HEALTH-COLOMBIA: Preemies Benefit from ‘Kangaroo Mother Care’

By IPS Correspondents Reprint | | Print |

María Isabel García

BOGOTA, Jan 12 2000 (IPS) - Being born too early has ironically become almost an advantage for the thousands of babies from poor families in Colombia that benefit from the governmental Social Security Institute’s (ISS) Kangaroo Programme.

The programme uses the “kangaroo mother care technique”, consisting of skin-to-skin contact between premature or low birth weight newborn infants and their mothers.

Under the technique, first developed in Colombia two decades ago, but now being studied and applied in countries as far afield as Ethiopia, Indonesia, Madagascar, the Netherlands, South Africa, Sweden, the Ukraine, the United States, and Vietnam, the mother (or father) replaces the incubator and becomes the infant’s main source of food, heat and stimulation.

According to the Internet web page of the “International Network for Kangaroo Mother Care” (INK), the temperature of the infant held against the chest of the mother in an upright position “is kept within normal range by the mother’s body heat.

“Several studies have shown that temperature, oxygenation, heart rate and other physiologic parameters are maintained within normal ranges during the Kangaroo position. The baby can be breast fed at any time. Kangaroo position is maintained until the infant no longer tolerates it.”

INK adds that the method “has already been incorporated into LBW [low birth weight] infant care standards in many places all around the world, and at all levels of care.”

When Dr. Edgar Rey with the Mother and Child Institute of Bogota first came up with the technique in 1978, the public health establishment had only one incubator available for every three premature or low birth weight infants.

When asked why the technique was first developed in Colombia rather than in an industrialised country, Zita Figueroa de Calume, the neonatal pediatrician who heads the Kangaroo Programme, told IPS that “the kangaroo mother technique is more a result of need than of genius.”

The technique is cost-effective, costing the ISS an estimated 400 dollars per child during the first year of life. Another benefit of the programme is the earlier release of mother and child from the hospital.

The Mother and Child Institute attends to the lowest income sectors in a city of six million, with 80 to 100 daily visits to the clinic.

An estimated 11 percent of babies are low birth weight in Colombia today, compared to five percent in the United States, for example. The phenomena of low birth weight and premature infants are closely linked to poverty.

The initial aim of the technique was the mere survival of high- risk infants, said Calume. But today, kangaroo mother care has been shown to reduce mortality rates among low birth weight infants, and to improve mother to child bonding.

Although the Kangaroo Programme initially drew criticism, the effectiveness of the technique is no longer disputed. The first study carried out by the Mother and Child Institute of Bogota on the results of the technique was done in 1989, and in 1993 a one- year follow-up was conducted.

The follow-up study involved 777 one-year-olds who weighed less than one kilo at birth, and compared the development of babies given kangaroo care and those put in incubators at birth.

A lower mortality rate was found among the babies that received kangaroo care, as well as better growth and emotional security and higher IQs.

Calume pointed out that another benefit of the programme was that the direct contact between fathers and their babies led to a change in cultural habits, and “enabled sexist Colombians to allow their emotional nature to emerge, thus creating a better domestic atmosphere for women.”

Furthermore, “kangaroo mothers are more competent,” she added.

The Kangaroo Programme provides a space for strong bonding between parents and infants in a country caught in the grip of civil strife for nearly five decades, with one of the world’s highest murder rates and high levels of domestic abuse.

The one-year follow-up of the babies receiving kangaroo care found that the mothers involved in the programme were much less likely to have gotten pregnant again than their peers.

“It is as if they feel they have not finished raising their children. They have understood the enormous responsibility of being parents,” she commented.

The Kangaroo Programme operates out of a small building connected to the ISS Children’s Clinic in west-central Bogota, with a team of 20 pediatricians, psychologists, neurologists, nurses, social workers and administrative staff.

The programme has drawn international recognition, and frequent visits by experts from most countries in Latin America, as well as Ethiopia, the Philippines, Indonesia, Madagascar, Mozambique, Nigeria, Senegal, South Africa, Togo, the Ukraine and Vietnam.

The programme is also being applied, with some variations, in countries with high levels of human development like the Netherlands and Sweden.

The basic technique used is the same worldwide, but it must be adapted to the specific cultures of each country, Calume pointed out.

However, the prospects for continued growth of the Kangaroo Programme in Colombia itself are not promising. The serious funding crisis plaguing the public health sector and the decline in funding for scientific research have put the programme at risk of losing funds. The programme’s chief source of external financing has been the World Laboratory, in Switzerland.