Serving Midland, Saginaw, Bay City, and Mt. Pleasant, MI
Kangaroo Mother Care and The Importance of Skin-to-Skin Contact
This article is taken directly from the Kangaroo Mother Care Promtion Website. Please use the link above for further information. P.S. It's not just for moms, dads can do it too!
What is KMC: How it Works
How It Works and the Benefits of doing KMC
Kangaroo Mother Care means skin to skin contact between mother and her newborn baby, this contact has remarkable effects. Breastfeeding is essential for the baby, from the first hour of life and onwards. The key message is : NEVER SEPARATE MOTHER AND HER NEWBORN. The benefits are even more crucial for a premature baby.
Dr Nils Bergman was the Doctor who introduced Kangaroo Mother Care (KMC) to South Africa. He has recently published the results of a strict scientific trial (in Acta Paediatrica) comparing skin to skin immediately after birth to incubator care . What he found was that skin to skin care was much better for the newborn than the incubator. Babies were warmer and calmer, breathed better and had a more stable heart rate with skin to skin care.
Surprisingly, the smaller the baby was-down to 1200grams- the more stable they were, and the more unstable in the incubator! This is opposite to what people think!
In fact there is other research suggesting that the incubator is harmful! Babies’ brain development requires skin to skin contact and being held and carried, and eye to eye contact to form the right brain pathways. Depriving babies of this skin to skin care makes alternative stress pathways which can lead to ADD, colic, sleep disorders etc.
Surprisingly incubators are still used for the very reason of stabilizing the baby when they in fact do the opposite!
So what are the benefits of Kangaroo Mother Care?
The benefits for all babies on KMC are that they stabilize faster on skin to skin care than in the incubator (they do not stabilize in the incubator in the first six hours of life)Then KMC babies have stable oxygen rates and breathing. The heart rate is stable. The temperature is most stable on the mother ( in skin to skin care the mothers chest automatically warms to warm a cold baby, and the mothers core temperature can drop if her baby has a temperature.) Another of the essential factors of KMC is breastfeeding: breastmilk production is stimulated by skin to skin care so baby gets all the benefits of breastmilk including the correct milk for humans. (Formula is made with cows milk which is designed for baby calves. The main protein in cows milk, casein, is actually toxic for the human baby’s gut so they get milk allergies on formula.)
The babies can breastfeed more often in KMC. This is necessary for growth as the baby’s stomach capacity at birth is only 5ml. After one week it is 30ml which only lasts for 90 minutes. Babies need to be feeding every one and a half to two hours.
The baby smells the breastmilk directly so the rooting instinct clicks in quickly and there are less subsequent problems with breastfeeding.
On the mothers chest the baby also gets gestation- specific breastmilk, if the baby is a premature, the milk content is different. Breasts can even produce different milk specific to the needs of each twin. The breastmilk contains all of the nucleotides necessary for brain growth. The mother’s colostrum carries the antibodies needed to protect the newborn with immunity.
In terms of protection, the baby will get antibodies and about a thousand other protective factors from the mother’s milk. There are less long term health problems for babies that have breastfed and had skin to skin contact. In skin to skin care the baby is in a relaxed mode so all of the hormones prepare the gut to absorb food maximally. The babies on KMC can grow at 30g per day which is three times that of an incubator baby. This will mean less time in hospital.
A major difference in skin to skin care is that babies cry less so they have less stress hormones like somatostatin circulating, so there are less brain bleeds which are very common in premature infants.
In Kangaroo Mother Care the development of the baby is the best. The baby is in the right place and therefore has the right behaviour. The baby is secure in skin to skin and the mother and infant bond is established early. This will mean that the baby will receive better long term emotional stability. The primary bond of mother and child is the base on which all subsequent relationships are built.
Developmental pathways of the brain grow in appropriate ways not in ways determined by stress.
ALL OF THESE ABOVE FACTORS ARE EVEN MORE IMPORTANT IF THE BABY IS BORN PREMATURE. Kangaroo Mother Care has many benefits for the mother.
Skin to skin care at birth helps the mother to bond with her baby immediately and the skin to skin contact releases oxytocin making the mother calmer and helping the production of breastmilk to start. Breastfeeding releases hormones which help to contract the uterus resulting in less blood loss at delivery. The mothers are empowered when they do skin to skin care. The Mum becomes central to the caring team. The skin to skin contact helps the mum and baby to settle in to a rhythm of sleeping and waking together called “sleep synchrony” so the mother gets more sleep.
For premature deliveries mothers often have a sense of guilt and anxiety and are prone to post-natal depression. Holding her baby on her chest in Kangaroo Mother Care helps her to feel that she is completing her baby’s gestation and that she is giving her child the best possible care.
The Importance of Skin to Skin Contact
by Jack Newman, M.D., FRCPC
There are now a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby's temperature is more stable and more normal, the baby's heart and breathing rates are more stable and more normal, and the baby's blood sugar is more elevated. Not only that, skin to skin contact immediately after birth allows the baby to be colonized by the same bacteria as the mother. This, plus breastfeeding, are thought to be important in the prevention of allergic diseases. When a baby is put into an incubator, his skin and gut are often colonized by bacteria different from his mother's.
We now know that this is true not only for the baby born at term and in good health, but also even for the premature baby. Skin to skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their needs for oxygen, and keeps them more stable in other ways as well.
From the point of view of breastfeeding, babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without any help and they are more likely to latch on well, especially if the mother did not receive medication during the labour or birth. As mentioned in "Breastfeeding - Starting out Right", a baby who latches on well gets milk more easily than a baby who latches on less well. When a baby latches on well, the mother is less likely to be sore. When a mother's milk is abundant, the baby can take the breast poorly and still get lots of milk, though the feedings may then be long or frequent or both, and the mother is more prone to develop problems such as blocked ducts and mastitis. In the first few days, however, the mother does not have a lot of milk (but she has enough!), and a good latch is important to help the baby get the milk that is available (yes, the milk is there even if someone has "proved" to you with the big pump that there isn't any). If the baby does not latch on well, the mother may be sore, and if the baby does not get milk well, the baby will want to be on the breast for long periods of time worsening the soreness.
To recap, skin to skin contact immediately after birth, which lasts for at least an hour has the following positive effects on the baby:
Are more likely to latch on
Are more likely to latch on well
Have more stable and normal skin temperatures
Have more stable and normal heart rates and blood pressures
Have higher blood sugars
Are less likely to cry
Are more likely to breastfeed exclusively longer
There is no reason that the vast majority of babies cannot be skin to skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence.
The baby should be dried off and put on the mother. Nobody should be pushing the baby to do anything; nobody should be trying to help the baby latch on during this time. The mother, of course, may make some attempts to help the baby, and this should not be discouraged. The mother and baby should just be left in peace to enjoy each other's company. (The mother and baby should not be left alone, however, especially if the mother has received medication, and it is important that not only the mother's partner, but also a nurse, midwife, doula or physician stay with them—occasionally, some babies do need medical help and someone qualified should be there "just in case"). The eyedrops and the injection of vitamin K can wait a couple of hours. By the way, immediate skin to skin contact can also be done after cæsarean section, even while the mother is getting stitched up, unless there are medical reasons which prevent it.
Studies have shown that even premature babies, as small as 1200 g (2 lb 10 oz) are more stable metabolically (including the level of their blood sugars) and breathe better if they are skin to skin immediately after birth. The need for an intravenous infusion, oxygen therapy or a nasogastric tube, for example, or all the preceding, does not preclude skin to skin contact. Skin to skin contact is quite compatible with other measures taken to keep the baby healthy. Of course, if the baby is quite sick, the baby's health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin to skin with the mother immediately after birth. Indeed, in the premature baby, as in the full term baby, skin to skin contact may decrease rapid breathing into the normal range.
Even if the baby does not latch on during the first hour or two, skin to skin contact is still good and important for the baby and the mother for all the other reasons mentioned.
If the baby does not take the breast right away, do not panic. There is almost never any rush, especially in the full term healthy baby. One of the most harmful approaches to feeding the newborn has been the bizarre notion that babies must feed every three hours. Babies should feed when they show signs of being ready, and keeping a baby next to his mother will make it obvious to her when the baby is ready. There is actually not a stitch of proof that babies must feed every three hours or by any schedule, but based on such a notion, many babies are being pushed into the breast because three hours have passed. The baby not interested yet in feeding may object strenuously, and thus is pushed even more, resulting, in many cases, in babies refusing the breast because we want to make sure they take the breast. And it gets worse. If the baby keeps objecting to being pushed into the breast and gets more and more upset, then the "obvious next step" is to give a supplement. And it is obvious where we are headed (see "When a Baby Refuses to Latch On").
Written by Jack Newman, firstname.lastname@example.org MD, FRCPC. © 2005
This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breast milk substitutes is violated.