Lucknow— Recently, a new Kangaroo Mother Care centre was inaugurated in Barabanki, located 30 kilometers from Lucknow, the capital of Uttar Pradesh. The Kangaroo Mother Care center in the hospital has generated significant interest among the women of Barabanki, with the hope that it will help reduce the infant mortality rate in the city. It is worth noting that Lucknow already has this facility available at the Sanjay Gandhi Post Graduate Institute and King George Medical University, Lucknow.

The concept of Human Milk Banking has emerged as a by-product of Kangaroo Mother Care (KMC). KMC is a method of caring for premature and low-birth-weight infants, especially in resource-limited settings. It entails skin-to-skin contact between the newborn and their mother or another caregiver, typically with the baby placed on the caregiver's chest, resembling a kangaroo carrying its young in a pouch. This method has been proven to be highly beneficial for both the baby and the mother and is often implemented in Kangaroo Mother Care Centers or units within hospitals and healthcare facilities. Kangaroo Mother Care for preterm infants was first introduced in Colombia in 1978 by Edgar Rey in Bogotá.

Speaking to The Mooknayak, Dr. Laxmi Kant Bharti, Department of Pediatrics at Sanjay Gandhi Post Graduate Institute, Lucknow, explained the concept of Kangaroo Mother Care. He mentioned that sometimes children are born underweight due to premature delivery, and in such cases, these children struggle to maintain their body temperature. To address this issue, mothers provide skin-to-skin contact to the child with a cloth wrapped around them. He also highlighted a new concept where fathers can replace mothers to provide warmth to the child.

Some key aspects of Kangaroo Mother Care include:

1. Skin-to-skin Contact: This provides warmth and regulates the temperature of the child.

2. Breastfeeding: It encourages early and frequent breastfeeding to provide essential nutrients and immune factors to the baby.

3. Emotional Bonding: KMC fosters emotional bonding between the mother and the child.

4. Reducing Infections: Kangaroo Mother Care has been associated with a lower risk of infection for premature babies compared to traditional incubator care.

Kangaroo Mother Care Centers are specialized units within hospitals or healthcare facilities where healthcare providers are trained to implement and monitor KMC for premature and low-birth-weight infants. These centers offer a conducive environment for mothers to practice KMC, receive guidance on breastfeeding, and ensure the well-being of their newborns. Health professionals in these centers also monitor the baby's growth and development, addressing any medical concerns that may arise.

Kangaroo Mother Care has gained recognition as an effective and cost-efficient method for improving the survival and well-being of premature and low-birth-weight infants, especially in settings where access to advanced medical technology and facilities is limited. It promotes the principles of family-centered care and empowers mothers to take an active role in their baby's care, ultimately contributing to positive outcomes for both the baby and the mother.

Speaking to The Mooknayak, a Neonatologist said, "Sometimes, preterm babies or babies whose weight is less than 2.5 Kg require special care to normalize their temperature. One such process is Kangaroo Mother Care, where the mother and the baby have skin-to-skin contact, similar to that of a Kangaroo. He added that a new concept called 'Immediate Kangaroo Mother Care' has emerged, in which the baby is taken for KMC immediately after birth inside the Neonatal Intensive Care Unit. He also mentioned that in Kangaroo discharge, the mother and the baby are discharged early from the hospital, allowing her to provide nutrition to the baby at home.

Breast Milk Donation: An Extension of KMC

Mothers at Kangaroo Mother Care centers are approached for milk donation, which is a voluntary service, and the mothers do not receive financial benefits for it. Other mothers can also donate breast milk at these centers. The first Breast Milk donation center was established in 1989 at Sion Hospital in Mumbai. Since then, numerous Human Milk Bank centers have been established in India. Lala Lajpat Rai Hospital in Kanpur recently became the latest addition to the list of hospitals with the facility of Breast Milk Donation. This facility can be crucial for children who are deprived of their mother's milk.

In cases where a mother loses her baby shortly after birth, doctors cease lactation through medication. However, the unit in Kanpur will facilitate milk donation, obviating the need to stop milk production. The Human Milk Donation centers are referred to as Comprehensive Lactation Management Centers (CLMC) in India. According to the website of the National Human Milk Bank of India, an organization working in the field of milk donation, a CLMC performs three functions:

1. It supports breastfeeding by helping new mothers breastfeed and resolve their lactation issues.

2. It helps mothers express milk for their own babies and donate excess milk to the CLMC.

3. It tests, stores, and pasteurizes collected milk and feeds it to vulnerable babies who do not have access to their mother's milk due to unavoidable reasons.

Speaking to The Mooknayak, Dr. Laxmi Kant Bharti, a Professor in the Department of Pediatrics at SGPGI, said, "In some conditions when the mother's milk cannot be given to the child, Mothers Milk Centers have been established by the government." He emphasized the importance of breast milk, stating that "mothers' milk has live cells. Although normal milk also contains protein and fats, mothers' milk fights bacteria directly because of the live cells." He explained that when there is bacteria in a room, the brain receives the signal through the nose before sending it to the breast to create antibodies against it, and consequently, the milk produces antibodies. Thus, breast milk is essential for the child's immunity.

Mother's milk is essential to protect the newborn from complications. A Neonatologist told The Mooknayak, "There are some circumstances in which the mother is not able to provide breast milk to the babies, but the milk is essential for the survival and well-being of the child. The unavailability may also lead to Necrotizing enterocolitis (NEC), a serious gastrointestinal problem that mostly affects premature babies. For this purpose, there are breast milk donation centers in various hospitals."

Despite the importance of Human Milk Banks and Kangaroo Mother Care, the growth of these milk banks in India has been sluggish. India currently has around 57 CLMCs. However, the rate of growth of these milk banks is not encouraging.

Key Milestones and Developments:

• 1989: The first Milk Bank was opened in India at Sion Hospital in Mumbai.

• 2013: SSKM Hospital in Kolkata opened East India's first Human Milk Bank.

• In 2013, Rajasthan's first Mother's Milk Bank began in Udaipur which was first of its kind in North India.

• In 2019, Uttar Pradesh received its first CLMC at King George Medical University, Lucknow.

• In 2021, Kerala inaugurated its first Milk bank at Ernakulum General Hospital.

Despite these achievements, the presence of only 57 CLMCs across India is not an encouraging number. It is imperative that the government works towards increasing the presence of these milk banks to prevent infant mortality rates in India.