February 25, 2014
Q&A with Joy Lawn: Kangaroo Mother Care
by Frances Alonzo
A mother’s touch really cam save a child’s life. That’s the claim behind Kangaroo Mother Care. It’s when a pre-term or low weight baby is literally tied to the mother’s front, skin to skin, to keep the baby warm. The idea is not new, but this simple act is literally saving thousands of babies around the world. There is solid research to back up the claims. The research is led by neonatologist Joy Lawn and appears in the International Journal of Epidemiology. Lawn spoke to VOA’s Frances Alonzo and outlined this most effective intervention to reduce newborn deaths in Asia.
Q&A with Joy Lawn: Kangaroo Mother Care
LAWN: Kangaroo Mother Care is when we have a little pre-term baby, who is very vulnerable, particularly to temperature, infections, and to difficulties in feeding. And that baby is tied to the mother’s front and what that provides is warmth and then from the mother breast-feeding, so the baby gains weight much more. But one of the other interesting things we are learning is that it really reduces the risk of infections. So instead of the baby being separated they get the mother's skin infections, which are actually good infections, and protect the baby from other bugs that they may get particularly in a hospital but it also has an effect on brain growth for the baby.
ALONZO: The whole idea of kangaroo care doesn’t seem really new. Had the medical community gotten away from what may be considered just natural motherhood, natural care of a child?
LAWN: I know that is exactly right. And what we see is the expectation for neonatal care for small babies, especially pre-term babies, is very much based on machines and hospitals and we would separate babies from their mothers. But this is actually very careful science and partly out of desperation maybe that the doctors started tying the babies to the mother's front which kept them warm.
ALONZO: How does this help with preemies born in Asia?
LAWN: Very important question. Asia has the highest rate of small babies born in the world. In some parts of Asia, particularly in South Asia, almost a third of babies are less than 2.5 kilograms. So low birth weight. And those babies are at the biggest risk of death and disability and of complications when they're small. And it used to be thought that there was nothing you could do for these babies. And so this is a real turnaround, not that it’s a poor person’s solution. Actually, interestingly, the countries that are moving fastest on changing their care to include kangaroo mother care are the richest countries. But this is something that’s very accessible that every baby and every mother in the world has the power to be able to do this. And it can really change survival for the babies. India alone has about 900,000 babies who die every year and the most common cause is being born preterm or being born too small compared to the size that you should be or both. And those babies, many of them could be saved by kangaroo mother care and by the supportive care that is provided with that.
ALONZO: What is it about the region in Asia that has low birth weight babies?
LAWN: What’s different in Asia, is that in South Asia there are also a lot of babies who are born smaller than expected and that isn’t just about feeding pregnant women or the nutrition you get when you are pregnant, a lot of that is about girls who are already too small, so that the girl who isn’t fed well who grows up shorter than she should be, her potential for having a normal size baby is reduced. In some settings in South Asia where you know maybe there is preferential care for the boys versus the girls. The boys may be fed more than the girls, but also maybe when the girls get ill they aren’t taken to hospitals. So your adult size as well as your genetics is also very determined by what happens in those first couple of years of life.
ALONZO: What you are saying is that if a baby girl is born, she’s preterm, but she’s not taken care of as much, she’s not given quite as much to eat, as an infant up to two years. So then as she grows older and becomes a mom herself, the likelihood of her having a preterm baby and low birth weight baby is much higher.
LAWN: Yeah, that’s exactly right. So I think the exciting thing now is that as we look around the world that people are really talking about how we are the first generation that has a chance to see a change in health for the whole of the next generation in every country. And the secret for that, particularly in South Asia, is this intergenerational change. So we can do things for babies that are born small now. We can improve their care. We can do kangaroo mother care and that will save lives today. But we will carry on having lots of small babies unless we pay attention also to those next generation going forward and the nutrition of girl children.