Kangaroo Mother Care — a key component of Early Newborn Care

A mother practices Kangaroo Mother Care (KMC) shortly after giving birth in a hospital.

Within minutes of giving birth, a midwife works quickly to prepare Jenny’s new born son for Kangaroo Mother Care (KMC).

The midwife thoroughly wipes down the baby, then immediately covers the baby with a warm blanket and gently places the baby on his mother’s chest to initiate breastfeeding while the cord is still attached to the baby and the placenta.

Jenny, who is 17 years old, has just delivered her first baby at the Mt. Hagen hospital. She instinctively puts a protective arm over her baby as soon as her baby is placed on her chest and draws in her son closer.

Sr. Susan Kolopu, Sister-in_charge of the Labour Ward (right)at the Mt. Hagen Hospital explains the importance of KMC to Julie who has just delivered her baby.

“The baby was kept warm in the uterine but as soon the baby is born, it is exposed to the cold so we encourage the mother to provide KMC while we observe the cord pulsation which can take up to 35 minutes,” says Sr. Susan Kolopu, sister-in-charge of the Labour Ward.

KMC is a practice that uses skin-to-skin contact — usually a parent’s own body — to warm and nurture a new-born baby in particular pre-term and low birth weight new-borns. Although recently introduced in PNG, KMC has been in practice for the last 40 years in many parts of the world. The midwives and health workers at Mt. Hagen Hospital Labour Ward have been practising KMC for almost a year as a key component of a package of services for Essential Early Newborn Care (EENC).

A midwife (centre) explains some of the new practices to students nurses in the Mt. Hagen Hospital Labour Ward.

With UNICEF’s support, 25 health workers at the Mt. Hagen Hospital were trained in EENC in November 2016, where changes were made immediately in the way deliveries were performed in the labour ward. To date, with UNICEF’s support, 175 health facilities in 11 provinces have trained staff and essential new-born care supplies, such as AMBU bags, mucus suckers, suction machines and cord clamps. Eighty two thousand (57 %) new-borns were assisted out of an estimated target of 144,000 new-borns in 2016.

“We do about 500 deliveries a month so we used to work fast to get a mother and baby out of the labour ward quickly. Previously, we cut the cord right away, took the baby to a weighing scale at the end of the room away from the mother to give it immunisation shots and do eye care. But we now realise that when we separate the baby too quickly from the mother, we disturb some systems that could help the baby further. We’ve made improvements now,” explains Sr. Kolopu.

These improvements include practicing KMC, breastfeeding within one hour of delivery, double gloving, delayed cord clamping and cutting and resuscitation where needed.

“As long as the cord is still pulsating after the child is born, it means the child is still getting the nutrients and the supply system that fed and kept the child alive in the uterus for nine months is still channelling nutrients through the cord so we let it complete its work first. We cut the cord when the cord ceases pulsating, which is about half an hour after delivery. We also do double gloving where we use the first glove for delivery and the second glove for cord care. These are things we learned and are now practising and we thank UNICEF for the training,” adds Sr. Kolopu.

Other changes are also visible in the labour ward — an examination trolley is pushed up to Jenny’s bedside ready for examinations to be done when the baby’s cord is cut. A weighing scale and a resuscitation trolley are also near the bedside. On the wall, a newly installed thermometer reads 28 degrees — the ideal room temperature for new born babies. Protocols for hand-washing, neonatal resuscitation, breastfeeding are properly displayed and are in use by service providers.

The results are impressive — delivery statistics and outcome for both mothers and babies between December 2016 and February 2017 show remarkable improvement in all areas.

Of the 1001 babies born in December 2016, there were 982 live births, 18 still births, 61 pre-term low birth weight babies and 25 babies resuscitated. Immediately after birth, 745 babies were provided with KMC for one hour while 78 mothers initiated breastfeeding within one hour of delivery.

In February 2017, of the 1830 babies born, there were 1819 live births, 25 still births, 94 pre-term low birth weight babies and 80 babies resuscitated. A total of 1262 mothers provided KMC for an hour immediately after birth while 1451 babies were breastfed within one hour of delivery.

Sr. Kolopu is pleased with the results and is committed to ensuring these changes become a daily routine in her ward.

“These two lives, of the mother and baby that are in front of us are very important people. They are coming to us because we are here and we have to provide what they need. What we are doing is helping our mothers and this new person that is coming to join us in this world”.