Introduction

Each year about 20 million infants of low birth weight are born worldwide, which imposes a heavy burden on healthcare and social systems in developing countries.1 ^w1 Medical care of low birthweight infants is complex, demands an expensive infrastructure and highly skilled staff, and is often a very disruptive experience for families.2 ^{w2 w3 w4} Premature babies in poorly resourced settings often end up in understaffed and ill equipped neonatal care units, that may be turned into potentially deadly traps by a range of factors colluding—for example, malfunctioning incubators, broken monitors, overcrowding, nosocomial infections, etc.

In 1978 Edgar Rey, a Colombian paediatrician concerned with the problems arising from a shortage of incubators and the impact of separating women from newborns in neonatal care units, developed Kangaroo Mother Care (KMC),3 a healthcare technique for low birthweight infants that is at least as effective as traditional care in a neonatal care unit.4 5

What does KMC entail?

In KMC, babies weighing 2000 g or less at birth and unable to regulate their body temperature remain with their mothers as incubators, main source of stimulation, and feeding. Newborns are attached to mothers and other carers' chests in skin to skin contact, wearing only a nappy and a baby bonnet, and are kept upright 24 hours a day. Mothers can share the role of provider of the kangaroo position with others, especially the babies' fathers, without disrupting breastfeeding routines. The carer should sleep in a semi-sitting position. The KMC begins as soon as the baby no longer requires other support from the neonatal care unit, although intermittent skin to …