Munich, June 2024 — Kangaroo Mother Care (KMC) is a care practice that benefits not only newborns and their families but also healthcare providers and hospitals. KMC centres care around the needs of the infant, empowers families, mitigates the workload for medical professionals, and saves resources in often overburdened healthcare systems. It includes continuous and prolonged skin-to-skin contact, exclusive breastfeeding, and timely discharge from the Neonatal Intensive Care Unit.
© Natalie Charpak
Definition of Kangaroo Mother Care
Kangaroo Mother Care (usually abbreviated as KMC) is a neonatal care practice which benefits all newborns but has proven particularly beneficial for babies born preterm, with a low birthweight, or in need of immediate medical attention.
According to the World Health Organization (WHO), Kangaroo Mother Care includes the following characteristics:
- continuous and prolonged skin-to-skin contact for at least 8 hours a day,
- exclusive breastfeeding or breastmilk feeding, and
- timely discharge either from the Neonatal Intensive Care Unit (NICU) to a lower level of care or discharge to home with close monitoring and support services available to families. [1]
In its most recent guidelines, the WHO emphatically recommends initiating KMC immediately after birth, even if the newborn is not yet considered clinically stable. [2] Immediate Kangaroo Mother Care (iKMC) avoids a potentially harmful, stressful, and ultimately unnecessary separation of the newborn from the mother (or parent taking her place).
Importantly, KMC is more than “just” skin-to-skin contact between a parent and their child. Rather, it is a practice that empowers families, especially mothers, to actively shape and contribute to their infant’s care. KMC centres care around the needs of the newborn, signalling a paradigm shift in how maternal and neonatal healthcare is understood and practiced.
Benefits of KMC
As multiple studies have repeatedly shown, KMC has significant health benefits for infants and their families. The scientific community has noted that, among other advantages, KMC
- reduces mortality rates,
- decreases rates of infection and sepsis,
- improves growth and weight-gain rates,
- stabilises heart rates,
- improves brain activity and cognitive development, and
- enhances long-term social and behavioural outcomes. [3-5]
Indeed, KMC also benefits the families who engage in it. The data show that
- breastfeeding rates increase,
- families leave the NICU faster and generally spend less time in hospital,
- both parents and infant have noticeably lower stress levels, and
- attachment and bonding between infant and parents are deepened. [3-5]
To conclude, when KMC is practiced, health outcomes improve drastically.
At the same time, hospitals and healthcare systems also profit from introducing the practice. Systematically encouraging families to practice iKMC and KMC ultimately cuts costs and lowers capital investments. Since it is family members who practice (i)KMC, medical staff is freed up to do other tasks. Moreover, hospitals need less expensive equipment which needs to be maintained and repaired regularly. [1, 4]
Parents’ rights to “Zero Separation”
Taking (i)KMC seriously as state-of-the-art neonatal care practice also requires hospitals (and the healthcare system as a whole) to rethink their treatment of parents and families. Proper (immediate) Kangaroo Mother Care is part and parcel of high-quality infant- and family-centred developmental care and as such deeply entwined with a “Zero Separation” policy. It means that parents are not seen as visitors but as integral part of the care team and trained and empowered to quickly become the competent main caregivers for their child – already in the NICU!
It follows that parents should be actively encouraged to extensively practice KMC already in the hospital and receive every support possible to do so. It is a sensible investment of time and resources by medical staff as supporting parents to become more confident in their role as main caregivers will alleviate their workloads in the long run. Hence, parents should never be treated as “problem” in the NICU and never have to pay a fee for wanting to be with their child at a time when he or she needs them the most.
Conclusion
As a care practice, iKMC and KMC have been shown to significantly enhance health outcomes for infants and their families. Hospitals and healthcare providers equally benefit from the practice. Already standards in many areas of the world, it is high time that all hospitals embrace iKMC and KMC as medically expedient interventions. In the same vein, families must be viewed and treated as part of the care team instead of being seen as mere visitors. Hospitals should never charge families a fee for wanting to practice (i)KMC. Indeed, (i)KMC should not be seen as a privilege for families but as an inherent right.
For more information, please also visit https://www.efcni.org/kmc/.
References
[1] World Health Organization. Kangaroo mother care: Implementation strategy for scale-up adaptable to different country contexts. World Health Organization, 2023, 9789240071636-eng.pdf (who.int).
[2] World Health Organization. “Kangaroo mother care started immediately after birth critical for saving lives, new research shows.” World Health Organization, 26 May 2021, https://www.who.int/news/item/26-05-2021-kangaroo-mother-care-started-immediately-after-birth-critical-for-saving-lives-new-research-shows. Last accessed 29 May 2024.
[3] Healthy Newborn Network. “Kangaroo Mother Care.” Healthy Newborn Network, https://www.healthynewbornnetwork.org/issue/kangaroo-mother-care/. Last accessed 29 May 2024.
[4] World Health Organization. Kangaroo mother care: a practical guide. World Health Organization, 2003, https://www.who.int/publications/i/item/9241590351.
[5] World Health Organization. WHO recommendations for care of the preterm or low-birth-weight infant. World Health Organization, 2022, https://apps.who.int/iris/handle/10665/363697.
