In Haiti, kangaroo mother care helps stabilize the health of premature babies

On the occasion of World Prematurity Day, governments around the globe are organizing events to raise awareness on the serious issue of premature births.

Every year, 15 million babies are born prematurely. And with more than 1 million premature deaths each year, prematurity is the second leading cause of death of children under 5 years old. Many of those who do survive may face a lifetime of challenges – from learning disabilities to visual and hearing problems.

A global movement called A Promise Renewed aims to reduce the death rate of children under 5 to 20 or fewer deaths per 1,000 live births by 2035. UNICEF is supporting specific actions geared to achieving a dramatic reduction in neonatal mortality.

One of the key priority interventions that has shown promise is ‘kangaroo mother care’, a programme that encourages mothers to wrap their premature babies to their chests using a pouch. Close body contact with the mother has proven to help stabilize babies’ body temperatures, steady their heart rates and help with breathing.

By Suzanne Suh

PORT-AU-PRINCE, Haiti - Marie Michelle François lies on a bed in the neonatal unit. Her newborn baby is strapped to her stomach in a stretchy wrap. His head is covered with a thick knit hat, despite the sweltering heat. Born at 32 weeks, he is one week old and weighs less than three pounds. His eyes flutter, but he does not awaken.

He isn’t her first premature baby. Ms. François has had another preterm baby, who died.

This is, however, the first time she has used kangaroo mother care.

Simple method

In Haiti, where, in 2008, nearly half the population did not have access to healthcare, and where only a quarter of women give birth with a skilled attendant present, a baby born before term is very vulnerable.

Yet, thanks to kangaroo mother care, more and more preterm babies born in the neonatal unit of the Hospital of the State University in Port-au-Prince are surviving.

The method, named for the similarity to how certain marsupials carry their young, was initially developed to care for preterm infants in areas where incubators are unavailable or unreliable. In kangaroo care, the baby wears only a diaper and a hat and is placed in foetal position with maximal skin-to-skin contact on the parent’s chest.

“Kangaroo care arguably offers the most benefits for preterm and low-birth-weight infants, who experience more normalized temperature, heart rate and respiratory rate, increased weight gain and reduced incidence of respiratory tract disease,” explains Health Specialist at UNICEF Haiti Mireille Tribié. Kangaroo care also helps to improve sleep patterns of infants, and helps to promote frequent breastfeeding.

Chief of the neonatal unit at the hospital Dr. Severe says, “What is great about kangaroo care is the simplicity of the method. After 10 days, we already see a much rapider turnover – babies gain weight much more quickly because the baby learns how to position itself to feed. Being close to the maternal heartbeat facilitates the baby’s development.”

New beginning, after the earthquake

After the earthquake of 12 January 2010 demolished the maternity ward along with the hospital, Dr. Severe and his colleagues found themselves in the direst of conditions – fighting to save the lives of women and babies in makeshift tents with no electricity or running water. “[O]ut of 12 patients, 11 would die – we had no electrical current. We finally created a neonatal ward in the obstetrics department, but we had no furniture. Mothers were on the floor, on chairs,” he recalls.

The turning point, in his opinion, was when UNICEF provided beds, incubators, cribs and other technical and financial support to the neonatal unit.

UNICEF also sponsored sending four health professionals to Cameroon last year to receive training on kangaroo care. UNICEF then helped them to pass on the knowledge in training sessions for teams of health personnel throughout Haiti.

Like human incubators

Naika Desrameux has worked in the neonatal unit since October 2011. “Before, there was a very high mortality rate among preterm newborns. We didn’t have enough incubators for them all. But with kangaroo care, the mothers are like human incubators. They keep the baby warm, and we don’t have to worry about infections.”

Ms. Desrameux is one of the professionals trained in Cameroon. “The reality in Cameroon is very similar to the reality here in Haiti, so I was very excited about coming back and teaching women this approach here. With kangaroo care, we can really have an impact here in Haiti. It is really magical to see,” she says.

For Ms. François, it is making the difference between life and death. “I wish I could have done this with my other babies,” she says, gazing down at her baby boy lying prone on her stomach. “I like having my baby near me all day.”