Natural incubator improving newborn survival

Bangladesh has made a commendable success in reducing the mortality rate of under-5 children. But neonatal mortality which indicates the death of a newborn within 28 days of birth is still a big concern and accounts for more than half of all under-5 deaths in Bangladesh. Pre-mature births, infections and birth complications such as initiation of breathing at birth, injury are three principal causes of these deaths. There is evidence that certain cost-effective interventions could reduce these deaths even without the availability of costly neonatal intensive care. Kangaroo Mother Care (KMC) is such a simple and cost-effective solution that can save premature and low birth weight babies from death and long term complications of prematurity.

Kangaroo Mother Care is a simple intervention in which mothers serve as human incubators for their newborns. The infant is held skin-to-skin on the mother's chest and placed between the mother’s breasts in an upright position, the head is turned to the side in a slightly extended position with legs and arms flexed and wrapped securely with a binder.

Researches have shown that maternal infant skin-to-skin contact is an effective and inexpensive way for keeping babies warm and synchronizes with mother’s temperature. It helps initiating breastfeeding early and ensures exclusive breastfeeding. It provides better breathing and heart rate and better growth. KMC keeps bonding between mother and her baby with closer eye contact and reduces the stress of the infant and sleep problems. It also reduces energy expenditure of the baby and thus helps gain weight. It reduces infections of the newborn even better than incubator. KMC aids generating more mature and organised electrical brain activity leading to better development of nervous system.

The practice of KMC is crucial for a resource poor country like Bangladesh where improved neonatal care facilities is limited to big hospitals. Also the high cost of managing preterm complications specially with incubator impinges a huge financial burden to the family. In those areas where no incubators are available for caring the preterm or low birth weight babies, KMC can be life-saving. KMC has the greatest impact during the first week of a preterm baby's life, when deaths are most likely to occur. Apart from mother, father and grandmother can also help keeping baby warm with Kangaroo Care in the absence of mother.

Although KMC has potentials to save many premature babies, it is not implemented widely in Bangladesh. Only a few centers have been providing the service at a small scale. There is a dire need to scale up the intervention throughout the country specially in rural parts of Bangladesh where it can demonstrate its greatest benefits.

The writer is the Professor of Neonatology, Dhaka Shishu Hospital. E-mail: childcare1952@gmail.com