Worldwide, more than 15 million children are born prematurely. This means that one in 10 children will be born before 37 weeks of gestational age, which is the most important cause of mortality in children under five years of age. According to data from the Spanish Society of Neonatology, the prematurity rate in Spain stands at 6.5%. "These figures are much higher in underdeveloped countries, for example, Malawi, whose prematurity rate is 18%, according to WHO data. After the covid-19 pandemic, countries like Nepal have seen their prematurity rate increased by up to 20%, data that alert us to what may be happening in other underdeveloped countries, where the decrease in quality and access to health medical assistance has been diminished ”, explains Dr. Pilar Bas,neonatologist at the Vithas Las Palmas maternal and child unit.
World Prematurity Day: the fragility of being born early
The benefits of 'kangaroo mother care' persist up to 20 years later
One of the techniques for these little ones to develop faster and better is the Kangaroo Mother Method (MMC) which, according to the expert, involves skin-to-skin contact between mother and child: “The child is naked (with a diaper and hat) in an upright position between the mother's breasts and under her clothes.
The mother will be a permanent source of heat, regulating the temperature of the newborn;
at the same time it will offer nutritional support (breastfeeding) and will reinforce the biological and affective bond.
The MMC must be offered continuously, without interruptions, and in a sustained way for the necessary time in order to show its benefits ”.
The MMC, for all this, is aimed at preterm and / or low birth weight newborns. However, it can be performed “in full-term newborns, and a good example of this is skin-to-skin, which is performed at the time of birth and has amply demonstrated its great advantages in terms of breastfeeding success rate. long-term maternal; the stabilization of the newborn, and the promotion of the mother-child bond ”, explains Bas. According to a study published in 2014, 82% of neonatal ICUs allow CMM to be performed in our country, "without limitations, that is, including the father," he adds.
"Although the MMC, as its name indicates, includes the mother as a source of heat, a reference of affective bond and nutritional source through breastfeeding, the father can also do it", continues the expert, "even if it does not provide nutritional support, because the rest of the benefits continue to be reproduced and, in addition, we know that those who do have a greater affective bond with the newborn ”. For the expert, all this favors the empowerment of parents, who will be more involved in the care of their child: “Likewise, it can be done by siblings, grandparents and any family member close to the newborn's family nucleus, as long as they have the maternal / paternal authorization and that parents are absent due to health, work, etc. The important thing is to offer the newborn as much time as possible in MMC ”,Bas argues.
These are the six main benefits of MMC
Pilar Bas, neonatologist.
A study recently published in the prestigious medical journal
shows the reduction in mortality in premature babies up to 30% when the parents practice CMM, says the doctor.
At the neurological level, it has been observed that premature newborns who perform MMC have a longer duration and integrity of sleep, favoring brain maturation.
Furthermore, “there is ample scientific evidence that shows a difference in neuropsychomotor development in children who received MMC, compared to those who did not.
They are children who better regulate stress and feel less pain in painful procedures ”, explains the neonatologist.
The MMC provides the premature newborn with a greater capacity to regulate temperature and physiology. In addition, children on MMC stabilize their heart rate, respiratory rate decreases, and blood oxygen levels improve. "The MMC is the ideal place to remove respiratory support (nasal ventilation) and allows, in many cases, to reduce the need for supplemental oxygen," says the specialist. In fact, "during CMM, premature infants decrease the number of apneas, that is, the cessation of breathing that occurs in these newborns due to immaturity of the central nervous system," says Bas.
It favors breastfeeding.
MMC prolongs breastfeeding up to three months, and increases the frequency of children who are discharged exclusively from breastfeeding.
"After putting into practice a session of the kangaroo method, many mothers assure that they have experienced an increase in milk production, being the ideal place for its extraction with breast pumps," says the specialist, who also emphasizes that the MMC improves growth and weight gain of premature babies.
The practice of this technique shortens the hospital stay by an average of two to three days, in addition to reducing the risk of contracting microorganisms produced in the hospital itself.
The MMC promotes the emotional bond with their parents.
“The newborn will find a safe place in the maternal or paternal breast that offers security, tranquility and food.
In addition, the MMC reduces maternal anxiety, as well as the depression and feelings of guilt presented by parents who have premature children ", points out Bas, who assures that" it increases the degree of competence of parents, empowering them and making them feel essential caregivers of their children".
Kangaroo method and covid-19
According to Bas, at the beginning of 2020, only information was available from China about SARS-CoV-2. From there, the immediate separation of newborns from their mothers began after delivery, if there was a minimal suspicion of infection, with the consequent withdrawal of breastfeeding: “This initial protocol was initially extrapolated to our hospitals, under the protection of the Spanish Society of Neonatology which, later, after consulting organizations such as UNICEF and the WHO, as well as scientific societies, corrected said document and prevented further separations of neonates from mothers infected with coronavirus. In this way, an attempt was made to promote immediate contact and breastfeeding ”.
However, the expert continues, “Spanish research on infected mothers who have given birth in hospitals show that skin-to-skin at the time of birth has been reduced by 50%, with the consequent decrease in the percentage of mothers who are discharged with exclusive breastfeeding ”. However, as he maintains, at the global level the WHO has launched a recent study that estimates that, if the MMC were applied in low birth weight newborns in underdeveloped countries, up to 126,000 deaths could be reduced. This shows that the benefit of performing MMC is 65 times higher than the risk of dying from covid-19. "The fear of the transmission of SARS-CoV-2 has led to the separation of mothers with covid-19 from their children," continues Bas,"With the subsequent discontinuation of skin-to-skin and breastfeeding in countries that already had high infant mortality rates." The WHO recalls that MMC is one of the best interventions "to increase the chances of survival of a premature or low birth weight newborn, especially in low-income countries," concludes Bas.
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