Kangaroo Mother Care saves lives

Sadias and Grace making more kalafong wraps for the skin to skin workshop

Keeping babies warm is one of the things that reduce neonatal mortality. We promote it strongly throughout the course. It also promotes breastfeeding, reduces the risk of hospital-acquired infection, is important for bonding and leads to faster growth.

Grace’s skin to skin workshop
Sadias, Bwindi course coordinator, taking part in the skin to skin workshop

When we went to the neonatal unit initially, there were 5 babies (including a set of twins) between 33 and 35 weeks in incubators or being held by their mothers in piles of blankets. The doctor asked for help because none of them were putting on weight. Grace went to work…

Twins in skin to skin mother care, also known as Kangaroo Mother Care (KMC)

All 5 had been discharged by the end of our week in Bwindi, all putting on weight. Well done to the nurses for being early adopters of KMC in Bwindi and for seeing the benefits straight away.

On day 3 of our visit, we noticed these pictures that had been put up in the anteroom to the neonatal unit where the mothers were waiting to see their babies.

On day 5, we did the round with the mothers actually present in the neonatal unit – the remaining 2 babies both skin to skin.


Kalafong wraps









Kim and Julia have been busy in London (and Alison in Amersham) making these baby slings for mothers of preterm babies in Liberia.  They will be used on the training courses in November and then left in country for use on the neonatal unit.  Skin to skin mother care develops the bond between mother and baby as well as helping to prevent infection and keeping the baby warm.  You can read more about the advantages of skin to skin care at https://www.nicheinternational.org.uk/2018/11/13/skin-to-skin-mother-and-father-care/.

We call them kalafongs on the Newborn Care Course but they are not actually called kalafong wraps – even in Kalafong hospital in South Africa which is where the pattern for these (very cheap and easy to make) skin to skin wraps is from, see https://www.up.ac.za/media/shared/Legacy/sitefiles/file/45/1335/877/thariinstructionsnewkmcwrappatternmay2011.pdf.

Skin to skin mother (and father) care

Keeping babies warm is one of the 4 themes identified by WHO as factors which contribute to bringing down neonatal mortality rates.  The mean temperature in Liberia is 27° C (81° F ), with temperatures rarely exceeding 36° C (97° F ) or falling below 20° C (68° F ).  But our learners today were telling me about the traditional birth attendants’ habit of holding the baby upside down and slapping its feet as soon as it is born and then washing it in cold water straight away.  Mind you, I am not sure it is that long ago that babies in my own country were treated like this.

Putting the baby skin-to-skin with its mother as soon as he or she is born is the best way to maintain his/her temperature and has many other advantages as well.  Take a look at this list from a South African site, www.kangaroomothercare.com:

Benefits of skin-to-skin contact for babies

  • Better brain development
  • Better emotional development
  • Less stress
  • Less crying
  • Less brain bleeds
  • More settled sleep
  • Babies are more alert when they are awake
  • Babies feel less pain from injections
  • The heart rate stabilizes
  • The oxygen saturation is more stable
  • Fewer apnoea attacks
  • Better breathing
  • The temperature is most stable on the mother
  • Breastfeeding starts more easily
  • More breast milk is produced
  • Gestation-specific milk is produced.
  • Faster weight gain
  • Baby can usually go home earlier
  • Enables colonisation of the baby’s skin with the mother’s friendly bacteria, thus providing protection against infection (UNICEF Baby Friendly Initiative information)

Benefits of skin-to-skin contact for parents

  • Parents become central to the caring team
  • Better bonding and interaction with their child
  • Emotional healing
  • Less guilt
  • Parents are calmer
  • Parents are empowered and more confident
  • Parents are able to learn their baby’s unique cues for hunger
  • Parents and baby get more sleep
  • Parents (especially mothers), are less depressed
  • Cope better in NICU
  • See baby as less “abnormal”
We have a long way to go with this in the UK.  On the course we teach that babies should be skin-to-skin with a parent for most of the day when on the neonatal unit.  All treatments except phototherapy can be carried out with the baby in this position.  Have a think about your own neonatal unit; do you have parents present all day with their baby tucked into their shirt?  If not, why not?

Learning how to tie a kalafong in the S2SMC practical session.