By Alka Gadgil
The Neonatal Intensive Care Unit (NICU) and Kangaroo Mother Care facility at Dr. RN Cooper Hospital in Mumbai, run by the Brihan Mumbai Municipal Corporation (BMC), is quietly buzzing with activity. Doctors and specialised nursing care professionals are busy attending to their little patients; new mothers – and sometimes fathers, too – are gently rocking their newborns in their arms; monitors and specialised machines are beeping: it all looks very disciplined, very high-tech, and yet the air is super-charged with emotions. After all, this facility caters to infants who are born pre-term and/or less than 2.5 kilos at birth, fighting for their survival.
Dr Shailesh Mohite, Dean of Dr. RN Cooper Hospital, talks about the significance of running a competent neonatal programme in the hospital. “There is a common misconception that women from lower socio-economic strata give birth to underweight babies. But, in my experience, that is not the case; women from any class can give birth to low-birth-weight babies. So, we felt that as a public health facility catering to people from all walks of life, setting up a NICU and Kangaroo Mother Care (KMC) ward in Cooper Hospital was vital because low-birth-weight babies are a perineal issue. The KMC ward at Cooper Hospital is state-of-the-art. In fact, one can’t enter this ward without permission; even the infant’s mother has to wear a special uniform before entering, and it’s mandatory for visitors to put on a mask,” he says.
The KMC approach is a high impact, low-cost intervention for saving the lives of low-birth-weight babies. Introduced in Columbia, at Instituto Materno Infantil by Dr Edgar Rey Sanabria, way back in 1978, the KMC approach was officially included as a critical neo-natal care strategy on a wide scale by the Department of Public Health, Maharashtra, with the assistance of UNICEF, in 2017. Across the state, the KMC approach has been adopted in 36 Special Neonatal Intensive Care Units, including in Cooper Hospital.
Dr Baraturam Bhaisara, who oversees the NICU unit at Cooper Hospital explains the idea behind promoting the concept of KMC, “This method involves infants being carried, usually by the mother, with skin-to-skin contact. We teach mothers a special way to hold the baby. Since the little one is already familiar with the mother’s scent, touch, the sound of her voice and her heartbeat, the child is most comfortable being close to the mother. That, however, doesn’t mean that both parents cannot practice kangaroo care. We do ask both parents to take turns holding the child as often and as long as possible throughout the baby’s stay in the hospital.” The KMC approach is known to facilitate effective breastfeeding and increase in the baby’s weight, leading to an early discharge from the NICU.
It’s heartening to see both parents and the healthcare professionals committed to the well-being of the children admitted to the KMC ward in Cooper Hospital. Seeking permission to enter the facility, this writer, accompanied by Dr Bhaisara, meets some anxious, but very brave, mothers. Two women, with their babies in their lap, hesitantly strike up a conversation. They share the weight of their baby girls at the time of birth and reveal their struggles as new mothers.
“For many mothers, it’s a struggle between life and death,” remarks Dr Bhaisara, adding, “and for us in the healthcare sector, the challenge is to ensure that the mother and child reach a proper healthcare facility in time and then follow our advice.”
Those who have benefitted from the KMC approach are happy with the results. “My baby was in neonatal unit for some time and was well cared for. My practicing the KMC approach has enabled her to gain her strength and get better fast,” shares Shaheen.
Whereas during their stay in the hospital both mother and child are monitored and cared for, according to Dr Bhaisara, the real test is in ensuring that they follow KMC faithfully once they are back home, too. “When they leave the hospital, most parents are overcome by their everyday life. Their financial restrictions as well as social traditions dictate the way their baby is raised, which invariably ends up reversing the health gains made during the hospital stay. Therefore, proper training of mothers and constant follows-up are essential,” he says.
In the face of enormous challenges that confront maternal and child health in Maharashtra an internationally recognised neo-natal care strategy like the KMC method, which is virtually no-cost, easy to learn and follow, is definitely changing the lives of vulnerable pre-term babies.
Doctors reveal that often, immediately after child birth, mothers tend to develop a “guilt feeling”. This is especially true for mothers of pre-term infants. They worry about the future of their baby; they feel burdened with thoughts of their responsibilities towards the little one. However, with time and able assistance, more often than not, resilience overcomes any fears, as mothers bounce back, saying: “This is my child and I will do whatever it takes!”