A decade ago, Kenyatta National Hospital, Kenya’s largest referral hospital, was dealing with escalating baby mortality rates – 50 percent of preterm born infants did not survive. Since the cost of increasing the number of incubators was prohibitive, a new form of premature baby care was implemented: Kangaroo.

By Joan Barsulai and Lucy Maroncha, Nairobi

Loise Nyakoa delivered prematurely at a time when all the incubators were occupied. “I was very worried,” says the 26 year old. “I feared for my child’s survival.” Her son, Sidella, was born one month premature and weighed only one kilogram.

Like most low- to middle-income mothers giving birth for the first time, Nyakoa’s choices were limited to Kenyatta National Hospital (KNH).

But new mothers such as Nyakoa can now undergo another form of preterm babycare. In 2000, KNH began implementing the Kangaroo mother care programme. First implemented in 1978 in Bogota, Colombia and since taking root in many countries, Kangaroo involves placing the infant in direct skin contact between the mother’s breasts for easy feeding access. The infant is wrapped in a gown, tailored to resemble a kangaroo’s pouch, for 24 hours a day until it comes to term.

Mortality rate drop
Kangaroo children respond better to this treatment than those who are placed in incubators, according to KNH’s senior nursing officer, Florence Ogongo.

“The children can listen to their mothers’ heartbeat while lying on their mother and this creates a strong bond,” Ogongo explains. “As compared to incubator-bred infants, the Kangaroo babies gain weight faster, improve faster and leave the hospital earlier. Because of this, more mothers now prefer this care to incubation.”

The mortality rate of preterm babies at KNH has fallen from 50 percent to 30 percent since the inception of the Kangaroo programme.

A family affair
At KNH, every month 200 babies are born and half of them are born preterm.

“The babies are sometimes unstable and need intensive management which Kangaroo mother care can apply at a much cheaper cost than with incubators,” the nursing officer emphasizes.

The hospital has taken measures to ensure that this care can be provided around the clock. If a mother is incapacitated or temporarily unavailable – for example, if they want to take a bath – their husbands, relatives and nurses can all take turns caring for the infants.

“The infants,” says Ogongo, “quickly get accustomed to the warm body contact and they cannot tell the difference between when nurses and relatives take over to give the mother a break.”

Since it’s mostly spouses and relatives supporting mothers under Kangaroo care, infection rates to the infant are reduced compared to incubator care where different hands touch the babies when they are transferred between the mother for breastfeeding and the incubator.

Challenges
Kangaroo care does have challenges. “It requires a lot of commitment and if one does not have supportive relatives the mother would really suffer,” says Nyakoa. “Also, the baby gets used to being on the chest and when we are discharged he will need time getting used to being left alone on the bed.”

However, learning to be alone is inevitably the lot of all surviving newborns.