Together for babies born too soon: A KMC success story in Kenya

Purity and baby Ashley speak to a health worker at Mbeere health facility

Hospital nutritionist at the Mbeere South sub-county hospital reviews baby Ashley’s progress using the Maternal Child Health Booklet.

In late September 2019, Purity Wanja, still in her second trimester, went into premature labour. As a first-time mother living in a rural area of Kenya, she was worried about the health of her baby and immediately visited her local health centre. After an assessment, she was transferred to the Embu County Referral Hospital, a comprehensive care facility where, in the early hours of the next morning, she gave birth to a baby girl, who she named Ryeon Ashley.

Ashley weighed only 1000g and was quickly admitted to the newborn unit. During her first seven days, her weight dropped to 750g. She had feeding problems, difficulty breathing, and was unable to regulate her body temperature. She was also suffering from infections, the result of a weak immune system.

But Ashley was fortunate. Health workers at the hospital had received on-the-job training on kangaroo mother care (KMC) from Nutrition International. Once Ashley was clinically stable, the health workers provided the support Purity needed to perform KMC and help ensure her baby’s condition continued to improve.

“I was very worried at first because my baby was too small, and she could not even breastfeed on her own,” said Purity. “This was all new to me. I didn’t know what to do. Through the support of the health workers in the unit I gained the knowledge, skills and confidence to express breastmilk and feed my baby. I was also shown and guided on how to practice kangaroo mother care.”

Quality KMC involves holding the baby skin-to-skin on the mother’s or other family member’s chest continuously, ideally only feeding them breastmilk and having close follow-up of the mother and baby once they return home. It is a newborn care approach recommended for babies born early (preterm) or small (low birthweight) that provides warmth, protection from infection, stimulation and supports exclusive breastfeeding.

“I would position my baby, who would wear only a hat, diaper and socks, skin-to-skin on my chest and then secure her using a wrap known as a lesso,” said Purity.

Her husband and in-laws visited her every day while she was in hospital. Purity recognizes the importance of their support, both emotional and financial, while she was focused on helping Ashley’s condition improve. She relied heavily on the experience of her mother-in-law, a former community health worker.

“After 58 days at the facility, my baby was discharged,” said Purity. “This was great news for our family. I was given weekly follow-up dates and the nurses were available by phone in case there were any concerns. Baby Ashley was breastfeeding well and in good health. I am grateful to have seen such a miracle and all the support from my family and staff at Embu Referral Hospital.”

Purity continued to practice KMC after leaving hospital and community health volunteers regularly monitored her and her baby’s health. Now a year later, Ashley weighs 7.2kg. Although she is still small for her age, she is healthy, thriving and continues to reach development milestones.

Purity has become an advocate for KMC in her community. She is also active in reaching out to women and encouraging them to seek antenatal care at the clinic early and regularly, to prevent complications that could result in premature birth.

Nutrition International provides technical and financial assistance to the Ministry of Health to establish KMC units in 10 counties. To date, 15 units are now active in Bomet, Busia, Embu, Kajiado, Kiambu, Makueni, Murang’a, Nakuru, Nandi and Vihiga. From April to September 2020, 1,715 preterm and low birthweight babies received KMC in these units.

Additionally, in each of the 10 counties, spouses who had preterm babies have formed KMC community support groups. These groups provide opportunities for sharing experiences, as well as demystifying misinformation related to the causes and care of premature births. Baby Ashley had the support of her family, healthcare system and trained healthcare professionals who came together so she not only was able to survive but also thrive in the future.