SARASWATI COLLEGE OF NURSING,

UDAIPUR
MENTAL HEALTH NURSING

MICRO- TEACHING ON
ON
KMC

Submitted To: - Mr.

Submitted By :- Mr.
SUBJECT : Child health nursing

TOPIC : KANGAROO MOTHER CARE

GROUP : Mothers in the hospital

DATE OF LECTURE : 18-1-2019

VENUE : labour room

METHOD OF TEACHING : Lecture cum

demonstration INSTRUCTIONAL METHOD: live

demonstration

PREVIOUS KNOWLEDGE : Mothers have some knowledge about sputum collection

GENERAL KNOWLEDGE : At the end of the class mother will have knowledge about the procedure
of expression of breast milk

OBJECTIVES

GENERAL OBJECTIVE

“At the end of the class mothers will able to have in depth understanding of Kangaroo mother
care in detail

SPECIFIC OBJECTIVE: at the end of the class student will able to

 To introduce with the term “kangaroo mother care

 To describe components of kangaroo mother care
 To enlist benefits of kangaroo mother care
 To define eligibility criteria of kangaroo mother care
 To explain initiations of kangaroo mother care
 To understand Duration of kangaroo mother care
 To educate about Discharge care of kangaroo mother care
 To orient with follow up are of kangaroo mother care
 TIM TEACHING EVALUATION
SPECIFIC
E CONTENT LEARNING A V AID
OBJECTIVE
MNS
1 mn To introduces SELF INTRODUCTION : Explanation Discussion
myself and
the group Myself Binal Joshi, M.Sc. Nursing
student at. JG college of nursing,
Ahmedabad.

GROUP INTODUCTION :

I would like to present Health

education on” KANGAROO
MOTHER CARE”.

2 mn To introduce 1. INTRODUCTION Explanation By showing the poster of What is

the topic mother and baby in KMC kangaroo
Kangaroo mother care (KMC) is a mother care
method of caring for newborn infants.
In this method the infant in placed
between mother’s breasts in direct
skin-to-skin contact. It is particularly
useful in caring for low birth weight
infants below 2000 grams.

The main components of kangaroo

mother care are:

1.1 Skin to skin contact : This

component involves direct skin-to-
skin contact of the newborn with the
 mother which should be early and
continued for prolonged periods of
time.
Exclusive breastfeeding : Most of
the babies below 2000 grams would
gain weight adequately on exclusive
breastmilk feeding.
Physical, emotional and
educational support: This should be
provided by the nursing and medical
staff to the mother and the family.
Early discharge and follow up:
KMC should be initiated in the
hospital under supervision.

3 ms To enlist the BENEFITS OF KMC Explanation Discussion by showing flash What are the
benefits of cards benefits to child
KMC Breastfeeding: Studies have and mother?
shown that KMC results in increased
breastfeeding rate as well as increased
duration of breastfeeding. Studies
conducted in developed countries,
where skin-to-skin contact was even
initiated late and for a limited amount
of period per day, had shown a
beneficial effect on breast feeding.
Experience from AIIMS has shown
that KMC results in better exclusive
breast feeding rate at 6 weeks of age.
Thermal control and
 metabolism: Studies carried out in
low-income countries showed that
prolonged skin-to-skin contact
between the mother and her preterm/
LBW infant provides effective thermal
control and
are associated with a reduced risk of
hypothermia. Experience from AIIMS
has shown that KMC results in normal
temperature during the procedure
without any risk of hypothermia
during the KMC.
Growth: Infants cared for by KMC
have a slightly better daily weight gain
during hospital stay. Studies conducted
in different parts of world as well as at
AIIMS have shown that babies have
better weight gain with KMC.
Other effects: KMC helps both
infants and parents. Mothers report
being significantly less stressed during
kangaroo care than when the baby is
receiving incubator care. Mothers
prefer skin-to-skin contact to
conventional care and report increased
confidence, self-esteem, and feeling of
fulfillment. They describe asense of
empowerment, confidence and a
satisfaction that they can do
 something positive for their preterm
infants. Fathers felt more relaxed,
comfortable and better bonded while
providing kangaroo care.
3M To define 3. ELIGIBILITY Explanation Discussion What are the
NS eligibility CRITERIA FOR KMC eligibility
criteria for Baby criteria
mother and
child to All babies are eligible for KMC. Some
initiate KMC guidelines for practicing KMC include
i. Birth weight ≥1800gm: If
stable, can be started on KMC soon
after birth.
ii. Birth weight 1200-1799gm: In
such case the delivery should take
place in a equipped facility, which can
provide neonatal care. Should
delivery occur elsewhere, the baby
should be transferred to such facility
soon after birth, preferably with the
mother.
One of the best ways of transporting
small babies is keeping them in
continuous skin-to-skin contact with
the mother. It may take a couple of
days for a sick baby to become stable
before KMC can be initiated.
iii. Birth weight <1200gm: These
babies benefit most from transfer
before birth to a hospital with neonatal
intensive care facilities. It may take
days to weeks before baby’s condition
allows initiation of KMC.
3.2 Mother
All mothers can provide KMC,
irrespective of age, parity, education,
culture and religion. The following
aspects must be taken into
consideration when counseling for
KMC:
i. Willingness: The mother must
be willing to provide KMC.
Healthcare professionals should
counsel her adequately regarding
different aspects of KMC. Once
mother knows about KMC, she will be
willing to provide KMC to her baby.
ii. General health: If the mother
has suffered from complications
during pregnancy or delivery or is
otherwise ill, she should recover
reasonably well before she can initiate
KMC.
iii. Supportive family: She
needs support to deal with other
responsibilities at home. The other
family members e.g. father or
grandmother should also be
encouraged to provide kangaroo care
 to the LBW baby.
iv. Supportive community: This
is particularly important when there
are social, economic or family
constraints.
KMC can be provided using any
front open garment. You can
innovate / design a garment
whichwould help mother to provide
KMC to her baby.
3 To explain 4. INITIATION OF KMC Explanation When we should
how and Demonstration start KMC
Counselling: When baby is ready
whento for KMC, arrange a time with the
initiate KMC mother that is convenient for her and
herbaby. The first session is important
and requires time and undivided
attention. Ask her to wear light, loose
clothing. Provide a warm place for her.
Respect her requirement of privacy
while providing KMC. Encourage her
to bring her mother-in- law, other
relatives or her husband if she wishes,
as it helps to lend support
andreassurance. Talk to other key
family members especially mother-in-
law, sister-in-law and husband. Unless
they are convinced, it will not be
possible for the mother to do KMC at
home.
 Baby clothing: Baby should be
naked except cap, socks and nappy.
Kangaroo positioning: The baby
should be placed between the mother’s
breasts in an upright position.The head
should be turned to one side and in
slightly extended position. This
slightly extended head position keeps
the airway open and allows eye-to-eye
contact between the mother and the
baby. Avoid both forward flexion and
hyperextension of the head.
The hips should be flexed and
abducted in a “frog” position; the
elbows should also be flexed. Baby’s
abdomen should be somewhere at the
level of the mother’s epigastrium.
This way baby has enough room for
abdominal breathing. Mother’s
breathing stimulates the baby, thus
reducing the occurrence of apnea.
Mother can provide KMC sitting or
reclining in a bed or a chair. She can
keep herself in slightly backward
reclining position and support baby’s
body and neck using her own hand.
Feeding: The mother should be
explained that she should breastfeed in
the kangaroo position and that KMC
actually makes breastfeeding easier.
Furthermore, holding the baby near
the breast stimulates milk production.
4.4 Psychological support: The
mother should be encouraged to ask
for help if she is worried. The health
personnel should be prepared to
respond to her questions and
anxieties.
When mother is not available, other
family member such as
grandmother, father or other
relative can provide KMC.

The mother can sleep with the baby in

kangaroo position in a reclined or
semi-recumbent position, about 15
degree from horizontal. This can be
achieved with an adjustable bed, if
available, or with several pillows on
an ordinary bed. It has been observed
that this position may decrease the
risk of apnea for the baby.

5.TIME OF INITIATION
KMC can be started as soon as the
baby is stable. Babies with severe
illness or requiring special treatment
should wait until they are reasonably
 stable before KMC can be initiated.
During this period babies are treated
according to neonatal unit clinical
guidelines. Short KMC sessions can
be initiated during recovery with
ongoing medical treatment (IV fluids,
low concentration of oxygen). KMC
can be provided while the baby is
being fed via orogastric tube.
Once the baby begins to recover,
family members should be motivated
to practice KMC.

2 To discuss 6.DURATION OF KMC Explanation Discussion How much

duration of Skin-to-skin contact should start duration is
KMC gradually, with a smooth transition needed for
from conventional care to continuous KMC
KMC.
Sessions that last less than one hour
should, however, be avoided because
frequent handling may be too stressful
for the baby. The length of skin-to-
skin contacts should gradually be
increased to become as prolonged as
possible,interrupted only for changing
diapers, especially where no other
means of thermal control are
available.
 When the mother needs to be away
from her baby, other family members
(father, grandmother etc.) can also
help by caring for the baby in skin-to-
skin kangaroo position.
2 TO describe DISCHARGE CRITERIA FOR Explanation Discussion When you shold
the discharge BABY MOTHER DYAD discharge the
criteria for PRACTICING KMC mother and with
kmc Usually, a KMC baby can be what types of
discharged from the hospital when the criteria?
following criteria are met:
The baby’s general health is good and
there is no concurrent disease such as
apnea or infection.
Baby is feeding well, and is receiving
exclusively or predominantly
breastmilk.
Baby is gaining weight (at least
15g/kg/day for at least three
consecutive days) and has regained
birth weight.
Baby’s temperature is stable in the
KMC position (within the normal
range for at least three consecutive
days).
The mother is confident of taking care
of her baby at home and would be able
to come regularly for follow up visits.
 These criteria are usually met by the
time baby weighs around 1500gm.
The home environment is also very
important for the successful outcome
of KMC. The mother should go back
to a warm, smoke-free home. She
should have support for everyday
household tasks.

3 mn To understand 9. HOW LONG TO CONTINUE Explanation Discussion What is follow

follow up care KMC? up care advise?
for KMC Babies love to be cared skin-to-skin
with mothers after going home. This
should be continued for some time at
home and other family members can
also participate in providing KMC. It
can be weaned off, once the baby
starts becoming intolerant to the
procedure or at 40 weeks of post
conception age.
10.FOLLOW UP PLAN
The smaller the baby at discharge, the
earlier and more frequent follow-up
visits would be needed. If the baby is
discharged in accordance with the
above criteria, the following
suggestions would be valid in most
circumstances.
More frequent visits should be made if
baby is not growing well or if his
condition demands.
One follow-up visit every 2 weeks
period till weight of the baby is 3 kg.
Thereafter one follow-up per month
till 6 months of age.
One follow-up every three months till
one year of age
Summary

 Introduction of kangaroo mother care

 Definition of kangaroo mother care

 Components of kangaroo mother care

 Benefits of kangaroo mother care

 Eligibility criteria of kangaroo mother care

 Initiation of kangaroo mother care

 Duration of kangaroo mother care

 Technique of kangaroo mother care

 Discharge of kangaroo mother care

 Follow up care of kangaroo mother care

Conclusion

Kangaroo Mother Care Promotions aims to promote the spread and implementation of Kangaroo
Mother Care (KMC) as the standard method of care for all newborn babies, BOTH PREMATURE
AND FULL TERM.it is verymuch benefited to mother and child. As a pediatric speciality nurse this
health education oriented me about kangaroo mother care and also helped the mother who have
preterm,term or low birth weight baby.