Kangaroo mother care - Saving babies born too soon
13 September 2013 - There are no crying babies or cheering family members as you approach the Kangaroo Mother Care Unit (KMC) of the Queen Elizabeth Hospital in Blantyre. This is, after all, no average newborn ward. The babies here weigh less than 1.5kg and their tiny arms and legs are barely visible from under the blankets, woollen hats and booties that are keeping them warm. Their fragile state makes any visitor want to tip-toe around the ward, afraid any noise will upset them.
In a country such as Malawi, where incubators are expensive and of limited availability, Kangaroo Mother Care (KMC) is an alternative approach for premature baby-care. Continuous skin-to-skin contact is the key element of this treatment, as the mothers carry their babies on their bare chest, covering their little ones in warm blankets. This process encourages the babies to start controlling their own body temperature and warmth, and also strengthens the emotional bond between mother and child.
As some of the babies are too weak to be breastfed, their mothers feed them breast milk out of a small measuring cup. Not only do they have to develop a base weight of 2.5kgs, they also need to be strong enough to breastfeed without assistance before the hospital can discharge them.
Child mortality in Malawi is on the decline, but there are still too many babies dying in the first month of life. Latest figures indicate that every about 15000 babies don’t make it through the first month of life. In the newborn unit however, nurse Netsa Gowelo gives us hope.
‘After discharging a mother and child to proceed the KMC-therapy at home, it’s rare for a baby to get sick or worse’. ‘Every preterm baby needs to be observed closely, we can’t forget that they are incredibly fragile. This way of carrying your baby close to you doesn’t just serve the purpose of keeping him warm, it also gives you the chance to keep an eye on him’.
Trained nurses teach the mothers how they best position their baby, what symptoms they have to look out for and how they can lead their lives carrying their child on their chest. ‘Cooking is the perfect example of an everyday activity that suddenly becomes a lot less easy when you have a baby in front of you. That’s why we have an outside kitchen in which the mothers can practise cooking while they are still under our care’.
The appropriate infrastructure, built by UNICEF with the support of partners five years ago, makes this facility one of the best KMC referral points in the country.
In a similar unit in Chikwawa District Hospital, the visible differences couldn’t be clearer: the ward is a small room with three beds, a table and a weighing scale; nothing more.
Even though this may at first seem limited, Yvone Ngalauka, the Nurse in charge of the maternity ward, tells me we shouldn’t be concerned. ‘Normally the three beds suffice, only occasionally are there more than three mothers.
When there are though, they have to share a bed. Sometimes we see that a baby isn’t improving or gaining weight. In that case, we refer the mother immediately to Queen Elizabeth Hospital. Their intensive care unit has incubators and the staff received training from UNICEF, so difficult cases are better treated there’, said Ngalauka while assisting one of the mothers put her child on kangaroo.
In a low-income country like Malawi, with a high rate of premature births, Kangaroo Care is proving an effective, and appropriate way to treat and increase the chances of survival for these tiny, vulnerable babies.
Malawi is one of the countries that has signed up to A Promise Renewed – a global initiative supported by USAID and UNICEF to end preventable child deaths.