Health-and-Nutrition/C2/Kangaroo-Mother-Care/English-timed

Time	Narration
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

Debosmita, PoojaMoolya, Rajani st, Sandhya.np14