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00:00 Welcome to the Spoken Tutorial on Kangaroo mother care.
00:05 In this tutorial, we will learn -
00:08 what is Kangaroo mother care?
00:10 the components, importance and
00:13 procedure of Kangaroo mother care.
00:17 Let us first begin with the introduction of Kangaroo mother care.
00:22 As the name suggests -
00:24 it involves keeping the baby in skin to skin contact with the mother.
00:29 And, it is popularly known as KMC.
00:32 Remember, KMC should be given as soon as the baby is born.
00:39 It is especially recommended for low birth weight babies-
00:44 whose birth weight is less than 2.5 kilograms and
00:48 who do not require continuous monitoring.
00:52 However, it can be used for all normal, healthy full-term babies too.
00:59 KMC consists of two main components:
01:03 continuous and prolonged skin to skin contact between the mother and her baby
01:09 and exclusive breastfeeding.
01:13 Let’s discuss these components in detail.
01:17 The first component is skin to skin contact.
01:21 It improves the let down reflex
01:24 and ultimately increases the breast milk production.
01:28 Let down reflex has been explained in another tutorial of the same series.
01:34 The second component is exclusive breastfeeding.
01:38 Note that
01:40 exclusive breastfeeding is recommended for the first 6 months.
01:45 Next, let’s discuss the importance of Kangaroo care.
01:50 Prolonged skin to skin contact during KMC helps maintain the baby's body temperature
01:57 and the baby feels more secure.
02:01 KMC also decreases
02:03 the frequency of infection and
02:05 the rate of apnea in babies.
02:09 Apnea is defined as long pauses in breathing.
02:13 Apart from these-
02:15 KMC improves the frequency and duration of breastfeeding.
02:20 And, it strengthens the emotional bonding between the mother and her baby.
02:26 KMC also helps the baby-
02:28 to gain weight than any other conventional methods such as-
02:33 keeping the baby in radiant warmer
02:36 which creates stress for the baby and the mother.
02:40 It also improves the satisfaction and confidence in the mother
02:45 as she takes extra effort for her baby.
02:49 Interestingly, apart from mothers, KMC can be provided by-
02:54 father or
02:56 any adult family member too.
02:58 We will now discuss the points to be followed by KMC provider.
03:04 The KMC provider should be healthy and free from illness.
03:09 He or she should follow basic hygiene practices such as-
03:14 hand washing,
03:16 daily bath,

clipped fingernails,

03:18 tied up hair
03:20 and clean clothes.
03:22 He or she should not wear any jewellery, watches and threads
03:26 as these may become the barriers to maintain the hygiene
03:31 and it can cause injury to the baby.
03:35 Now, let us discuss the type of clothes the provider should wear during KMC -
03:42 clothes should be front open and lightweight.
03:46 for example, sari-blouse or front open gown.
03:51 Note that the KMC provider should wear this front open gown or blouse around KMC wrap.
03:58 Kangaroo bags or binders can be bought from the market as well.
04:04 These are useful if KMC has to be done for an extended period.
04:09 Alternately, the KMC provider can use soft clean cotton fabric.
04:16 Whereas the baby during KMC should -
04:19 wear a cap and a nappy.
04:22 If the baby passes stool or urine during KMC then
04:27 she should be cleaned and dried thoroughly.
04:30 Next, we will move ahead to the procedure of Kangaroo care in detail.
04:36 Firstly, the mother should stand in an upright position.
04:40 Then, either a health worker or any family member should do the following things step-wise-
04:48 by supporting the baby’s bottom and head,
04:51 place the baby between the mother’s bare breasts in an upright position.
04:56 Then turn the baby’s head to one side.
05:00 Make sure the baby’s head is slightly bending backward.
05:04 This position will keep the baby’s nose airways open
05:08 and will allow the baby to make eye to eye contact with the mother.
05:14 Then bend the baby’s hips slightly outward.
05:18 Remember to keep baby’s arms above the mother’s breast and
05:23 legs below the mother’s breast and
05:27 the baby’s abdomen on the chest of the mother.
05:29 Before wrapping with the cloth,
05:32 cover the baby with a blanket if environment is cold.
05:36 It will keep the baby and the mother warm.
05:39 Then wrap a cloth around the baby and mother’s chest and abdomen.
05:45 While wrapping, make sure -
05:47 the center of the cloth is on the baby
05:50 and both ends of the cloth should
05:53 pass through the armpits of the mother
05:56 and should cross at the back.
05:59 After that, bring the edges of the cloth in the front.
06:03 Secure these edges of the cloth with a safe knot under the baby’s bottom.
06:09 This is comfortable and helps support the baby.
06:14 Also it avoids slipping of the baby.
06:17 Remember, as the mother becomes comfortable, she should learn to wrap the cloth by herself.
06:24 The technique of self-wrapping during KMC will be explained in another tutorial of the same series.
06:32 It will increase the mother’s confidence and make her independent.
06:37 If mother is uncomfortable while using a cloth then she can use a stretchy band.
06:43 It is easy and comfortable to use.
06:46 While using a stretchy band,
06:49 adjust the edge of the band above the baby’s ear to support his head.
06:54 Then, tilt the baby’s head slightly
06:57 to breathe freely and
06:59 to make eye-to-eye contact with the mother as explained earlier.
07:04 The wrapped cloth or stretchy band should not be too tight or too loose.
07:11 It should be comfortable enough for the baby to breathe freely.
07:15 Remember, while carrying a baby in KMC position, mother should be able to
07:20 walk, stand, sit or
07:23 involve in different activities.
07:26 If a mother is very comfortable then
07:29 she can even sleep during Kangaroo care in a reclined or a semi-reclined position.
07:35 Now let’s discuss how to feed the baby during KMC.
07:40 Either mother can feed the baby
07:43 by simply loosening the wrapped cloth and
07:46 positioning the baby for breastfeeding.
07:50 Or, she can manually express breast milk and
07:54 feed the baby using a cup or spoon.
07:57 Remember, each day baby should gain up to 25 to 30 grams of weight.
08:03 Expected weight gain of a baby in a month is up to 900 to 1,000 grams.
08:10 Hence, mother or health worker should
08:13 monitor the weight of the baby during routine check-ups.
08:17 If the baby fails to gain sufficient weight,
08:21 health worker should monitor the breastfeeding technique of the mother or
08:25 check how many times the baby urinates.
08:28 Also, guide the mother about the correct latching.
08:32 Correct latching has been explained in an another tutorial of the same series.
08:39 Next, let’s learn how to remove the baby from the wrapped cloth.
08:44 Firstly, the mother should sit in the upright position.
08:48 Then start untying the knot with one hand and
08:53 support the baby’s bottom with other hand on the outside of wrapped cloth.
08:58 After that, loosen the wrapped cloth with the same hand which was earlier used for untying the knot.
09:04 Then shift the hand under the cloth which was supporting the baby’s bottom and
09:11 use the other hand to support the baby’s bottom from outside the cloth.
09:16 Then lift the baby up and free her from the wrapped cloth.
09:21 After that, remember to hold the baby’s head in a way
09:26 where the thumb is behind one ear and
09:28 other fingers are around the other ear.
09:30 During KMC,
09:32 the mother should immediately consult the doctor and the health worker -
09:37 if the baby is not alert and active,
09:41 if the baby is breathing too fast or taking too long pauses,
09:46 if the baby’s lips or tongue turns blue
09:50 and if baby’s feet are cold.
09:53 This brings us to the end of this tutorial on Kangaroo mother care.
09:58 Thanks for joining.

Contributors and Content Editors

PoojaMoolya, Rajani st, Sandhya.np14