 In this part, I will be discussing about kangaroo mother care, okay. Now we all know that there are many studies which have published which shows that babies who are who are kind of placed in kangaroo mother care, they do have improved weight gain, they have good temperature stability, especially for babies who are born premature or who are low birth weight. But you know in my opinion, even if babies born normal weight, you know everything like you know perfectly healthy, I still feel that we should give kangaroo mother care, anybody can give it, mother can give it, father can give it, grandparents can give it, you know, any adult in the family can definitely do kangaroo mother care. I have given really good, you know, kind of tutorials on what care to take, which babies should not be given kangaroo mother care and lot of, you know, different procedures. And in my second tutorial, actually this I kind of it is this particular tutorial is, you know, we have got a recommendation from actually one of my colleague pediatrician Dr. Korana and he is a trained neonatologist from Australia and you know, what they do is they make this KMC bag, you know, in their town. So, he is from Chattin Skirt and, you know, he has kind of shown us the way, the process of making KMC bag, you know, and this KMC bag has cap, you know, it has a very good kind of like, you know, support for the baby and it has come out really well. So, in this tutorial, we have shown if you have access to a sewing machine or if you know any self-help group of women who could, you know, show this or stitch this KMC bag, you know, and mothers can buy it for minimal cost, you know. So, do kind of watch it and see understand that how to make those KMC bag. You can even try it if you have a sewing machine at home and, you know, learn. Thank you so much. Welcome to the spoken tutorial on kangaroo mother care. In this tutorial, we will learn what is kangaroo mother care, the components, importance and procedure of kangaroo mother care. Let us first begin with the introduction of kangaroo mother care. As the name suggests, it involves keeping the baby in skin to skin contact with the mother and is popularly known as KMC. Remember, KMC should be given as soon as the baby is born. It is especially recommended for low birth weight babies whose birth weight is less than 2.5 kilograms and who do not require continuous monitoring. However, it can be used for all normal, healthy, full term babies too. KMC consists of two main components, continuous and prolonged skin to skin contact between the mother and her baby and exclusive breastfeeding. Let's discuss these two components in detail. The first component is skin to skin contact. It improves the let down reflex and ultimately increases the breast milk production. Let down reflex has been explained in another tutorial of the same series. The second component is exclusive breastfeeding. Note that exclusive breastfeeding is recommended for the first six months. Next, let's discuss the importance of kangaroo care. That skin to skin contact during KMC helps maintain the baby's body temperature and the baby feels more secure. KMC also decreases the frequency of infection and the rate of apnea in babies. Apnea is defined as long pauses in breathing. Apart from these, KMC improves the frequency and duration of breastfeeding. It strengthens the emotional bonding between the mother and her baby. KMC also helps the baby to gain weight than any other conventional methods such as keeping the baby in radiant warmer, which creates stress for the baby and the mother. It also improves the satisfaction and confidence in the mother as she takes extra effort for her baby. Interestingly, apart from mothers, KMC can be provided by father or any other family member too. We will now discuss the points to be followed by KMC provider. The KMC provider should be healthy and free from illness. He or she should follow basic hygiene practices such as hand washing, daily bath, clipped fingernails, tied up hair and clean clothes. He or she should not wear any jewellery, watches and threads as these may become the barriers to maintain the hygiene and it can cause injury to the baby. Now let us discuss the type of clothes the provider should wear during KMC. Clothes should be front open and lightweight. For example, saree blouse or front open gown. Note that the KMC provider should wear this front open gown or blouse around KMC wrap. Kangaroo bags or binders can be bought from the market as well. These are useful if KMC has to be done for an extended period. Alternately, the KMC provider can use soft clean cotton fabric whereas the baby during KMC should wear a cap and a nappy. If the baby passes stool or urine during KMC then she should be cleaned and dried thoroughly. Next we will move ahead to the procedure of kangaroo care in detail. Firstly, the mother should stand in an upright position. Then either a health worker or any family member should do the following things stepwise. By supporting the baby's bottom and head, place the baby between the mother's bare breasts in an upright position. Then turn the baby's head to one side. Make sure the baby's head is slightly bending backward. This position will keep the baby's nose airways open and will allow the baby to make eye-to-eye contact with the mother. Then bend the baby's hips slightly outward. Remember to keep baby's arms above the mother's breast, legs below the mother's breast and baby's abdomen on chest of the mother. Before wrapping with the cloth, cover the baby with a blanket if environment is cold. It will keep the baby and the mother warm. Then wrap a cloth around the baby and the mother's chest and abdomen. While wrapping, make sure the center of the cloth is on the baby and both ends of the cloth should pass through the armpits of the mother and should cross at the back. After that, bring the edges of the cloth in the front. Secure these edges of the cloth with a safe knot under the baby's bottom. This is comfortable and helps support the baby. Also, it avoids slipping of the baby. Remember, as the mother becomes comfortable, she should learn to wrap the cloth by herself. The technique of self-wrapping during KMC will be explained in another tutorial of the same series. It will increase the mother's confidence and make her independent. If mother is uncomfortable while using a cloth, then she can use a stretchy band. It is easy and comfortable to use. While using a stretchy band, adjust the edge of the band above the baby's ear to support his head. Then tilt the baby's head slightly to breathe freely and to make eye-to-eye contact with the mother as explained earlier. The wrapped cloth or stretchy band should not be too tight or too loose. It should be comfortable enough for the baby to breathe freely. Remember, while carrying the baby in KMC position, mother should be able to walk, stand, sit or involve in different activities. If a mother is very comfortable, then she can even sleep during kangaroo care in a reclined or semi-reclined position. Now let's discuss how to feed the baby during KMC. Either mother can feed the baby by simply loosening the wrapped cloth and positioning the baby for breastfeeding or she can manually express breast milk and feed the baby using a cup or a spoon. Remember, each day baby should gain up to 25-30 grams of weight. Hence, expected weight gain of a baby in a month is up to 900-1000 grams. Hence, mother or health worker should monitor the weight of the baby during routine checkups. If the baby fails to gain sufficient weight, health worker should monitor the breastfeeding technique of the mother or check how many times the baby urinates. Also, guide the mother about the correct clatching. Correct clatching has been explained in another tutorial of the same series. Next, let's learn how to remove the baby from the wrapped cloth. Firstly, the mother should sit in the right position. Then start untying the knot with one hand and support the baby's bottom with other hand on the outside of the wrapped cloth. After that, loosen the wrapped cloth with the same hand which was earlier used for untying the knot. Then shift the hand under the cloth which was supporting the baby's bottom and use the other hand to support the baby's bottom from outside the cloth. Then lift the baby up and free her from the wrapped cloth. After that, remember to hold the baby's head in a way where the thumb is behind one ear and other fingers are around the other ear. In KMC, the mother should immediately consult the doctor and the health worker if the baby is not alert and active, if the baby is breathing too fast or taking too long pauses, if the baby's lips or tongue turns blue and if baby's feet are cold. This brings us to the end of this tutorial. Thanks for joining. Welcome to the spoken tutorial on the making of a kangaroo bag with an attached cap. In this tutorial, we will learn the benefits of a kangaroo bag, the procedure of making a kangaroo bag with an attached cap. Let us begin. A kangaroo bag is used to provide kangaroo mother care or KMC. Two mother care has been explained in another tutorial of the same series. A kangaroo bag makes KMC convenient for the mother. Mothers have a unique natural mechanism to maintain the baby's body temperature. It works by changing the blood circulation specifically between the breasts. This happens when there is skin-to-skin contact between the mother and baby. This skin-to-skin contact is made easier and sustainable by a kangaroo bag. This bag also keeps the mother's hands free while providing KMC. It distributes the weight of the baby evenly on the mother's chest. Therefore, it prevents backache. A kangaroo bag is always made with an attached cap. New born babies lose heat from their head. The attached cap covers the baby's head and prevents loss of heat. It is important to make at least two kangaroo bags for a mother. She can use the second bag when the first bag needs to be washed and dried. To make two kangaroo bags, you will need 1.5 meters of soft flannel cloth, a pair of scissors, a sewing machine, a cloth chalk or marker, a measuring tape. Soft flannel cloth is the best cloth for newborn babies. It doesn't cause irritation to their soft skin. It is available in many different colours and designs at local markets. The first step is cutting the flannel cloth required to make one bag. For this, open the soft flannel cloth. Lay it vertically on a table. The printed side or the right side of the cloth should not be visible. The plain side or the wrong side should be visible on the upper side. Use a measuring tape to measure 60 cm for the length of the bag. Mark it with a cloth chalk or a marker. Measure 30 cm for the width of the bag. Mark it with a cloth chalk or a marker. Cut the cloth along the marked lines using a scissor. Now we have a 60 cm by 30 cm cloth piece ready. Next step is to fold the cloth for the bottom leg pouch. Fold 1 cm of the lower edge of the cloth horizontally. This is required later for hemming. Then fold the cloth horizontally up to 15 cm for the length of the pouch. Measure 15 cm after folding it. Next step is to cut the openings in the pouch for the baby's legs. Without opening the 15 cm pouch fold, fold the cloth vertically in half. The plain side or the wrong side should be outside after folding the cloth. Measure 8 cm in length from the top of the 15 cm pouch fold. Mark it on the side of the cloth that is open. Measure 8 cm in breadth at the bottom from the folded side of the cloth. Cut it with a cloth chalk or a marker. Connect the two markings by drawing a curve. Cut the cloth along the curve using a scissor. Now open the vertical fold. Fold it vertically in half with the printed side outside. Do not open the horizontal pouch fold. Line and hold the four layers of cloth together along the curve. Cut any extra cloth to make the curve of the leg openings smoother. This completes the cutting of the pouch of the kangaroo bag. Keep it aside. Next step is to cut the cloth for making belts. A kangaroo bag has three belts. One belt goes around the neck of the mother. The other two belts are tied to each other at the waist of the mother. We will use the remaining flannel cloth to cut these belts. Measure and mark 80 cm for the length of a belt. Measure and mark 6 cm for its breadth. Cut three such belts. Keep them aside. Next step is to cut the cloth for a cap. From the remaining flannel cloth measure 30 cm for the length of the cap. Mark it with a cloth chalk or a marker. Measure and mark 15 cm for the breadth of the cap. Cut the cloth along the marked lines using a scissor. Now we have a 30 cm by 15 cm cloth piece ready for the cap. Now we will learn how to sew the cap. Fold the cap cloth piece horizontally in half at the midline. The plain side or the wrong side should be outside after folding the cloth. Sew the edges of two layers of cloth together on either side of the fold. Hem the other two sides of the cloth. Now the cap is ready to be attached to the bag. Keep it aside. Next step is to sew the three belts for the kangaroo bag. First fold the belts vertically 1.5 cm from the left. Then fold them vertically 1.5 cm from the right. The printed or the right side should be visible after folding the belts. Now fold the belts vertically a little less than half near the midline. The previous two folds from the right and left should be hidden inside this fold. Folding thrice will make the belts strong enough to hold the baby's weight. Now sew them straight along the third fold. Sew back and forth along the fold thrice to add extra strength. Belts are ready. Keep them aside. Next we will learn how to sew the pouch of the bag. This is a picture of the pouch cloth piece that we had cut. Hem the C shaped curves on the right and left sides of this cloth. Next hem the upper horizontal edge of the pouch. Fold it twice before sewing. The second fold should be bigger than the first one. The pouch is ready. Next step is to attach the belts to the pouch. Fold the pouch horizontally. The plain or wrong side of the cloth should be outside. Place a belt between the top corner of the pouch and the cloth below. Sew the three layers together leaving half an inch space from the side. Sew back and forth three times to ensure that the belt is attached properly. Similarly, sew the second belt on the other top corner of the pouch. In this picture the pouch is ready and the belts are attached to it. Next step is to attach the cap and the third belt. Start hemming the two sides of the remaining cloth above the pouch. Do not hem the entire length of the cloth. Stop about half an inch before reaching the top end. Place an end of the belt at the printed side of the top end of the cloth. Place a corner of the cap over the same end of the belt. Align and hold the three layers together. Fold the layers on the upper end tightly. Then, sew them together two to three times. Now attach the cap to the cloth along the horizontal edge. The breadth of the cap may be more than that of the cloth. If it is, then make a small pleat in the cap cloth. Hold the pleat while sewing to align both layers of cloth properly. Now place the other end of the belt at the other end of the cloth. Place the other corner of the cap over the belt. Align and hold the three layers together. Fold the layers on the upper end tightly. Then, sew them together two to three times. Hem the remaining vertical edge of the cloth if you did not do it before. Lastly, cut all the extra threads. The kangaroo bag with an attached cap is ready. This brings us to the end of this tutorial. Thank you for joining.