This article was originally published by WHO.
Mothers and babies should stay together after birth even when the baby is small or sick
Today, WHO released two new resources to support wider uptake of kangaroo mother care (KMC) – a lifesaving technique which includes ongoing skin-to-skin contact and exclusive breastfeeding – to benefit more small and preterm babies.
Now the leading cause of death of children under 5, prematurity is an urgent public health issue. Every year, an estimated 13.4 million babies are born preterm (before 37 weeks of pregnancy) while an even higher number – over 20 million babies – have a low birthweight (under 2.5 kg at birth). For these babies, KMC is a proven, effective intervention for saving lives and improving their health and development.
“Kangaroo mother care is one of the most critical, lifesaving measures to improve the survival prospects and wellbeing of babies born early or small,” said Dr Anshu Banerjee, Director for Maternal, Newborn, Child and Adolescent Health at WHO. “Ensuring mothers and babies everywhere can stay together and practice kangaroo mother care immediately after birth will require a radical rethink of how maternal and newborn care is organized – these new publications aim to support this process.”
The two publications – a global position paper and implementation strategy – seek to enable the expansion of KMC within health facilities and at home, globally. They follow the release of landmark new guidelines published last year, which recommend KMC as the essential standard of care for all preterm and low birthweight babies, starting right after birth. The new documents highlight that it should be available both for babies that are well and sick – for at least eight hours a day – including in intensive care.
“For most health facilities, achieving the widespread adoption of kangaroo mother care for all preterm or low birthweight babies will require fundamental changes in newborn care provision, especially neonatal intensive care,” said Dr Shuchita Gupta, Medical Officer at WHO who coordinated the development of the new documents. “This includes changes to the physical layout of care facilities, that enable the mother to stay with her small and sick baby inside the newborn care unit on a 24/7 basis. It also means changing the way healthcare is provided so that obstetricians, midwives, paediatricians, and nurses work together in harmony to care for mothers and babies in one place, as a unit.”
KMC has been shown to significantly improve survival and health outcomes for preterm and low birthweight babies, compared to clinical stabilization in a more ‘high-tech’ incubator or warmer. In fact, data shows it can increase preterm survival rates by as much as a third, reduce infections, prevent hypothermia, and improve feeding and growth. It is also empowering and reassuring for mothers and families who take a leading role in providing care for their infants.
Despite these benefits, only around a third of countries are estimated to have an updated policy or guideline on KMC, meaning millions of preterm and low birthweight babies are likely to be missing out on this lifesaving technique.
The new documents outline some key actions that should be taken to enable the wider adoption and implementation of KMC:
- Governments should recognize and include KMC as essential care for all preterm or small babies, ensuring it is financed and monitored – including the necessary infrastructure changes within hospitals – as part of national programmes. Additional parental leave and entitlements can help address the special needs of caregivers of preterm or low birthweight infants so that they can provide the requisite care.
- Facilities and healthcare providers should help ensure small and preterm babies can benefit from skin-to-skin contact with their mother for the recommended 8-24 hours a day, starting immediately after birth.
- Critically, both mother and newborn should receive respectful care, together, as a unit – even when the infant is sick and requires care inside the newborn care unit.
- Parents and caregivers should be involved in routine care and all aspects of decision-making around care for their newborns. They should be supported – with coaching, emotional and practical assistance – to provide KMC for their small and preterm babies.
- Partners and family members can help in providing KMC, providing relief for the mother, stepping in if she is unwell, and helping meet her needs while she is caring for her baby.
Developed in collaboration with a multi-country, multi-stakeholder working group, these resources are directed to governments, programme partners, policy makers and the broader public health community, to help countries expand KMC for babies born early or small. Around the world, WHO is providing ongoing assistance in implementing and scaling up KMC as the foundation of small and/or sick newborn care within national maternal, newborn and child health programmes.
The Working Group that developed these documents is comprised of various scientific experts, Ministries of Health and representatives from UN agencies (UNICEF, the World Bank, WHO), bilateral agencies (USAID, Japan International Cooperation Agency -JICA, Norwegian Agency for Development Cooperation-NORAD, the Foreign and Commonwealth Development Office of the United Kingdom- UK-FCDO), donor organizations (Bill and Melinda Gates Foundation, the Children’s Investment Fund Foundation (CIFF), Laerdal Foundation), parents groups (European Foundation for the Care of Newborn Infants, FUNDAPREMA, Preemie Connect), professional associations (the American Academy of Pediatrics,, Council of International Neonatal Nurses (COINN), the International Confederation of Midwives, the International Federation of Gynecology and Obstetrics (FIGO), the International Pediatric Association), and non-governmental organizations (Kangaroo Foundation, Médecins sans Frontières, Save the Children) and specialized partnerships like the Partnership for Maternal, Newborn and Child Health.View External Link