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Some good stuff about kangaroo care coming out of Africa! When you don't have a modern hospital to incubate a preemie, what's better than a parent's chest? NOTHING!

Some good stuff about kangaroo care coming out of Africa! When you don't have a modern hospital to incubate a preemie, what's better than a parent's chest? NOTHING!
Bathsheba Ochieng’ lies with her twins in the Kangaroo Mother Care Room at Matungu Subcounty Hospital. Her babies were born prematurely, weighing 1.9kg and 1.5kg

The Matungu Subcounty Hospital simply borrowed a leaf from kangaroos. It gets mothers, mothers-in-law or even a few fathers to cradle a baby against their bare chest for a considerable duration every day, thus becoming human incubators.

Since the hospital switched to Kangaroo Mother Care in nurturing pre-term babies, the four incubators in the New Born Unit are underused.

The nurse behind this shift is Consolata Mukodo. She’s the maternity in-charge. She says about the NBU unit, “We only bring a premature baby here if it’s sick.”

Mothers now nurse their preterm infants in an improvised KMC care room. Here, beds and chairs are modified for the comfort of mothers, who may be distraught by the delicacy of their underweight babies.

In March last year, there were three women in the room and one, Bathsheba Ochieng’, had twins. Discharge from the hospital depends on the babies’ weight gain. This may take several weeks.

Fifty-seven premature babies were attended to in 2016 at the hospital. Mukodo says all are alive. She regrets that when the programme began in 2015, two babies died shortly after discharge. To date, none has died at the facility.

The KMC room can accommodate seven mothers. Once babies gain the desired weight of 1.8kg, they qualify to be released. One condition is attached, though. “The mother must bring someone to help her care for the baby,” Mukodo says. This would ensure the baby’s needs are met at home. The alternate caregiver may be the mother’s spouse or preferably her mother-in-law.

While a mother is still admitted at the facility, community health volunteer Patrick Namatsi swiftly moves in. He visits the home of the mother to encourage at least one or two members of her homestead to visit the hospital. They are taught the importance of KMC and how they can help at home.

Every morning, Mukodo does rounds, teaching kangaroo skills.

Dr Alfred Ambundo, the Matungu Subcounty medical health officer, says in KMC, “The key factor is providing the right temperature to the babies in the most affordable way.” County Health director Dr Arthur Andere adds that, “What kills premature babies is normally lack of warmth. The mother will provide the warmth that her baby requires.”

BETTER BABY CARE

It is recommended that for 24 hours, the baby remains strapped on its mother with her garments on, and therefore, there is no time the baby would be cold. The babies are to be freed only when absolutely necessary.

Dr Andere says hospital incubators can be a death trap. “When many children are put together, chances of cross-infection are very high. Some of the babies may die.”

Under kangaroo care, “Babies can be taken care of in their natural environment at home, and there will be minimal cross-infection.”

Babies receiving kangaroo care have been noticed to sleep longer and breathe better. They also gain weight faster, medical personnel have observed.

Mother Petronila Awinja recalls being in the KMC ward for six weeks. “My baby was born after seven months at 800gm but is now 1.72kg,” she says. Awinja can tie her baby herself vertically between her breasts. With her baby in that position, she can walk around, sit, lie down or even read, and her baby can be easily breastfed. Due to the skin-to-skin contact, “I can detect if my baby is breathing,” Awinja says.

At the hospital, a mother may not have someone to relieve her for a break. Therefore, she’s allowed to do it intermittently while she cares for other needs.