In-Hospital & Outpatient KMC
  1. In-Hospital Kangaroo Mother Care
    1. KMC position
      1. As soon as the premature/LBW baby is in stable condition, based on the attending doctor’s assessment, the mother can start providing kangaroo mother care (KMC), starting with the kangaroo position.
      2. The stable LBW baby is placed on the mother’s chest, skin-to-skin, prone in between her breasts, with the head turned to one side and held close to the chest by any of the KMC clothing enumerated previously.
      3. While in position, the baby’s stability is constantly monitored in terms of temperature, heart rate, breathing rate and oxygenation/color. This is done by hospital personnel with or without the aid of equipment in the nursery or newborn intensive care unit.
      4. The mother is likewise monitored for any signs of anxiety, distress or level of comfort during the kangaroo position.
      5. Duration of keeping the baby in this position is dependent on the mother and baby’s tolerability, stability and comfortability. It can be anywhere from 1-24 hours while in the hospital setting. It is expected, however, that the mother and baby dyad will be slowly adapted to the position until continuous 24-hour KMC is possible, usually in the ward or KMC unit, which the hospital facility should be able to provide.
      6. Intermittent KMC position has been shown to be beneficial to both mother and baby, provided appropriate incubator care is given while the mother is away or unable to keep the baby in position. Continuous KMC is highly desirable before the baby is discharged to home KMC.
      7. The mother is taught how to handle her small baby and maneuver the baby’s position in and out of her KMC clothing for feeding or washing.
      8. Sleeping in KMC position is also demonstrated and the mother and baby are both monitored in their adaptation process.
    2. Outpatient or Home Kangaroo Mother Care
      1. Feeding techniques using the dropper or cup, when appropriate for the baby, is taught and demonstrated to the mother. It is important that the mother return-demonstrates her capability to feed using these supplementary methods to direct breastfeeding
      2. Special breastfeeding positions for the LBW, previously enumerated, shall be taught to the mother and her capability to do the same on her own must be demonstrated while in the hospital setting.
      3. Weight gain and growth should be monitored and consistent progress for at least three days should be documented before discharge to home KMC.
    3. Preparing for home KMC
      1. A person other than the mother should be taught the KMC position, when planning for home KMC is started. The father is preferred in this situation, followed by any other household member whom the mother chooses to assist her in the provision of KMC position for her baby.
      2. The mother’s capability to breastfeed or breast milk feeds by other methods is assured.
      3. Baby’s consistent weight gain for at least three days has been documented.
      4. Continuation of home medications and vitamin/mineral supplements is assured either through consistent supply from the hospital or the family’s capability is assured through a social worker’s assessment of their resources.
      5. The family’s capability and commitment for follow-up in the KMC clinic is assured, through a standard social worker’s assessment. If this is not possible, the facility should provide ways to assist the family in fulfilling the follow-up schedules prescribed by the attending physician.
  2. Outpatient or Home Kangaroo Mother Care