In a bright and colourful room in the government-run Veerangana Avanti Bai Women’s Hospital in Uttar Pradesh’s Lucknow, mothers are quietly nurturing their premature infants through their touch.
With soothing music in the background, the skin-to-skin contact or Kangaroo Mother Care (KMC) between the mother and the baby works wonders ensuring the survival of these babies.
KMC is a standard therapy for caring low-birth-weight infants in under-resourced settings that can reduce “morbidity and mortality” and recommended by the World Health Organization (WHO). According to estimates, the therapy has the potential to reduce 1 million infant deaths globally every year.
Sridevi, who uses one name, is one such mother to have benefitted from the innovative therapy. For Sridevi was worried about the survival of her daughter who weighed just 900 grammes at birth. She was all the more precious because she was the second surviving child of six pregnancies.
Initially reluctant to adopt the therapy, she agreed to experiment with the advice - give a skin to skin touch to the baby for prolonged hours. She did it religiously and when she was discharged from the hospital, her baby weighed 2 kilogrammes. Sridevi continues the therapy at home and now her daughter is a healthy six-month-old.
This skin-to-skin touch technique has recently been introduced in Veerangana Avanti Bai Women’s Hospital in the state capital where the room was readied in 15-days time. It will be also be launched in all the 79 Sick Newborn Care Units (SNCUs) across the country’s most populous state.
“A dedicated ward for KMC started on July 30. Specialised chairs, beds and gowns were arranged to enable mothers to give skin therapy to the babies. The room was designed to make the mothers feel comfortable as in many cases they are required to give around 20 hours of KMC to the baby,” Subodhini Briscoe, sister-in-charge at Avanti Bai hospital, said.
“The screen in the room shows them breastfeeding tricks and other newborn care methods. The instrumental music relaxes them and makes them comfortable to allow KMC to the newborn,” she added.
Dr Vishwajeet Kumar, a physician with a master’s degree in global health from John Hopkins University, and his wife Aarti Kumar introduced the therapy as a community experiment in Shivgarh, nearly 80 km from Lucknow, in 2003. Both quit their careers abroad and chose to work in Shivgarh villages. Aarti is an infotech professional and worked in Singapore.
An article about their work was published in the journal The Lancet and Melinda Gates, the co-chair and trustee of Bill & Melinda Gates Foundation, visited the community to see how the model was working.
“What is unique about KMC is the human touch. There are no machines and no medication. Neither the baby nor the mother is treated and made to feel as a patient. Instead, it is a simple method wherein a mother keeps a bare-bodied infant on her own bare body. This regulates the baby’s body temperature and induces lactation in the mother,” Dr Vishwajeet, CEO and principal scientist in the Community Empowerment Lab that has introduced the technique in the state, said.
However, despite its benefits, less than 1% infants were receiving its benefits, said Dr Vishwajeet.
“In UP, 54 lakh babies are born every year, of which 2.6 lakh die in the first 28 days (newborn period). Potentially 66,000 of these babies could be saved through KMC,” he added.
KMC was also started in the government-run King George’s Medical University in 2005 but could not run for long. “The doctors who started KMC were transferred and thus the practice was discontinued,” Dr Vishwajeet said.
However, this time the government is planning to take the practice to all government hospitals across the state and officials are hoping it can help bring down infant mortality rate.
“Within a few months, 79 KMC units would be functional across the state. A budget of Rs 1 lakh has been sent to each district to ensure that KMC units are made an integral part of the SNCUs and furniture and gowns etc are arranged,” Alok Kumar, director of National Health Mission (NHM), said.
Awareness programmes through social media and other methods will also be undertaken on a massive scale to apprise pregnant women about KMC, he added.
A number of private hospitals have also shown the willingness to introduce KMC in their facilities. “Some private hospitals here contacted us to start KMC as they are convinced by the benefits of the practice,” Dr Vishwajeet said.
Dr Fahad Ishlahi, managing director of Lucknow’s Metro Hospital, said they have been using incubators and other such equipment to take care of pre-term babies.
“But this KMC is a really good option. Since we have observed the results in some mothers, we are going to introduce this in a big way in our hospital.”
Dr Jyotsna Mehta, a leading gynaecologist in Lucknow, said this practice has a number of benefits and she encourages mothers of normal babies to follow the therapy as well.
“Not just in cases of preterm deliveries and underweight babies, we ensure that soon after delivery, a skin to skin contact is ensured between the mother and baby,” she added.
What is Kangaroo Mother Care (KMC)?
KMC is a technique for creating a womb-like environment for the newborn after birth that provides the four basic needs of the baby: warmth, food, love and protection. It significantly benefits all newborns, especially those with low birth weight and premature babies.
It involves three aspects of infant care: skin-to-skin contact, exclusive breastfeeding and support to the mother and baby. Babies kept in KMC position are found to have improved survival, reduced illness, weight gain and overall neurodevelopment.
Who can give KMC?
While the best person to provide KMC is the mother in order to enable breastfeeding, any healthy person can provide KMC to the baby. The father can also provide KMC. Often mothers are exhausted after delivery or have other complications and need to be supported to ensure prolonged KMC to the baby.
How should KMC be given?
All newborns should be provided KMC at birth. Preterm and babies weighing less than 2000g need prolonged KMC for 20 hours daily. The baby should wear a nappy and cap. “Sit in a chair with cushions so you can lean back a bit and be comfortable. It is best for your baby if you are half lying, half sitting. The angle of 30-40 degrees helps baby’s breathing. Place your baby on your chest facing you with her legs curled up in the foetal position. This is best for the baby’s hips. Put his/her tiny hands near his/her face for self-soothing. The baby has been doing that for months in the womb already. Cover the baby and yourself. Your body will automatically warm up if your baby is cold or will cool down if your baby is hot. You might find that you start to sweat. Don’t worry, that is normal,” Aarti said.