PMNCH / Isabel Pinto
Eunice and twins. Skin-to-skin contact between mother and newborn baby after birth is practiced.
© Credits

Kangaroo mother care: A practice guide for health workers

This is a cover page for the kangaroo mother care practice guide.

This guide is intended to assist health workers in supporting mothers and families in practicing Kangaroo Mother Care (KMC) both in health facilities and at home.

It also offers brief guidance for policymakers, health facility administrators, and local programme managers on how to create a supportive environment and provide the necessary health system resources to support health workers in assisting mothers and families in practicing KMC.

Table of contents

SECTION 1. Introduction to the guide

A mother welcomes her newborn and provides immediate KMC.
General TWG Long An Hospital /KC. Luong
A mother provides immediate KMC to her preterm newborn, who requires CPAP support, in the presence of the father.
© Credits

This section introduces the Guide- rationale, intended audience, and how to use. 

  • What is the context for updating the KMC Practice Guide?
  • Who is this Guide for?
  • How was this Guide developed?
  • How is this Guide intended to be used?

SECTION 2. Understanding KMC

A mother and her newborn baby in a hospital setting while the mother provides KMC.
General TWG Long An Hospital /KC. Luong
A mother breastfeeds her newborn in the kangaroo position in Vietnam.
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This section explains what KMC is, why it is important, and the key aspects of KMC practice that align with the latest evidence or best practice. This information will be useful for those who are unfamiliar with KMC, as well as for experienced health workers. 

  • What is Kangaroo Mother Care (KMC)?
  • Why is KMC important?
  • Who should receive KMC?
  • Who can provide KMC?
  • Where and when should KMC be provided?
  • How long should KMC continue and when to stop?

SECTION 3. Practicing kangaroo mother care at all health system levels: requirements and actions

New mothers practicing Kangaroo mother care in a hospital setting.
WHO /Blink Media - H.Abebe
New mothers with their infants providing KMC at Felege Hiwot Hospital in Bahir Dar, Ethiopia.
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This section explains how KMC can be implemented as a core component of small and/or sick newborn care at all levels of health system highlighting that KMC is not a separate programme. It outlines the essential requirements and actions for implementing KMC in primary, secondary, and tertiary-level health facilities and at home. 

  • How to implement KMC as an essential component of small and/or sick newborn care at all health system levels
  • Transfer of mother-newborn dyad between health system levels
  • What are the health system requirements for implementing KMC
    • Requirements for implementing KMC in health facilities
    • Requirements for transfer of newborns within a health facility
    • Requirements for implementing KMC at home

SECTION 4. Practical guidance on providing KMC in health facilities

A healthcare worker and a newborn in a hospital setting.
General TWG Long An Hospital /KC. Luong
A healthcare worker examines a newborn on kangaroo position in Vietnam.
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This section provides practical guidance for health workers on supporting mothers and families in practising KMC in health facilities starting at birth.

  • Preparing the mother and family for KMC during antenatal period
    • Breastfeeding counselling
    • Counselling for KMC
  • How to start KMC in birthing areas (labour room or operation theatre or post-operative recovery room)
    • Preparing the mother or surrogate to provide skin-to-skin contact
    • Ensuring adequate preparation in birthing areas to receive a preterm or LBW infant
    • Essential care of the newborn (including KMC) in the first hour after birth
      • Initiating skin-to-skin contact immediately after birth
      • Considerations for caesarean section birth
      • Considerations for multiple births
      • Supporting early initiation of breastfeeding/breastmilk feeding
      • Essential care of the mother in the first hour after birth
  • Transferring the mother/surrogate-newborn dyad to the mother-newborn care unit or KMC area in KMC position after the first hour after birth
  • Continuing KMC in mother-newborn care unit or KMC area after the first hour of life through to discharge
    • Postnatal counselling on KMC
    • Training the mother/family to put a newborn in the kangaroo position/KMC position
    • Supporting exclusive breastfeeding/breastmilk feeding
    • Providing medical and supportive care to the newborn while receiving KMC
    • Monitoring the newborn while receiving KMC
    • Caring for and monitoring the mother while providing KMC
  • Monitoring the duration and quality of KMC in the health facility 
  • Preparing and supporting the mother and family for discharge for continued KMC at home
    • Discharge criteria
    • Discharge counselling
    • Transfer to home in kangaroo position/KMC position

SECTION 5. Supporting mothers and families in practicing KMC at home

A father provides skin-to-skin contact to his newborn at home.
Fundación Canguro /Kangaroo Foundation
A father provides skin-to-skin contact to his newborn at home in Colombia.
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This section describes how mothers and families can be supported in practising KMC at home- this could mean continuing KMC at home after discharge from the health facility after birth, or first starting KMC at home for small newborns born at home or those born in health facilities, but discharged early, without starting on KMC. 

  • Continuing KMC post-discharge
  • Starting KMC at home
    • Identifying preterm or LBW newborns eligible for KMC
    • Newborn requiring referral   
    • Preparing, counselling, and supporting the mother and family for KMC
  • Monitoring and follow-up
  • Transfer from home to health facility 

SECTION 6. Appendices

Kangaroo mother care in a hospital setting.
WHO /G. Borrero
A doctor guides a mother to do proper Kangaroo Mother Care positioning in Da Nang, Vietnam.
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This section includes links to tools and aids to help health workers in implementing KMC on ground.

  • Videos
  • Counselling guides
  • Frequently asked questions
  • Special considerations for practicing KMC in humanitarian and fragile settings 

 

SECTION 7. References

A mother and her infant child provides iKMC in a hospital setting.
General TWG Long An Hospital /KC. Luong
A mother provides KMC to her newborn son. Her older son is involved in looking after his new brother.
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This section provides references to some key information included in this Guide.