Kangaroo Mother Care is an effective method of bonding and healing
May 15th marks International Kangaroo Mother Care (KMC) Awareness Day. Kangaroo mother care (KMC) refers to the practice of providing continuous skin-to-skin contact between mother and baby, exclusive breastmilk feeding, and early discharge from hospital. KMC is an especially important intervention for babies that are born prematurely.
“What many people don’t know is that KMC also facilitates the process of healing for babies experiencing health challenges here at our hospital,” explains Sr Zeenat Dalwai, Operational Manager in charge of the KMC ward at the Mowbray Maternity Hospital. “Inside this ward there are babies with different issues, it’s not just premature babies. We have had infants that are very sick, or babies that have had feeding issues. We are very blessed at our hospital to have the big KMC ward. The main aim of KMC ward is to facilitate the opportunity for a mom to spend that very precious time with her baby. This is a space where mom and baby can have the space and time that was lost when baby was sick, and being treated in ICU or high care for their illness. I don’t want people to think that KMC is just for the very small babies. Skin to skin is such a simple yet effective method of bonding, and of healing between mom and baby.”
As part of the Western Cape Government Health and wellness Mother Baby Friendly Initiative policy, all babies must be placed in the skin to skin position immediately after birth and should remain in that position for at least an hour. Besides being good for bonding, it also provides warmth to the baby, regulates the baby’s heartbeat, and enhances lactation. Babies have direct access to the breast and can feed at any time.” Sr Dalwai explains that in addition, to giving the opportunity for mothers to bond and get to know their babies better, the hospital also offers health education around breastfeeding as well as resuscitation training. “Should our mothers have any issues at home, we want them to know what to do until help arrives via EMS.”
During the pandemic, visiting hours have had to be restricted and visitors limited for the health and safety of staff, patients and visitors to the hospital, which impacted the educational component of the Mother-Baby Friendly Initiative. The Department’s Mother-Baby Friendly Hospitals Initiative has driven the hospitals efforts to ensure that loved ones who visit mom and baby can also participate in KMC. “It is unfortunate that during this pandemic we do not have the opportunity to provide the education and support to a larger group of caregivers as we did prior to COVID-19. Many of our moms, especially our younger mothers or those who have experienced trauma during birth, are in need of support. This is why we ensure that during visiting hours any one family member or caregiver has the opportunity to visit. If mom requests, then we allow the visitor to provide skin-to-skin to the baby.”
Rosine Umuhoza, a 26-year-old mother from Mowbray, has spent the past two months at Mowbray Hospital and shares how one week of KMC has made such a difference to her little baby girl, Gianna. ”I never thought I would be here this long. I had no issues with my pregnancy, no high blood pressure, no sugar. After giving birth everything was fine. I had an emergency c-section as I had been in labour for quite a while. Then about nine minutes after her birth, while holding her, she seemed to have ‘fainted’ and lost consciousness, turning blue. The nurse took her from my chest and they did CPR. She was revived, intubated, and admitted to ICU. She remained there for nine days with little improvement. She had seizures and the staff did so well and tried everything. We were counselled and told that there is a possibility she may not make it. On 19 March we were transferred to Red Cross War Memorial Children’s hospital. When we got there the doctors were worried and each time they tried to remove the intubation tubes she would stop breathing. We saw speech therapists and physiotherapists. Little by little things improved and she was placed on oxygen. However, she still had problems feeding and so we returned to Mowbray Maternity Hospital so that she could receive continuous care while healing.
Gianna was placed in the High Care Ward and for several days was nourished via a feeding tube, which she adapted to well. Slowly but surely she started gaining weight and now she is a healthy 3.8 kg. “Day by Day I would sit with her in High Care and preferred staying with her rather than go back to my ward. I spoke to the doctors and they agreed that we could be admitted to the KMC ward where I could spend more one on one time with her, skin to skin. It was advised this would be good so that she could learn to bond with me and smell me. I started doing this every day and immediately I could see how she would be busy looking on my chest as she could smell the milk and wanted to feed. So then, I took the chance and tried to put my nipple in her mouth…slowly she started to suck and I was so happy! Some days she refused, and others she would try, and now she is drinking out of feeding cup as it seems to be easier for her. I have been here for one week and I have learnt so much from the doctors, nurses and staff, and I am happy to say that today we will be discharged!
Rosine agrees that the practice of KMC has helped her tremendously. “It has been so amazing to be here, I was exhausted and by being in this ward I can see the improvement. I can see when she is hungry, I can now feed her and we have created a better bond.”
Sr Dalwai reminds us that KMC does not start in the KMC ward, it is encouraged from birth inside the labour ward. Whether baby is moved to High Care ward because of illness or is a healthy baby and discharged, the practice is encouraged by the health care team at all times. “KMC can be done anytime, every day, and there is no time limit. Every baby is different so it is dependent on mom’s journey and baby’s journey. When we send a baby home, our desire is to send home a happy mother and baby, and ensure that the baby is sent to an environment where we know the baby will be happy and thrive. We want mom and baby to be comfortable with each other. It would be pointless for the baby to be at goal weight and discharged but not have achieved success with feeding, so we always encourage our mothers to be patient and ensure that both mom and baby are happy and healthy. The opportunities experienced here at the hospital are to equip moms to nurse in the best way possible at home. We encourage momd to attend their follow-up appointment dates as part of the First Thousand Days health plan, to remember their resuscitation training, to apply their health education given by our nurses, and to take their babies for their immunisations.”
The benefits of Kangaroo mother care are numerous. It is beneficial for parents because it improves growth and reduces morbidities in low birth infants, it promotes attachment and bonding, helps to promote increased milk production and breastfeeding success. Sr Dalwai adds that along with the emotional, neurological and psychological development of kangaroo care, temperature control and unspoken language between baby and mommy is so important. “KMC does not stop at our hospital, it must continue in the community. Moms that are going back to work who are able to breastfeed, are shown how to express and freeze their milk. We explain how caregivers can also be included as unfortunately most of our moms have to go back to work quickly as they have to provide for their families. I think that the most amazing thing for me is that with all the advancements in medical technology that is available worldwide, something as simple and natural as KMC can have so much benefits. I think that is just amazing!”