By Kanina Foss
Kangaroos have taught humans how to care for their premature babies. Mothers mimicking marsupials by placing their babies skin-to-skin between their breasts are achieving better results than incubators.
The babies in the Kangaroo Mother Care (KMC) ward at Dr George Mukhari Hospital in Ga-Rankuwa gain weight faster and are discharged faster. The idea is so simple, it could belong only to Mother Nature.
Using a cotton sling called a kangaroo tie, premature babies wearing only nappies are placed upright between their mothers' naked breasts for protection and warmth. Kangaroos use their pouches to incubate their young.
Snugly encased between one milk-engorged mammary gland and another, the babies are taken out only for feeding, weighing, nappy-changing or when the mother needs to bath.
The temperature between a women's breasts is always just right. According to KMC unit head Sister Lilly Masote, breasts are thermo-neutral.
When they get too hot, they lose heat, and when they get too cold, they gain heat. Incubators, on the other hand, have to be constantly adjusted to the right temperature.
When it's cold, the babies wear woollen caps to cover their heads - the only bits that are exposed. They are positioned with their heads to the side, arms and legs tucked close to the body, to retain warmth and so that they can suck their thumbs if they want to. Twins are positioned side by side.
Complications arising from premature births account for more than 20 percent of all newborn deaths. Babies in the KMC ward are protected against infections because they have contact with the immunity-building bacteria on their mothers' skins.
According to Masote, they suffer from fewer infections and are discharged quicker. "They stay less time because the babies grow much faster."
Babies can be kangarooed when they weigh as little as 900g. Some babies at Dr George Mukhari were born after only seven months in the womb. The smallest weighs 1,1kg.
Before KMC, they would have been placed in incubators in the neonatal intensive-care ward. Their mothers would have stayed in separate wards and visited them every three hours for feeding.
With KMC, the mothers have constant physical contact with their babies, enabling a greater degree of bonding.
"It instills confidence in the mothers because they're taking part," said Masote.
They're able to walk around, eat, receive visitors and sleep with their babies between their breasts.
"I find it relaxing knowing my child is with me every minute of every day," said mother Hlangusabo Msiza.
KMC makes it easier for siblings to understand why their mothers can't come home, because they can see the baby needs to be held. If a mother passes away during childbirth, a female guardian is encouraged to administer KMC.
The babies are too underdeveloped to suckle, so they are fed breast milk through a nasogastric tube that is inserted through the nostril and into the stomach. When the babies get too big for KMC, they squirm and complain.
That's how the sisters know they're ready to come out and meet the world.
Kangaroo care is saving the hospital money. A single incubator costs R76 000. With KMC, the only piece of equipment needed is a kangaroo tie, a piece of cloth that winds around the mother's abdomen, crosses on her back, and ties in front. Also, fewer and less senior staff members are needed to provide support for kangaroo mothers.
The hospital has been using KMC intermittently since 2000, but the opening of a dedicated ward with 25 beds on March 18 is enabling them to provide kangaroo care 24 hours a day.
Babies born with severe complications such as respiratory problems are still sent to the neonatal ICU.
KMC was started in Bogota, Colombia, where overcrowded hospitals and a lack of funding made it necessary for doctors to find an alternative to incubators. Two paediatricians looked at kangaroos and decided that the method would work for a different type of mammal.
The nurses at Dr George Mukhari agree. "It works so miraculously," said Masote.