirt.
~ Hand sanitizer and hand washing artcles-soap and water.
Step of Procedure:-
Preparation
Counseling:-
~ explain the benefits of kmc to the mothe r and other family members
~ Discuss with the mother clear the doubt s to remove the anxiety.
Mothers clothing:- mother should wear front open light dress as per culture.
Baby clothing:-
Baby should be dressed with fronts open sleeveless shirts cap socks nappy and hand gloves.
Binder:-
It helps mthers hold their baby safety close to their chest. To begin with,use a soft piece of fabric,cotton dupatta or a cotton cloth about a meter square,folded diagonally in two and secured with a safe knot or tucked up under the mother's armpit.
All these options leave the mother with both hands free and allow her to move around easily while carrying the baby skin to skin.
Procedure:-
Kangaroo positioning:-
* The baby should be placed between the mother's breast in an upright position.
* Baby's head should be turned to one side and in a slightly extended position which helps to keep the air way open and allow eye contact between mother and baby.
* Baby's hips should be flexed and placed on mothers epigastrium.
* Baby should be placed in between the mother naked breasts as explained the position above and binder . Then mother should wear a loose fronts open shirt over it.
MONITORING:-
During intial stage of KMC the baby should be monitored for air way breathing color and temperature.Hands and feet should be examined to assed the warmth. Airway mustbbe kept clear with regular breathing normal skin color and temperature.
Baby neck position should be neither too flexed nor too extended.
FEEDING:-
Holding the baby near the breast stimulate milk production and the kangaroo position makes the breast feeding easier.
PSYCHOLOGICAL SUPPORT TO MOTHER:-
~Remove anxiety by encouraging her to ask questions clear her doubts.
~ Mother needs to be motivated to continue KMC.
PRIVACY:-
~ avoid unnecessary exposure on the part of the mother which makes her nervous and demotivating.
Time of initiation of kmc:-
It can be started as soon as baby is stable.
DURATION:-
~ it should not be <1 hour.
~ encourage her to increase the duration each time to provide KMC as long as possible.
~ When mother is not available then other family member such as father grandmother aunty can be provided kmc.
~ Mother can sleep with baby in kmc position in a semierecumbent position abouts 15-30 minutes.
~ Supporting garments can be used to carry the baby in kangroo position during sleep and rest.
Discontinuation of kmc:-
KMC can be continued untill the baby gains weight arounds 2500g/ reaches 40 weeks of post conception age.
IT can be discontinued if baby starts wriggling to show discomfort pulls limbs out cries and fusses every time when mother tries to put the baby back into skin contact.
When mother and baby are comfortable kmc can be continued as long as possible.
Postprocedural step
When to discontinue KMC?
~ As mother and baby is comfortable when gestation age reaches at term weight is arounds 2.5 kg.
~ Baby starts wrigglies and uncomfortable.
Follow up~
Baby should be followed once a week till 37 40 weeks of gestation till weight reaches up to 2.5 _3.0 kg adequte weight gain .
Baby should be seen at an interval of 1-2 months during 1 st yr of life.
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