KANGAROO MOTHER CARE Introduction:

Numerous studies over more than two decades have shown that what is now known as Kangaroo Mother Care (KMC), is best for both full-term and premature babies in every way. When separated from their mothers, babies' vital signs show that they are in distress (breathing, heart rate, temperature, hormones, etc. become irregular), but when reunited with their mothers, babies' vital signs normalise, and they begin to thrive.

Healthy Babies All "healthy" newborns (including premature babies above 2.5lbs) should be place skin-to-skin on the mother's naked chest and kept there permanently, or as much as is possible, immediately after birth. Pediatric examinations or resuscitation can be done on the mother's chest if needed. Mother and baby can be

covered by a warm blanket if the room is cold, and a knitted cap on the baby's head will prevent heat loss through the head. If medical assistance is needed, it can be given on the mother's chest. Babies can be tube fed, on IV drips and on ventilators while on the mother's chest, and babies' vital signs stabilise better in their natural habitat (skin -to-skin with their mother) than if they are placed in incubators or heated cots. If removed from their mothers, newborns make high levels of cortisol (a stress hormone that can cause brain damage) but when returned to their mother's chest, their hormones normalise. Breastfeeding should be initiated within the first hour of life if the baby is mature enough to be able to suck, and should continue on cue nursing from then on. In the case of undrugged, full term babies, it is best to place them on their mother's chest, with the baby's head between her breasts. Using his sense of smell and the grasp reflex (along with "head bobbing") the baby will self -attach to the breast, and is more likely to get the correct latch-on position, than if baby were held and assisted in finding the breast. (Drugged and premature babies may need assistance). On discharge from the hospital, the mother should be encouraged to wear her baby, skin-to-skin in a kangaroo carrier, or other carrier where the mother wraps her baby on her chest, throughout the day. At night the baby should sleep within an arm's reach of his mother, either on a safe bed sleeping surface, or in a side-crib attached to the mother's bed. Mom should be able to touch her baby at all times, and baby's vitals will be regulated by being close to his mother. In this environment, a baby is also reassured by the sound of his mother's breathing, heartbeat, touch and smell.Breastfeeding should continue on cue.

Ill Babies In the case of very tiny, or ill babies, they may need incubator care, but if this is necessary, the mother should be encouraged to be with her baby as much as possible, with her hand in the incubator, touching her baby, reassuring her baby of her presence. Through touch and the sound of her voice, a baby's stress hormones decrease and vitals regulate. If the mother is ill as well and unable to be with her baby, her baby should be wrapped skin-to-skin on the father's chest. If the baby is in an incubator, the father should be with the baby, touching and talking to the baby as much as possible. The baby will recognise his father's voice, and be reassured by his presence. Babies tube fed in the NICU should receive their mother's pumped milk, or the milk of another mother. And exclusive diet of human milk benefits premature babies, and the sicker a newborn is, the more desperately he needs this healing gold. In the case of very ill babies, they should still be held skin-to-skin on their mother's chest for as many hours per day as is possible, and the mother can sit in a comfortable reclining chair in the NICU nursery to do so. Normal Kangaroo Mother Care should be instituted as soon as possible. If very tiny premature twins are born needing incubator care, they should be placed together in the same incubator. Twin babies who can feel each other's presence physically survive better than if they are separated. Babies born with conditions that are incompatible with life, should be kept on their mother's chest so that they are not distressed during their short lives. Having held her dying baby will also help the mother to grieve and let go. Very tiny babies, believed to be dead, should also be placed skin -to-skin on the mother. There are numerous documented cases of these babies "miraculously reviving" from the warmth of their mother's body and the reassuring sound of her heartbeat.

Kangaroo Mother Care is summed up well with this simple lesson: Never separate a mother and her newborn unless it is absolutely unavoidable.

The process of holding a baby on one's chest, skin-to-skin, is referred to as Kangaroo Mother Care. However, it is a practice that all mammals participate in naturally (watch a cat with her new kittens or dog with her newborn puppies). Kangaroo Mother Care benefits all human babies as well, and especially NICU babies, in several ways. KMC babies stabilize faster with skin-to-skin care than in an incubator (very few newborns stabilize well within an incubator during the first fragile hours of life). KMC babies have stable oxygen rates and breathing thanks to the steady regulation of mother's respiration. A KMC baby's heart rate is stable (mother's heartbeat regulates baby's heartbeat).

 A baby's temperature is most stable on his mother - in skin-to-skin care mother's chest automatically warms to warm a cold baby, while her core temperature drops if baby is too warm and needs to be cooled. Sleeping within an arm's reach of baby (as long as a parent does not smoke) also regulates all of his physiological needs in the same way ~ they are kept steady thanks to Mom's warm, even-paced body. We lose far fewer babies to prematurity, irregularity of breathing or heartbeat after birth, and SIDS all with the natural help of skin-to-skin holding, or Kangaroo Care.

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