Pat,

It sounds like this lady needs some help with the kangaroo care. in
countries where there are no or inadequate other facilities the mother acts
as the incubator and family members help (father, sisters, aunty, grandma,
friends). According to Nils Bergman's studies, a baby kept in skin to skin
contact will maintain a more evenly stable temperature than a baby kept in
an isolette (preemie or full term). In fact it has been shown that a
mother's  temperature will raise 2 degrees to warm her cool baby (the
fathers temp won't raise nor will the temp of others who are not post partum
but the human warmth is still more evenly stabilising than an incubator.

As we all know a baby will feed better if warm and a baby will learn to feed
if kept in skin to skin contact and the colostum will flow if baby is kept
in skin to skin contact. since these simple methods have been shown to be
true and reliable we should be using them more and informing others of them.
we need to at least try out such evidence based research and maybe not over
rely on  expensive equipment.

the problem is the lady needs the help of some dedicated people who believe
in keeping baby in skin to skin contact. i don't mean for a few hours here
and there but for constant  24 hours a day till at least the babies are much
improved and feeding well and gaining weight and if at any time they seem to
drop back then it is a sure indication they need more days of kangaroo
mother care (KMC). If she can manage to do it and believe in it she needs to
keep one baby all the time strapped to her body. She needs  to have at least
6 friends possibly 9 who will help her rotate the other babies and then have
each baby spend a rotation of 4 hours twice a day with her or however else
it fits around the times the babies will feed.

sure it does mean she is restricted for a week or two or maybe four. but if
these are healthy prem babies who can suck at 35 weeks with no other
problems they will do very well with KMC. Don't forget the supply line
trick. if babies drink at the breast with a supply line that will mean less
energy used up to feed as babies use up more energy at the bottle than they
do at the breast. It is also efficient to feed by the supply line as they
don't have to be  refed after spending that time at the breast. It may mean
the time mum spends going between hospital and home and the time spent
washing bottles and pumping will now be spent having  a baby strapped to her
chest and feeding the three in rotation and sometimes twin style
continually. it will take dedication and belief in the body's ability to
make milk and respond and care for the babies. You can learn more about this
in the video by Dr Nils Bergman Kangaroo mother care. [log in to unmask]

I have informed mothers of well prem babies as young as 32 weeks of these
techniques and when the mothers are motivated to take their baby home soon
and to have their baby breast feeding they do it and those babies usually go
home doing very very well earlier than the ones who are not kept in such
close contact with the mum for as long. give it a try if they can posssibly
find the right kind of helpers and if she can bring herself to trust in it
and really give it a good try

good luck
from
Ruth C in Australia where it is so hot right now the mom would have to get
into the bath with them all to keep cool

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