Kangaroo mother care (KMC), which involves skin-to-skin contact (SSC), is an intervention to care for premature or low birth weight (LBW) infants. The technique and intervention is the recommended evidence-based care for LBW infants by the World Health Organization (WHO) since 2003. In the 2003 WHO Kangaroo Mother Care practical guide, KMC is defined as a "powerful, easy-to-use method to promote the health and well-being of infants born preterm as well as full-term", with its key components being:
Early, continuous, and prolonged SSC between the mother and the baby; Exclusive breastfeeding (ideally); Initiated in a hospital setting and can be continued at home; Allows for early discharge of the baby to the family; After discharge, includes close followup The early KMC technique was first presented by Rey and Martinez in 1983, in Bogotá, Colombia, where it was developed as an alternative to inadequate and insufficient incubator care for those preterm newborn infants who had overcome initial problems and required only to feed and grow. Decades of research and development, much from researchers from emerging economies, has improved upon the initial work and has documented that modern evidence-based KMC lowers infant mortality and the risk of hospital-acquired infection, increases weight gain of infants, increases rates of breastfeeding, protects neuromotor and brain development of infants, and improves mother-infants bonding, among other benefits. Today, the WHO recommends "Kangaroo mother care (KMC) for preterm or low-birth-weight infants should be started as soon as possible after birth" based on "high-certainty evidence".
Scientific documentation of benefits Originally babies who were eligible for KMC included LBW infants weighing less than 2,000 grams (4 lb 7 oz) and breathing and eating independently. Cardiopulmonary monitoring, oximetry, supplemental oxygen or nasal ventilation (continuous positive airway pressure), intravenous infusions, and monitor leads do not prevent KMC. In fact, babies who are in KMC tend to be less prone to apnea and bradycardia and have stabilization of oxygen needs. KMC has been shown to provide many benefits to the infant, as well as to the family directly involved in the infant's care. Large reviews of the thousands of scientific articles that present the body of evidence have been published, that serve as the bases for practical guides for practitioners. After initial reviews of scientific evidence in the mid-1990s highlighted research ongoing in both developed and developing countries, research into KMC grew exponentially. Systematic reviews of hundreds of scientific articles have documented the impact of KMC on mortality, morbidity, and quality of survival LBW infants. A randomized controlled trial published in 2016 reported that babies born between 1,500 and 2,200 grams (3 lb 5 oz and 4 lb 14 oz) became physiologically stable in SSC starting from birth, compared to similar babies in incubators. A descriptive study of case series in a hospital without any technical resources evaluated two of the components of the KMC: the inpatient kangaroo position and kangaroo feeding and was published in 1994. This paper supports the hypothesis that, in cases of absence of technical resources, inpatient kangaroo position and nutrition is an acceptable alternative.
In 2016, a Cochrane review, "Kangaroo mother care to reduce morbidity and mortality in low birthweight infants", was published bringing together data from 21 studies including 3,042 LBW babies (less than 1,500 grams (3 lb 5 oz) at birth). This review showed that babies receiving kangaroo care had a reduced risk of death, hospital-acquired infection, and low body temperature (hypothermia); was also associated with increased weight gain, growth in length, and rates of breastfeeding.
Preterm and LBW infants Kangaroo care "is an effective and safe alternative to conventional neonatal care for LBW infants, mainly in resource-limited countries". KMC reduces mortality, and also morbidity in resource limited settings, though further studies are needed. Kangaroo care arguably offers the most benefits for preterm and LBW infants, who experience more normalized temperature, heart rate, and respiratory rate, increased weight gain, and fewer hospital-acquired infections. Additionally, studies suggest that preterm infants who experience kangaroo care have improved cognitive development, decreased stress levels, reduced pain responses, normalized growth, and positive effects on motor development. Kangaroo care also helps to improve sleep patterns of infants and may be a good intervention for colic. Earlier discharge from hospital is also a possible outcome Finally, kangaroo care helps to promote frequent breastfeeding and can enhance mother–infant bonding. Evidence from a recent systematic review supports the use of kangaroo mother care as a substitute for conventional neonatal care in settings where resources are limited.
For parents Kangaroo care is beneficial for parents because it promotes attachment and bonding, improves parental confidence, and helps to promote increased milk production and breastfeeding success. A 2017 study found that the psychological benefits of kangaroo care for parents of preterm infants are fairly extensive. Research shows that the use of kangaroo care is linked to lower parental anxiety levels. It was shown to decrease anxiety scores in both mothers and fathers, unrelated to parents' marital status. Kangaroo care has also been shown to lead to greater confidence in parenting skills. Parents who used kangaroo care displayed higher confidence in their ability to care for their child. It has been shown to positively impact breastfeeding as well, with mothers producing larger amounts of milk for longer periods of time.
For fathers
Both preterm and full term infants benefit from SSC for the first few weeks of life with the baby's father as well. The new baby is familiar with the father's voice, and it is believed that contact with the father helps the infant to stabilize and promotes father to infant bonding. If the infant's mother had a caesarean birth, the father can hold their baby in SSC while the mother recovers from the anesthetic. A 2016 study looked at international literature reviews of early SSC benefits for infants and fathers. Their findings for infants included:
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