G’day new mamas!
If your new baby is premature or on the small side, you’re likely to follow your instincts and keep that tiny infant close to your body to provide warmth.
Much like those marsupial mothers Down Under.
Turns out their technique is the basis of an underutilized practice known as kangaroo mother care (KMC) that can reduce human infant deaths by more than a third as compared to conventional care. Simple, low-tech, and effective, the practice is comprised of early, continuous, and prolonged skin-to-skin contact between newborn and mother. The result: The infant’s temperature and breathing rate are better regulated.
A new meta-analysis by researchers at Harvard and Boston Children’s Hospital looked at 124 studies that examined the effect of skin-to-skin care (usually combined with breastfeeding) on neonatal cases.
Low birth-weight babies showed the most dramatic increase in survival rates, but even for full-term babies, their oxygenation, temperature regulation, and pain tolerance improved.
“Skin-to-skin care is instinctive,” said Dr. Grace Chan, Ph.D., an instructor in pediatrics at Harvard Medical School and a physician at Boston Children’s Hospital.
Chan, the study’s senior author, told Healthline the question isn’t about the efficacy of the treatment but of the challenges in spreading the word.
“It’s up to facilities and institutions how to integrate KMC into their programs,” she said. “Technology is incredible. Thanks to it, lots of preterm babies survive. But there’s a need to balance tech with other interventions.”
Spreading the Word
Chan and other pediatricians would like to see skin-to-skin programs spread through the United States as well as abroad. Sometimes that means rethinking care to accommodate a low-tech solution.
There’s plenty of evidence that KMC works. The issue now, according to Chan, is how to let more parents know.
Up to 4 million babies worldwide die each year during their first month of life. Most at risk are infants born early or at a low birth weight. Most Western countries offer health technologies such as incubators, which can help high-risk infants improve. However, such equipment is not widely available in low- and middle-income countries, where 99 percent of all neonatal deaths occur.
The study revealed that newborns weighing less than 4.4 pounds who survived to receive kangaroo care were a 36 percent less likely to die and 47 percent less likely to get amajor infection.
Linda Ray, the mother of premature twins born in New York, said she wished the program had been available to her at the time she gave birth. “It would be incredibly helpful for both mother and child,” she told Healthline. “It’s primal.”
The study was funded by the Saving Newborn Lives initiative of Save the Children.
Practice Can Help All Infants
The researchers said that while skin-to-skin infant care is particularly useful for low birth weight babies born where medical equipment such as incubators are scarce, the practice is beneficial for all newborns and mothers.
“It’s important to reduce the stigma in low-income areas,” Chan said. “There are different barriers in different places. We are looking at those challenges, what will lead to mothers’ acceptance, what will affect cultural differences.”
For example, a Save the Children report notes that in Malawi there has been considerable progress in making KMC available in central and district hospitals. But one of the barriers to continuous skin-to-skin contact reported by mothers in Malawi is the use of the traditional chitenje as wraps.
The material makes it difficult to hold a baby in the front. Plus, it takes two people to tie the wrap, which is made of a thick material and causes irritation from the large knot at the back.
In an attempt to get around these problems, a local group (Lærdal Global Health) has developed an ergonomic baby wrap carrier that can be produced cheaply. Research is now under way to see if this compromise improves KMC practices.
It’s a little less complicated with kangaroos. Most human babies are born able to survive outside the womb. Infant marsupials — known as joeys — are not.
Marsupials have a short gestation period (about four to five weeks), and the joey is born in an essentially fetal state. The blind, furless, miniature newborn, the size of a jellybean, crawls up its mother’s fur into the pouch, where it latches onto a teat for food. It will not re-emerge for several months, during which time it develops fully.