Kangaroo mother care: need of the day

Neonatal mortality figures in developing globally as of 2016 was 19 per 1000 live birth [1], 28% due to preterm birth [2]. Prematurity, babies born prior to 37 weeks of gestation, puts newborns at risk for infections, hypothermia, development delay, visual disorders and long term morbidity. In developed countries Neonatal Intensive Care Units where trained nurses and physicians care for these patients. In developing countries NICUS are scarce therefore not an adequate solution for this population. Sohail et al. present a compelling case report shedding light on the benefits of Kangaroo Mother Care (KMC). KMC was introduced in 1978 in Bogota [3] as an alternative to incubators and since then has slowly spread through the developing world. The KMC is cost effective and implementable in low resource countries. It is composed on 20+ hours daily of skin to skin contact, exclusive breast feeding, early hospital discharge and hospital follow ups. Studies show lower rates of infections, better thermo regulation, increased mother child bonding [4]. General physiological parameters were also improved in these newborns. The data is encouraging with a meta analysis showing KMC is associated with a 51% reduction in cause specific mortality [5]. This cost effective model could be extrapolated and implemented in regions of developed countries where NICUs are not readily accessible, or are of financially prohibitive costs. Furthermore the 6 step training program for implementation of KMC is economically friendly and does not require extra personnel, enabling a sustainable model [6]. As mentioned in the article some of the NICU equipment, such as incubators, are expensive and difficult to maintain in the developing world, thus limiting their use. The KMC does not require such tools and the skin to skin contact can be attained with a wrap around cloth. One essential aspect to global health and designing healthcare solutions for low-medium resource settings is sustainability. Through this case report we can appreciate the implementation of a cost effective easy to implement solution with data showing decreased morbidity and mortality through this use of KMC. It is very encouraging to read such an elegant solution to the global burden of morbidity and mortality associated with low birth weight and prematurity.

 

1 World Health Organization. Essential newborn care: report of a technical working group (Trieste, 25-29 April 1994). Geneva: World Health Organization, 1996. Available: https://apps.who.int/iris/handle/10665/63076 [Accessed 11 Nov 2018].Google Scholar

2 Lawn JE , Cousens SN , Darmstadt GL , et al . 1 year after the Lancet neonatal survival series — was the call for action heard? Lancet 2006;367:1541–7.doi:10.1016/S0140-6736(06)68587-5 CrossRefPubMedWeb of ScienceGoogle Scholar

3 Rey ES , Martinez HG . Universidad national. Bogota: Curso, de Medcena, 1983.Google Scholar

4 Bera A , Ghosh J , Singh AK , et al . Effect of kangaroo mother care on vital physiological parameters of the low birth weight newborn. Indian J Community Med 2014;39:245–9.doi:10.4103/0970-0218.143030

5 Lawn JE , Mwansa-Kambafwile J , Horta BL , et al . ‘Kangaroo mother care’ to prevent neonatal deaths due to preterm birth complications. Int J Epidemiol 2010;39:i144–54.doi:10.1093/ije/dyq031

6 Kangaroo Mother Care Implementation Guide, June 18 2012. Available: https://www.healthynewbornnetwork.org>resource>kangaroo-mother-care