Kangaroo mother care (KMC) initiation includes family counselling, suitable clothing, correct positioning, observation, feeding support, and privacy.
Preparation and family support
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Arrange a convenient time when the neonate is ready for KMC. Initial sessions require extended interaction and a caring, patient demonstration.
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Encourage family participation to build a positive attitude and support continued KMC at home. Interaction with mothers already practicing KMC can help.
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Any acceptable front-open dress that retains the neonate for an extended period can be used, including a blouse, sari, gown, or shawl.
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Respect the mother’s sensitivities and provide culturally acceptable privacy.
Kangaroo positioning
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Place the neonate upright between the mother’s breasts.
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Keep the head slightly extended and turned to one side to maintain an open airway and allow eye-to-eye contact.
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Keep the hips flexed and abducted in a frog position, with the arms flexed.
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Position the baby’s abdomen at the mother’s epigastrium. Maternal breathing stimulates the baby and reduces apnea.
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Support the baby’s bottom with a sling or binder.
Monitoring
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Monitor carefully, especially during the initial stages. Ensure the neck is neither excessively flexed nor excessively extended.
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Check that the airway is clear, breathing is regular, color is pink, and temperature is maintained.
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Encourage the mother to observe the neonate so that she learns to monitor the baby during KMC.
Feeding
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Teach breastfeeding and milk expression while the neonate is in the KMC position.
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Holding the neonate near the breast stimulates milk production.
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Expressed milk can be given using a paladai, spoon, or tube.