# migrations

dir: embeddings_queue
filename: 00001-embeddings.sqlite.sql
hash: d3755dfd232be8e8301f4d7fcfb3a486
sql:
CREATE TABLE embeddings_queue (
    seq_id INTEGER PRIMARY KEY,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    operation INTEGER NOT NULL,
    topic TEXT NOT NULL,
    id TEXT NOT NULL,
    vector BLOB,
    encoding TEXT,
    metadata TEXT
);


dir: sysdb
filename: 00001-collections.sqlite.sql
hash: 38352d725ad1c16074fac420b22b4633
sql:
CREATE TABLE collections (
    id TEXT PRIMARY KEY,
    name TEXT NOT NULL,
    topic TEXT NOT NULL,
    UNIQUE (name)
);

CREATE TABLE collection_metadata (
    collection_id TEXT REFERENCES collections(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (collection_id, key)
);


dir: sysdb
filename: 00002-segments.sqlite.sql
hash: 2913cb6a503055a95f625448037e8912
sql:
CREATE TABLE segments (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    topic TEXT,
    collection TEXT REFERENCES collection(id)
);

CREATE TABLE segment_metadata (
    segment_id TEXT  REFERENCES segments(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (segment_id, key)
);


dir: sysdb
filename: 00004-tenants-databases.sqlite.sql
hash: 048867ce8fcdefe4023c7110e4433591
sql:
CREATE TABLE IF NOT EXISTS tenants (
    id TEXT PRIMARY KEY,
    UNIQUE (id)
);

CREATE TABLE IF NOT EXISTS databases (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per tenant
    tenant_id TEXT NOT NULL REFERENCES tenants(id) ON DELETE CASCADE,
    UNIQUE (tenant_id, name) -- Ensure that a tenant has only one database with a given name
);

CREATE TABLE IF NOT EXISTS collections_tmp (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per database
    topic TEXT NOT NULL,
    dimension INTEGER,
    database_id TEXT NOT NULL REFERENCES databases(id) ON DELETE CASCADE,
    UNIQUE (name, database_id)
);

-- Create default tenant and database
INSERT OR REPLACE INTO tenants (id) VALUES ('default_tenant'); -- The default tenant id is 'default_tenant' others are UUIDs
INSERT OR REPLACE INTO databases (id, name, tenant_id) VALUES ('00000000-0000-0000-0000-000000000000', 'default_database', 'default_tenant');

INSERT OR REPLACE INTO collections_tmp (id, name, topic, dimension, database_id)
    SELECT id, name, topic, dimension, '00000000-0000-0000-0000-000000000000' FROM collections;
DROP TABLE collections;
ALTER TABLE collections_tmp RENAME TO collections;


dir: sysdb
filename: 00005-remove-topic.sqlite.sql
hash: b1367c826b8fba5f96f27befdc1d42d2
sql:
-- Remove the topic column from the Collections and Segments tables

ALTER TABLE collections DROP COLUMN topic;
ALTER TABLE segments DROP COLUMN topic;


dir: sysdb
filename: 00006-collection-segment-metadata.sqlite.sql
hash: 4eea7468935bf25d4604a0fed2366116
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE collection_metadata ADD COLUMN bool_value INTEGER;
ALTER TABLE segment_metadata ADD COLUMN bool_value INTEGER;


dir: sysdb
filename: 00007-collection-config.sqlite.sql
hash: 1c7e63bba346a42a18b6ab7f1c989bed
sql:
-- Stores collection configuration dictionaries.
ALTER TABLE collections ADD COLUMN config_json_str TEXT;


dir: sysdb
filename: 00008-maintenance-log.sqlite.sql
hash: 0a0e7e93111a01789addf64961c6127c
sql:
-- Records when database maintenance operations are performed.
-- At time of creation, this table is only used to record vacuum operations.
CREATE TABLE maintenance_log (
  id INT PRIMARY KEY,
  timestamp INT NOT NULL,
  operation TEXT NOT NULL
);


dir: sysdb
filename: 00009-segment-collection-not-null.sqlite.sql
hash: 054355aef9e63702bf54ea29e61563f1
sql:
-- This makes segments.collection non-nullable.
CREATE TABLE segments_temp (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    collection TEXT REFERENCES collection(id) NOT NULL
);

INSERT INTO segments_temp SELECT * FROM segments;
DROP TABLE segments;
ALTER TABLE segments_temp RENAME TO segments;


dir: metadb
filename: 00001-embedding-metadata.sqlite.sql
hash: 2b4cf52c4bb2676e21d6860a4409f856
sql:
CREATE TABLE embeddings (
    id INTEGER PRIMARY KEY,
    segment_id TEXT NOT NULL,
    embedding_id TEXT NOT NULL,
    seq_id BLOB NOT NULL,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    UNIQUE (segment_id, embedding_id)
);

CREATE TABLE embedding_metadata (
    id INTEGER REFERENCES embeddings(id),
    key TEXT NOT NULL,
    string_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (id, key)
);

CREATE TABLE max_seq_id (
    segment_id TEXT PRIMARY KEY,
    seq_id BLOB NOT NULL
);

CREATE VIRTUAL TABLE embedding_fulltext USING fts5(id, string_value);


dir: metadb
filename: 00002-embedding-metadata.sqlite.sql
hash: 12a570f7121b3a8ce750a2a7c36da20f
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE embedding_metadata ADD COLUMN bool_value INTEGER


dir: metadb
filename: 00003-full-text-tokenize.sqlite.sql
hash: f97ad6334aeaa8f419f01110b648b97a
sql:
CREATE VIRTUAL TABLE embedding_fulltext_search USING fts5(string_value, tokenize='trigram');
INSERT INTO embedding_fulltext_search (rowid, string_value) SELECT rowid, string_value FROM embedding_metadata;
DROP TABLE embedding_fulltext;


dir: metadb
filename: 00004-metadata-indices.sqlite.sql
hash: fb36603a45ee2cd0254cef3ef86585e8
sql:
CREATE INDEX IF NOT EXISTS embedding_metadata_int_value ON embedding_metadata (key, int_value) WHERE int_value IS NOT NULL;
CREATE INDEX IF NOT EXISTS embedding_metadata_float_value ON embedding_metadata (key, float_value) WHERE float_value IS NOT NULL;
CREATE INDEX IF NOT EXISTS embedding_metadata_string_value ON embedding_metadata (key, string_value) WHERE string_value IS NOT NULL;


# embeddings_queue

created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a2837112-8c55-49d3-8434-ecf1b1ddeb0b
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 0, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 0, "chroma:document": "HOME\nBASED\nKANGAROO\n:\nMOTHER CARE\nMANUAL FOR IMPLEMENTATION AT\nPRIMARY HEALTH CARE LEVEL"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: eb4b373c-5fe1-4d9b-a6b3-3eb0a2ad6c64
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 1, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 1, "chroma:document": "Required citation:\nGovernment of Maharashtra, UNICEF, KMC Foundation of India, 2021.\nHome Based Kangaroo Mother Care: Manual for implementation at Primary Health Care level.\nGovernment of Maharashtra.\nThe authors and their employers and the presentations of the materials in this report do not imply any\nexpression of opinion on the part of the Government of Maharashtra or UNICEF or KMC Foundation of\nIndia regarding the endorsement by these agencies. The views expressed in this manual do not\nnecessarily re\u0000ect the views or policies of these agencies. This work may be copied, redistributed and\nadapted for non-commercial purposes provided that the work is appropriately cited.\nPublished by:\nState Family Welfare Bureau, Government of Maharashtra RB Mills Road,\nNaidu Hospital Campus, Pune 411 001,\nISBN Number:\nList of Contributors:\nPrincipal Author\nProf. Shashi N Vani, M.D., D. Ped., FIAP, FNNF\nManaging Trustee KMC Foundation, India,\nEmeritus Professor of Paediatrics including Neonatology,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4a39d58e-1359-4363-9269-76565816c1f2
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 1, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 2, "chroma:document": "Managing Trustee KMC Foundation, India,\nEmeritus Professor of Paediatrics including Neonatology,\nP S Medical College, Karamsad, Gujarat.\nADVISORY GROUP\nGovernment of Maharashtra\n1. Dr. Pradeep Vyas, IAS, Additional Chief Secretary\n2. Ramaswami N., IAS, Commissioner, Health Services and MD NHM\n3. Dr. Archana Patil, Director of Health Services\n4. Dr. Ramchandra Hankare, DD RCH\n5. Dr. Ashish Bharati, Assistant Director, Department of Public Health\nUNICEF\n1. Smt. Rajeshwari Chandrashekhar, Chief of the Field Of\u0000ce, UNICEF, Mumbai\n2. Dr. Khanindra Bhuyan, Health Specialist\n3. Dr. Mangesh Gadhari, Health of\u0000cer\n4. Dr. Prashant Hingankar, Consultant\nExpert Reviewers\n1. Prof. Simin Irani, MD, FNNF, Retd. Professor and HOD of Neonatology, Seth GS Medical College,\nK E M Hospital Mumbai and Somaiya Medical College, Mumbai\n2. Prof. Nikhil Kharod, MD, Joint Secretary KMC Foundation, R etd. Prof. and HOD Paediatrics,\nP S M C, and CEO, Tribhuvan Foundation, Anand, Gujarat"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 328245d5-9706-4057-b0d1-c5326ff017bb
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 1, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 3, "chroma:document": "P S M C, and CEO, Tribhuvan Foundation, Anand, Gujarat\n3. Prof. Rekha Udani, MD, Retd. Professor and HOD of Neonatology, K E M Hospital Mumbai and\nB Y Patil Hospital, Navi Mumbai\n4. Prof. L S Deshmukh, MD, DM (Neonatology), Prof and HOD of Medical College, Aurangabad\n5. Prof. Ruchi Nanavati, MD, Prof and HOD, Neonatology, K E M Hospital Mumbai\n6. Prof. Sushma Malik, MD, Prof and HOD, Neonatology, Nair Hospital, Mumbai,\nMembers of KMC Foundation, India\n7. Dr. Parag Dagli, MD, Trustee KMCF, India, Neonatal and Pediatric intensivist,\nDirector Apple Children Hospital, Ahmedabad\n8. Dr. Jatin Mistri, MD, MRCPCH (UK) , CCST (Neonatal medicine,) UK, Trustee KMCF , India\n9. Dr. Ravi Parikh, MD, D Ped, MRCPCH (UK), CCST ( Neonatal Medicine) UK, Trustee, KMCF, India"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 128fe41a-d0dc-4044-9afd-033d091be7ae
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 2, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 4, "chroma:document": "CONTENTS\nAbbreviations used in this manual 1 3.B.3 Skills required for feeding LBWI during HBKMC 30\nAbout this manual for Healthcare Providers for 3.C. Kangaroo Discharge and Follow Up of\nHome Based Kangaroo Mother Care 2 newborns receiving HBKMC 31\n3.C.1 Planned early discharge and random\nCHAPTER ONE: early discharge 32\nA few basic facts of newborn healthcare for HCPs 3 3.C.2 General schedule for home visits of\nASHA workers 33\n1.1 A few important De\u0000nitions: 3\n3.C.3 Activities of the ASHA/HCPs during the home\n1.2 Why should we take care of our newborns? 3\nvisits of a baby in HBKMC 33\n1.3 Basic principles of newborn care: 3\n3.C.4 Checklist for activities during follow up home\n1.4 Levels of newborn care 4 visits of ASHA/CHWs 36\n1.5 Why should we promote Homebased\nKangaroo Mother Care in India? 4 CHAPTER FOUR:\n1.6 Different groups needing HBKMC in India. 4 Communication and Counseling for promoting HBKMC 38\nCHAPTER TWO: CHAPTER FIVE:"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: bbc337bd-f712-4b20-809a-7737ac81f731
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 2, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 5, "chroma:document": "CHAPTER TWO: CHAPTER FIVE:\nBasics and Bene\u0000ts of Kangaroo Mother Care 6 Reports of Home Based Kangaroo Mother Care 40\n2.1 What is KMC? 6\n2.2 WHO de\u0000nition of KMC 6 CHAPTER SIX:\n2.3 Bene\u0000ts of KMC 6 Practice of Home Based KMC during COVID Pandemic 41\n2.4 Role of KMC in Early Child Development (ECD) 8\n2.5 A few basic aspects of KMC 8 CHAPTER SEVEN:\n2.6 When to stop KMC? 10 Experiences of Home Based KMC in Gujarat\nand Maharashtra 44\n2.7 Scope of Kangaroo Mother Care in community 10\nA. Gujarat 44\nCHAPTER THREE: B. Maharashtra 46\nPractice guidelines for Home Based Kangaroo\nMother Care 11 REFERENCES 48\n3.A. Kangaroo Position: 11\nANNEXURES: 52\n3.A.1 Which babies are eligible for HBKMC? 11\n1. Suggested recording & reporting formats\n3.A.2 Who can provide KMC? 12\nfor HBKMC 52\n3.A.3 Facilities and support expected from family\n2. Frequently asked questions (FAQs) about KMC 56\nmembers for HBKMC 12\n3. KMC Pretest (Sample Questionnaire) 62\n3.A.4 Advance preparations for KMC at home 13"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d22ec6a5-40cf-406b-9e90-4b7e090354b5
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 2, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 6, "chroma:document": "3. KMC Pretest (Sample Questionnaire) 62\n3.A.4 Advance preparations for KMC at home 13\n4. Question bank for self-learning exercise 64\n3.A.5 Immediate preparations just before the actual\nstart of KP/KMC 15 5. Training for KMC 68\n3.A.6 Actual procedure of Kangaroo Position/KMC 16 6. Budget for HBKMC roll out in a district 71\n3.A.7 Caring the baby in Kangaroo Position at homes 18 7. Additional resources 72\n3.A.8 Monitoring the infant during KMC 18 7.1 Important skills for use of simple instruments 72\n3.A.9 Danger signals of the baby during KMC and 7.2 Classi\u0000cation of the newborns in view of further\nactions to be taken 18 management 74\n3.B. Kangaroo Nutrition 21 7.3 Minor Problems of Newborns 76\n3.B.1 Steps for successful breast feeding for stable 7.4 The Common Traditional Practices affecting\now birth weight babies 22 Newborn care 79\n3.B.2 Feeding of unstable(sick) and too small babies 7.5 A few common dif\u0000culties of breast feeding 82\n(VLBWI/ELBWI) 25"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 61b12a7d-7716-467a-a6f7-f06665e1d8ec
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 4, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 7, "chroma:document": "National Health Mission\n8th Floor, Arogya Bhavan,\nSt. George\u2019s Hospital Compound,\nP. D. Mello Road,\nMumbai 400 001.\nDr. Ramaswami. N, IAS,\nCommissioner Health Services,\nMD (NHM) GOM\nMESSAGE\nKangaroo Mother Care (KMC) is an evidence based, simple, cost-effective way of caring for low\nbirth weight infants and has already been promoted at various levels of public health facilities in the state\nof Maharashtra. Considering the importance of this intervention, having guidelines for practicing KMC\nat home is the need of hour particularly in tribal areas where prevalence of low birth weight is high.\nThis manual gives a clear guidance to service providers especially frontline health workers on how\nhome based KMC can be implemented for caring of low birth weight newborn at the village level. Many\ntips for care of the new born babies by the mothers / ASHAs / ANMs at the village level are highlighted,\nwhich will be very useful."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 45135ccd-e874-4183-bfb7-8d633d95b93b
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 4, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 8, "chroma:document": "which will be very useful.\nI hope that this manual will also be used by programme managers for supervision during field level\nvisits and will help in reducing child mortality and malnutrition in the tribal areas of the state.\nI appreciate the support of KMC Foundation of India and UNICEF in formulating this manual for\nhealth workers."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a4f398d3-ae30-4901-ae70-645216fb3a93
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 5, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 9, "chroma:document": "Dr. Archana Patil\nMD, PhD"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: cfa6c3b9-fa45-464f-9a26-3613babe2e93
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 6, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 10, "chroma:document": "United Nations Children\u2019s Fund\nUNICEF Office for Maharashtra-\nB wing, 4th Floor, 215, Atrium,\nBehind Courtayrd Marriott Hotel,\nAndheri Kurla Road, Chakala,\nAndheri (East), Mumbai - 400 093,\nMaharashtra, India.\nPREFACE\nPromoting maternal and newborn health and routine immunization are two important priorities for\nUNICEF. Even though Maharashtra has made great progress in reducing the maternal and newborn\ndeath rates, the progress is uneven. Tribal, urban slum and rural populations are the most disadvantaged\ngroups, in these population groups, neonatal mortality is higher than the state averages, therefore\ndifferent Reproductive Maternal Neonatal Child Health and Adolescent interventions need to be\nprioritized. There is evidence to show that in some of the tribal areas as well as urban slums, the neonatal\nmortality rates are higher than the state average. Government officials are held accountable by activists"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a7d3bb18-7599-49ac-b129-51cdef6f506e
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 6, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 11, "chroma:document": "for the higher levels of malnutrition among women and children of the tribal blocks. I am happy that\npartnership between UNICEF, KMC Foundation of India and Public Health Department catalyzed the\nroll out the first ever Home Based Kangaroo Mother Care (HBKMC) programme in 78 tribal blocks in\nthe state since 2019, reaching thousands of low birth weight babies.\nThis manual, authored by Prof. Shashi Vani, who first started in the Kangaroo Mother Care ward in\nIndia way back in 1993 at the neonatology division of the Civil Hospital and B.J. Medical College,\nAhmedabad, will go a long way in improving skills of frontline functionaries and mothers on Kangaroo\nMother Care and breast feeding among the low birth weight babies. It is an opportune moment for\npromoting home based KMC, which is an effective, simple and affordable intervention for improving\nsurvival, growth and development of low birth weight babies."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 377af6e9-fbce-49bf-99ca-2c19c6c6d533
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 6, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 12, "chroma:document": "survival, growth and development of low birth weight babies.\nOn behalf of UNICEF, I assure the highest commitment for the realization of the rights of the most\ndisadvantaged children in Maharashtra and for the scale up of home based KMC in the state.\nRajeshwari Chandrasekar\nChief of the Field Office"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 009cbedd-799b-4ef1-b1c2-e90b65ab9e2e
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 7, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 13, "chroma:document": "Office\u0000:\nProf. Shashi N. Vani\nM.D., D. Ped., FIAR, FNNF"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 8, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 14, "chroma:document": "ABBREVIATIONS\nAbbreviation Complete term\nAKP Alternate KMC Provider/ Surrogate KMC Provider\nAWW Angan Wadi Worker\nANM Auxiliary Nurse Midwife\nCHW Community Health Worker\nEBM Expressed Breast Milk\nENBC Essential Newborn Care\nECD Early Child Development\nFKC Father Kangaroo Care\nHBKMC Home Based Kangaroo Mother Care\nHBNC Home Based Newborn care\nHCP Health Care Providers\nIMNCI Integrated Management of Newborn and Childhood Illnesses\nIYCF Infant and Young Child Feeding\nIMR Infant Mortality Rate\nIV Intravenous\nKMC Kangaroo Mother Care\nKP Kangaroo Position\nKC Kangaroo Care\nLBW Low Birth Weight\nLMP Last Menstrual Period\nMOM Mother's Own Milk\nNGO Non Government Organization\nNICU Neonatal Intensive Care Unit\nNSCU Newborn Special Care Unit\nNSSK Navjaat Shishu Suraksha Karyakram\nROP Retinopathy of Prematurity\nSBA Skilled Birth Attendant\nSNCU Special Newborn Care Unit\nUNICEF United Nations Children Fund\nWHO World Health Organization\n| 1 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e7a98be5-dcaa-42ad-99ab-fb9ccc35ffb1
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 9, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 15, "chroma:document": "ABOUT THIS MANUAL FOR\nHEALTHCARE PROVIDERS FOR HOME BASED\nKANGAROO MOTHER CARE\nWe are happy to prepare this manual for the a few sections on training and a few practical aspects\npromotion of Home Based Kangaroo Mother Care of newborn care which will be useful for the workers\n(HBKMC) by the Healthcare Providers (HCP) who in remote areas. The trainees are advised to refer to\nprovide services to mother, newborn and child in our the training module and guideline for HBNC for\ncountry. The main focus is ASHAs, AWWs and details of other components of HBNC. In this manual,\nANMs, who are the frontline workers / {Community only the components of HBKMC and the relevant\nhealth workers (CHW) in the health system}. HBKMC aspects are highlighted. HCPs have some\nis very much needed in India in different situations, information and knowledge about KMC through\nand it has not been addressed properly. This manual different training programs of Essential Newborn"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: cc475e14-9468-4a85-8891-7943d23cc263
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 9, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 16, "chroma:document": "should help to \u0000ll this void. In the dif\u0000cult to reach Care (ENBC), Navjaat Shishu Surakha Karyakram\nvillages and tribal areas, the facilities of road, (NSSK) and others. But have no skills and con\u0000dence\ntransport and communication are very poor. Poverty, to guide mothers for KMC as detailed capacity\nilliteracy and gender discrimination are prevalent. building is not done. This manual is prepared to build\nHealth care facilities are situated in faraway places the missing gaps of knowledge and skills about KMC\nmaking it very dif\u0000cult for the public to access these. as relevant to home based care in remote rural and\nIn such situations, home based newborn care tribal villages and hamlets and urban slums.\n(HBNC) including KMC has proved to be of great use\nand helps to save many newborns. In urban slums,\nthe problems are even more complex including\npoverty, poor infrastructure, poor water, sanitation\nand hygiene services, fragmented health services,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ed52d4bc-2d5a-45cc-a0f4-5f335d72bf89
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 9, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 17, "chroma:document": "and hygiene services, fragmented health services,\ndue to which health services are not utilized properly.\nThe promotion of HBKMC should be a part of\nEssential newborn care (ENBC) and HBNC and not\nto be considered as an independent topic. This\nseparate manual is prepared with the main objective\nthat if basic knowledge and skills are provided to the\nmothers, they can practice HBKMC so that newborn\nbabies get the best results of this simple, yet a very\nuseful intervention with several bene\u0000ts.\nWe have tried to make this manual as simple and\npractical as possible. Practical guidelines for all the\nthree major components of KMC i.e. Kangaroo\nPosition, Nutrition and Discharge and follow up are\nprovided. Important subjects like communication and\ncounselling for improving the quality and coverage\nof HBKMC, records and reporting and a special\nchapter on practice of KMC during the current Covid\n19 pandemic have been added. Annexures include\nFig. 1: Kangaroo Mother Care\n| 2 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3aaca5cd-43bb-4ad7-bab9-247f5c43754a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 10, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 18, "chroma:document": "CHAPTER ONE\nA FEW BASIC FACTS OF NEWBORN HEALTHCARE\nFOR HCPS /CHWs\nIt will be useful to refresh a few basic facts of 1.2 Why should we take care of our\nnewborn care before we proceed for care of the\nnewborns?\nnewborn babies with HBKMC.\nFirst 1000 days of life from conception to two\nyears of life of the child are the most important\n1.1 Important De\u0000nitions:\nperiod of life for survival, growth and\nNewborn baby: A baby from the time of birth development. Adequate health promotion and\nl\nto 28 days or \u0000rst four weeks of age. nutrition during this 1000 days period is not only\ncritical for pregnant women's survival but also for\nFull term baby: A baby born between 37 to\nl\nthe survival of the newborn, his/ her ability to\n41 weeks and six days of gestational age/\ngrow and learn, which helps in breaking the\npregnancy {Born between 253 to 293 days\nintergenerational cycle of poverty and\nafter the date of \u0000rst day of last menstrual\nmalnutrition. As per the estimates developed by\nperiod (LMP)}."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 10, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 19, "chroma:document": "malnutrition. As per the estimates developed by\nperiod (LMP)}.\nthe United Nations Inter-agency Group for Child\nPreterm or Premature baby (born too soon): Mortality Estimation, an estimated 522,000 new\nl\nA baby born before 37 weeks of gestational born babies died out of 824,000 children below\nage /pregnancy (Born before 253 days after \u0000ve years who died in India in 2020; most of these\nthe \u0000rst day of the last menstrual period). deaths are preventable.\nBirth weight of a baby: The earliest weight The indirect impact of Covid 19 pandemic may\nl\nrecorded soon after birth of a baby preferably have exacerbated the neonatal mortality rates in\nin \u0000rst two hours of life. In case the weight different states of India and simple interventions\ncannot be recorded within the \u0000rst 2 hours due like early exclusive breast feeding and KMC,\nto several issues, the \u0000rst weight recorded together with skilled birth attendance can save"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f1d06691-93c9-4492-b4bf-60347f6bf721
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 10, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 20, "chroma:document": "to several issues, the \u0000rst weight recorded together with skilled birth attendance can save\nwithin the \u0000rst seven days of life is considered lives of many newborn babies.\nas birth weight. In that case, it is desired that\nalong with the weight record, the day on\n1.3 Basic principles of newborn care:\nwhich the weight is measured should be\nmentioned. For example: Birth weight of baby a) Ensure regular breathing.\nof Sita 1.7 KG (on 5th day of life).\nb) Preserve adequate body warmth, adopt\nl Low Birth Weight baby - (born too small): The warm chain for newborn care.\nbaby whose birth weight is less than 2500\nc) Provide optimum nutrition, preferably\ngrams.\nexclusive Mother's Own Milk (MOM) either\nl An Infant: A child from the time of birth till as direct breastfeeding or as expressed breast\ncompleting one year of age. The \u0000rst month of milk.\nlife is described as the neonatal period and\nd) Hand washing and other measures of\nthe remaining 11 months period is called post"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e60aeb96-bc05-4725-a6e8-7df0d644c2a1
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 10, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 21, "chroma:document": "d) Hand washing and other measures of\nthe remaining 11 months period is called post\nprevention of infections including observing\nneonatal period.\nclean delivery practices with \u0000ve/six cleans.\nClean chain of baby care and avoiding\n| 3 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 43111e24-92d2-4a00-938e-aac751aff6b1
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 11, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 22, "chroma:document": "CHAPTER ONE\nA FEW BASIC FACTS OF NEWBORN HEALTHCARE FOR HCPS /CHWs\nharmful traditional newborn care practices 1.5 Why should we promote Home\nwhich are likely to introduce infections\nbased Kangaroo Mother Care in\n(Unhygienic cord care, pre lacteal feeds,\nIndia?\napplication of Kajal in eyes, bottle feeding\netc.)\nHBKMC is required in developing countries like\ne) Early identi\u0000cation of danger signals in India for the following reasons:\nnewborn, immediate prompt actions and if\nAmple scienti\u0000c evidence recommends that simple\nrequired referral to higher care hospitals\ninterventions like KMC including breast milk\nwith all due precautions and preparations.\nfeeding (Early initiation of breastfeeding, use of\nThese basic principles of care are applicable\nexpressed breast milk, exclusive breast milk\nto all the newborns including full term or\nfeeding etc.), hand washing and other infection\npremature, healthy or sick and whether\nprevention measures if done well and widely, can"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4f15f39d-8763-4bb1-9648-2ffa4955ccb8
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 11, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 23, "chroma:document": "premature, healthy or sick and whether\nprevention measures if done well and widely, can\ndelivered at home or hospital.\nprevent most neonatal deaths.\nA systematic review conducted in 2016 showed\n1.4 Levels of newborn care:\nthat at discharge or 40-41 weeks of\npostmenstrual age(PMA), KMC was associated\nPrimary or essential newborn care: Required\nl\nwith signi\u0000cant reduction in the risk of mortality\nfor almost 85% of all the newborns. The care\n(40%), infections acquired in the hospitals (65%)\nincludes making sure of good breathing,\nand hypothermia (78%) in newborns.\nkeeping mother and her baby together in skin\nto skin contact, keeping adequately warm, India has a huge number of LBW and preterm\npromoting breastfeeding, infection prevention newborns who have very high rates of death and\nmeasures and early detection of danger illnesses. HBNC including HBKMC through\nsignals and appropriate actions, if required ASHAs, AWWs, ANMs with proper training can"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: db0c6cc2-aa12-4e4a-97f2-a0e4c820f15b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 11, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 24, "chroma:document": "signals and appropriate actions, if required ASHAs, AWWs, ANMs with proper training can\nand referral to higher centres with suitable save the lives of many of these babies.\nprecautions and care.\nSpecial care or intermediary care: Required 1.6 Different groups needing HBKMC\nl\nfor about 10 to 12% of the newborn babies.\nin India\nIncludes oxygen therapy, intravenous \u0000uids\nand medications, antibiotics, phototherapy, Similar to HBNC, HBKMC is offered in following\ngavage feeding etc. Usually given in special different scenario:\nnewborn care units (SNCUs) or level\nII/Intermediate care units. Group I\nIntensive care or tertiary care: Required for The baby is delivered in a hospital and following\nl\nabout 3 to 5% of newborn babies. Can be the hospital protocols, KMC is started under the\ngiven only by specially trained specialists instructions of doctors and trained nurses. Once\ndoctors and nurses in advanced care units the baby starts showing consistent improvement,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 11, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 25, "chroma:document": "doctors and nurses in advanced care units the baby starts showing consistent improvement,\nwith sophisticated equipment and advanced the newborn is discharged from hospital as per the\nmanagement. laid down protocol and subsequent care including\nKMC is continued at home with regularly\nSpecialized Care for the newborns: Surgical\nl scheduled follow up visits to the hospital.\ncare, foetal therapy etc.\n| 4 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 0af19543-8077-46c2-bf09-e89b4089c238
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 12, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 26, "chroma:document": "CHAPTER ONE\nA FEW BASIC FACTS OF NEWBORN HEALTHCARE FOR HCPS /CHWs\nGroup II Group III\nIn this group, the baby is delivered in the hospital In this group, the baby is delivered at home and\nand the baby is eligible to receive KMC. But the the subsequent care of the newborn has to be\nmother is not able to stay in the hospital for her given only at home.\npersonal, socio-cultural reasons or the facility\nIn all these cases, through regular home visits, the\ndoes not have expertise and/or equipment to\nASHAs have the opportunity to offer good quality\nprovide care for the small and sick newborn, who\nof HBNC including HBKMC and improve the\nis cared for at home.\nchances of survival of the newborn, especially the\nsmall and sick babies.\nFig. 2: KMC at home for twins\n| 5 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 13, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 27, "chroma:document": "CHAPTER TWO\nBASICS AND BENEFITS OF KANGAROO\nMOTHER CARE (KMC)\n2.1 What is KMC? 2.3 Bene\u0000ts of KMC:\nKMC is an evidence based, low cost, yet high impact, There are several bene\u0000ts for the baby, for the\nsimple and natural method of care of newborns with mother, family members, hospital, community and\nadded bene\u0000ts to low birth weight and preterm ultimately to the nation.\nbabies. It is a method of holding the newborn directly\n\u00fc Bene\u0000ts of KMC to the baby:\nin skin to skin contact on mother\u2019s chest in between\nher breasts, without any layer of clothing in between, l High potential to reduce deaths and\nwith baby\u2019s neck slightly extended and the body of sickness of preterm and LBW newborns\nthe baby is in as much vertical position as possible so (Almost up to 40% of total neonatal\nthat mother and baby can have eye to eye contact mortality can be prevented).\nand both are covered together from above. The\nPrevents neonatal hypothermia (Body\nl\nnewborn is breastfed every two hours. This is better"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 13, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 28, "chroma:document": "Prevents neonatal hypothermia (Body\nl\nnewborn is breastfed every two hours. This is better\ncooling).\ndescribed as a loving body hug than mere super\u0000cial\nskin to skin touch. l Helps to warm up the newborn who\nalready has thermal stress (mild cooling of\nthe body).\nDevelops thermal synchrony between\nl\nmother\u2019s body temperature and baby\u2019s\nbody temperature (When the baby\u2019s body\ntemperature reduces slightly, mother\u2019s body\ntemperature rises a little high and vice\nversa).\nIncreases the duration of exclusive breast\nl\nmilk feeding, resulting in better weight gain,\ngrowth.\nReduces the risk of severe neonatal\nl\ninfections including hospital acquired\n(Nosocomial) infections as well as\nFig. 3: Helping mother for KMC\nsepticaemia (severe infection affecting\nmultiple organs).\n2.2 WHO de\u0000nition of KMC:\nIncreases mother baby bonding.\nl\nKMC consists of- early, prolonged and continuous Facilitates early physiological stability of\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 13, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 29, "chroma:document": "l\nKMC consists of- early, prolonged and continuous Facilitates early physiological stability of\nl\nskin to skin contact between the mother and her heart rate and respiration of the neonate.\nbaby, with exclusive breast feeding whenever\nPromotes good quality sleep and improves\nl\npossible, early discharge with adequate follow up\nneuro development and behaviour\nand support and initiation of practice in the facility\ndevelopment.\nand continuation at home.\n| 6 |"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 14, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 30, "chroma:document": "CHAPTER TWO\nBASICS AND BENEFITS OF KANGAROO MOTHER CARE (KMC)\nBene\u0000ts of KMC to Newborn Babies\nrates of illnesses\nMany long term and\nand deaths\nother bene\u0000ts\nPrevents body cooling\nSatis\u0000es all \u0000ve sensations\n(Hypothermia), maintains\n(taste, Smell, Vision,\nbody temperature\nTouch , hearing)\nImproves breast feeding\nand growth\nPain\nchances of infections Prevents reduction of\nblood sugar\nImproves good quiet sleep\nStabilizes heart rate, respirations\nImproves brain and colour of baby\ndevelopment\nImprov es mother baby bonding,\nfee ling of safety and security\nReduces the requirement of oxygen and There is increased bonding between mother\nl l\nepisodes of apnoeic attacks (Temporary and her baby.\ncessation of breathing for more than 20\nMother feels empowered and con\u0000dent to\nl\nseconds at a time, often causing choking of\ntake care of her small baby in the hospital\nrespirations and bluish discolouration of\nand continue the same care at home after\nskin due to lack of oxygen) which frequently"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1043bbb8-36e3-4c06-96e6-fcde55b4d214
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 14, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 31, "chroma:document": "and continue the same care at home after\nskin due to lack of oxygen) which frequently\ndischarge (Applicable for hospital\noccur in very preterm babies.\ndelivered babies).\nReduces the neonatal stress and improves\nl\nLess chances of post -partum (After\nl\nthe feeling of security in the baby and\ndelivery) depression and psychosis in\nbabies cry less.\nmother.\nReduces the feeling of mild to moderate\nl\nBetter supply of breast milk due to increased\nl\npain following simple procedures like heel\nproduction of hormones.\nprick, venepuncture, testing for Retinopathy\nof Prematurity etc. l Earlier involution of uterus and stopping of\npost -partum bleeding in mother.\nIn short, all the \u0000ve senses of the baby i.e.\nl\ntouch, smell, hearing, vision and taste are l Early return to home settings.\nsatis\u0000ed very early resulting in better\n\u00fc Bene\u0000ts of KMC to the family:\nneurodevelopment.\nEconomical due to lesser stay of the baby and\n\u00fc Bene\u0000ts of KMC to mother:\nmother in the hospital and less use of"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3aa39c4f-0d9e-459c-b32c-c45eb2e0ca5a
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 14, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 32, "chroma:document": "\u00fc Bene\u0000ts of KMC to mother:\nmother in the hospital and less use of\nDue to active involvement in the care of small medications, oxygen etc. (Applicable for\nand even sick baby soon after birth: hospital delivered babies).\n| 7 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 34d89939-e09c-4ec7-8769-360e80c1ece4
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 15, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 33, "chroma:document": "CHAPTER TWO\nBASICS AND BENEFITS OF KANGAROO MOTHER CARE (KMC)\nImproved quality of breast feeding and less growth, they get their mental stimulation through love\nl\nchances of illness to the baby. and affection and achieve their full potential of\ndevelopment and become happy, healthy and\nBetter family support and involvement of\nl\nresponsible adults. To be effective ECD should be\nfamily members in the care of the baby.\nstarted as early as possible after birth:\nEarly return to work and routine family life.\nl\nKMC provides the best start to LBW and preterm\nl\nl Reduced incidence of child abandonment babies who are prone to developmental\nand abuse. problems.\nl Bene\u0000ts of KMC to the hospital: (Applicable l In the \u0000rst few hours after birth, the baby\u2019s brain\nonly for hospital delivered cases). is very responsive to various modes of brain\nstimulation which lay a strong foundation for\nSaves money on health care costs of small\nl\nimmediate and long -term development."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 2cb72740-6d84-44b0-9cdd-a53ae15b9700
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 15, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 34, "chroma:document": "Saves money on health care costs of small\nl\nimmediate and long -term development.\nand sick newborn and even during post -\nnatal period. Immediate skin to skin contact soon after birth\nl\nprovides an excellent opportunity and lays the\nBetter use of manpower and infrastructure.\nl\nstrong foundation for early child development.\nReduced requirements of antibiotics and\nl\nKMC provides a womb-like environment and\nother medications, oxygen, formulae etc. l\nduring KMC, the baby gets good sleep, cries\nl Less chances of hospital acquired infections less, feels less pain, feels secure and stress free.\nwhich are much more dif\u0000cult to treat. All these help for the better brain development of\nthe baby along with the added bene\u0000ts of breast\nLess burden on nursing staff due to more\nl\nfeeding.\ninvolvement of the mother in the care of her\nbaby. During KMC, breast feeding is encouraged\nl\nwhich adds to development of the brain. Breast\n\u00fc Bene\u0000ts to Community and the Nation:"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 7aa7cf9e-a2fd-4664-bce0-d68e511df64d
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 15, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 35, "chroma:document": "l\nwhich adds to development of the brain. Breast\n\u00fc Bene\u0000ts to Community and the Nation:\nmilk has several components which help for\nBetter orientation in good newborn care\nl better mental development of the child.\npractices and better participation.\nKMC stimulates all the \u0000ve sensations which help\nl\nBetter quality of survival (Thriving well)\nl in early brain development.\namong the LBW and pre -term infants.\nReduction in cost of newborn care due to\nl 2.5 A few basic aspects of KMC:\nmultiple reasons and better utilization of the\nfunds. \u00fc KMC has three major components:\nBetter quality of intelligent future citizens. A Kangaroo Position- Skin to skin contact\nl\nbetween mother and her baby preferably in\nvertical position and eye to eye contact.\n2.4 Role of KMC in Early Child\nB Kangaroo Nutrition- Exclusive breast milk\nDevelopment (ECD):\nfeeding as much as possible.\nCurrently our goal for newborn care is not to just\nC Kangaroo Discharge and Follow Up-"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4daeeb0e-5e9b-45d5-8273-27fabe6e8ee9
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 15, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 36, "chroma:document": "Currently our goal for newborn care is not to just\nC Kangaroo Discharge and Follow Up-\nensure only the survival but also to ensure that babies\nPlanned early discharge and regular follow up\nthrive well. Along with good nutrition and physical\nincluding follow up for neuro-motor, neuro-\n| 8 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1904ef5d-c609-4a5f-92a6-9fdac06af0bd
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 16, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 37, "chroma:document": "CHAPTER TWO\nBASICS AND BENEFITS OF KANGAROO MOTHER CARE (KMC)\nbehaviour and sensory development for all half hours and preferably combined with\nbabies. breast milk feeding. This prolonged skin to\nskin contact can be labelled as Kangaroo\nAll carried out in a supportive environment, both\nCare. Skin to skin contact for a few minutes\nin facility as well as at home.\ncannot be labelled as Kangaroo Care. In\n\u00fc Early skin to skin contact, soon after birth: case of hospital delivered cases, routine\nweighing, Vitamin K administration and\nEarly skin to skin contact is advised soon after\nbirth dose vaccination of BCG, Hepatitis B\nbirth, in the labour room itself for all the babies\nand OPV can be done after the initial one to\nirrespective of gestation age and birth weight\none and half hours of direct skin to skin\nexcept for those who require immediate\ncontact on mother\u2019s chest.\nattention for resuscitation or other life -saving\ninterventions. It is helpful for following: \u00fc Duration of KMC:"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9ecefd96-fcc3-4404-abb4-9f458c12914c
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 16, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 38, "chroma:document": "interventions. It is helpful for following: \u00fc Duration of KMC:\nl Rapid physiological stability for the baby, l Ideally KMC should be given for a total of at\nin terms of heart rate and respirations. least 20 hours in a day, which improves\nsurvival of the LBW and preterm babies.\nPreventing cooling of the baby soon after\nl\nbirth. Mother can continue providing KMC as\nl\nlong as it is comfortable for her. She can\nStimulating early breast milk production.\nl\nthen hand over the baby for continuing\nl Developing early bonding between mother KMC to Alternate Kangaroo Care Provider\nand her baby. (AKP), if available or keep the baby in her\nbed for a break and again continue with\nAll the bene\u0000ts of non -separation of the\nl\nmore sessions.\nmother and her baby including reducing\nthe mental stress of mother as well as the During the 24 hours, the total hours of KMC\nl\nbaby. given are calculated by adding the hours\ngiven by mother as well as by the AKP in\nReduction of chances of early neonatal\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9c0e7c55-bed5-4fe7-907d-55ae1c7576c6
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 16, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 39, "chroma:document": "given by mother as well as by the AKP in\nReduction of chances of early neonatal\nl\ndifferent sessions.\ninfections.\n\u00fc Types of KMC:\nContinuous KMC:\nl\nThe longer the duration of KMC, the better\nare the impacts. It should be ideally given\nfor almost 24 hours in a day, or at least for\nmore than 20 hours in a day. Only\nobligatory breaks are taken by the mother\nfor her bath, food and other personal needs\nand for the baby for diaper change, cup\nfeeding, routine clinical examinations etc.\nFig. 4: Immediate skin to skin contact soon after The support from Alternate KMC Provider\nbirth/baby on mother\u2019s abdomen soon after birth (AKP) from the family is very helpful for\ngiving continuous KMC.\nIdeally this early skin to skin contact should\nl\nbe prolonged for at least one to one and a\n| 9 |"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ef9bf06b-62b4-40aa-9e84-4a08547a0121
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 17, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 40, "chroma:document": "CHAPTER TWO\nBASICS AND BENEFITS OF KANGAROO MOTHER CARE (KMC)\nl Intermittent KMC: 2.7 Scope of Kangaroo Mother Care in\nKMC is given for a few hours at a time with community:\nlong breaks in between each session. This\n\u00fc KMC can be given to:\ntype is mainly done for extremely LBWI and\nstabilized sick babies and also when the All the stable LBW babies including preterm\nl\nmother is recovering from surgery like CS, babies even at home.\ntubal ligation etc. where support from AKP\nIt can be given to term babies also as much\nl\nis not available.\nas they are comfortable in KMC position in\nthe initial few days after birth.\n2.6 When to stop KMC?\nFor sick babies, if hospitalization is not\nl\nIf the mother and baby are comfortable, KMC should possible, as a measure to relieve pain and\nbe continued till the baby\u2019s weight is more than 2500 reduce stress.\ngm. Around that time, the baby starts wriggling in\nFor transport of the newborn wherever\nl\nKangaroo Position to show that s/he is"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 360edfdd-efa6-4135-8989-0a673c3e1dbd
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 17, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 41, "chroma:document": "For transport of the newborn wherever\nl\nKangaroo Position to show that s/he is\nrequired for taking to higher centers for\nuncomfortable, pulls her limbs out, cries every time\nhospitalization or for follow up for special\nthe mother tries to put the baby in skin-to-skin\ncheck of eyes, hearing and assessment for\ncontact. This is when it is safe to advise the mother to\nbrain development or for regular\nwean the baby gradually from KMC. Breast feeding\nassessment of nutrition and growth and for\nmust continue. Mother can return to the occasional\nimmunizations etc.\nKMC after giving bath, or just before sleep or during\ncold nights.\n\u00fc Don\u2019ts of Kangaroo Mother Care:\nDo not bathe till the infant weighs\nl\n2500gand stable. Body sponging may be\ndone.\nDo not handle infant too frequently.\nl\nDo not give bottle feed.\nl\nl Do not allow infant to be in contact with sick Fig. 5: KMC ward in Govt hospital, Maharashtra\npeople.\nDuring KMC, as far as possible do not hold\nl\nthe baby horizontally, particularly the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 46b5a81f-0fae-41ef-b906-14cfdc21f8d0
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 17, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 42, "chroma:document": "people.\nDuring KMC, as far as possible do not hold\nl\nthe baby horizontally, particularly the\nbabies who are very premature or very\nsmall.\nDo not apply any cream or oil on the\nl\numbilical stump.\n|10|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a2449194-b6a0-4602-9118-62af7255616e
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 18, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 43, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED\nKANGAROO MOTHER CARE\nIn this chapter practice guidelines are provided for\nguiding mothers for KMC at homes. Basic 3.A.1 Which babies are eligible for\napproach remains the same as that of facility\nHBKMC?\nbased KMC.\n\u00fc Recommendations:\nBroadly three major components are included in\nKMC: l Generally, all newborn babies born at home\nwho are not having serious problems\nA) Kangaroo Position.\nirrespective of weight or maturity should be\nB) Kangaroo Nutrition. provided KMC (skin to skin contact/kangaroo\nposition).\nC) Kangaroo (discharge and ) follow up.\nEnsure all LBW and premature babies receive\nl\n(The component of planned early discharge as a\nKMC.\npart of KMC is not applicable in case of Home\nbased KMC in group 2 and group 3. Ideally, neonates having serious problems\nl\nshould be referred to hospitals having Mother\nRegular follow up is very important for all the\nand Newborn Care Units, Special Newborn\nthree groups of HBKMC)."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4571c25e-7f90-471a-9165-018140609a4a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 18, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 44, "chroma:document": "and Newborn Care Units, Special Newborn\nthree groups of HBKMC).\nCare Units or Neonatal Intensive care Units,\nwhere better care can be given. But if that is\n3.A Kangaroo Position: not possible, even these babies with serious\nproblems can be kept in Kangaroo position\n\u00fc Topics covered in this chapter:\nand feeding with expressed breast milk can\n3.A.1 Which babies are eligible for HBKMC? be tried.\nl\n3.A.2 Who can provide KMC? \u00fc General guidelines in hospitals:\nl\n3.A.3 Facilities and support expected from The timing and initiation of FBKMC depends\nl\nfamily members for HBKMC. on the birth weight and stability of the infant.\nIn the facilities, following guidelines are\n3.A.4 Advance preparations for KMC at\nl\nprovided, which may not be applicable at\nhome.\nhomes as well:\n3.A.5 Immediate preparations just before the\nl\n1. Birth weight more than 1800 grams and less\nactual start of KP/KMC.\nthan 2500 grams:\n3.A.6 Actual procedure of Kangaroo\nl\nThese infants are generally stable at birth."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d431ef0a-e066-45b3-ac44-069744503215
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 18, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 45, "chroma:document": "than 2500 grams:\n3.A.6 Actual procedure of Kangaroo\nl\nThese infants are generally stable at birth.\nPosition/KMC.\nTherefore, in most such cases KMC can be\nl 3.A.7 Caring the baby in Kangaroo Position initiated soon after birth in the labour room\nat home. and continued in the postnatal ward. The\nneonate weighing less than 2000gm should\n3.A.8 Monitoring the infant during KMC.\nl\nbe accorded priority for initiating KMC\nl 3.A.9 Danger signals of the baby during considering the huge burden of LBW infants in\nKMC and actions to be taken. the country.\n|11|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8a8a08d4-83ea-4e15-badc-e5117758c5d3
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 19, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 46, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\n2. Birth weight more than 1200g and less than Should maintain basic standards of personal\nl\n1800g: hygiene (Proper hand wash, daily bath,\nclipped \u0000ngernails, tied up hair, clean\nMany infants in this group have signi\u0000cant\nwashed clothes). No skin infections,\nproblems in the neonatal period. Such infants\nespecially on mother\u2019s chest.\nmay need care in a Special Newborn Care\nUnit (SNCU) or a Newborn Intensive Care Mother should not be smoking or drinking\nl\nUnit (NICU), which can be provided while the alcohol or any addictive drugs during\nmother provides KMC in these units. KMC can pregnancy and lactation period and\nbe given to a hemodynamically stable infant especially during the time providing KMC.\nreceiving IV \u0000uids, antibiotics and oxygen.\nThe term KMC is very often misinterpreted that\nThe duration may be gradually increased and\nonly mothers can provide KMC, which is not true."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 19, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 47, "chroma:document": "The duration may be gradually increased and\nonly mothers can provide KMC, which is not true.\nthereafter the infant may be transferred to a\nOther adult family members including father,\ndedicated KMC ward.\nmother -in -law, grand -parents, uncle, aunt, sister\n3. Birth weight less than 1200g: or any responsible, willing and healthy person can\nalso be an alternate KMC provider (AKP). Even\nThese infants frequently experience serious\nfriends, neighbours and staff members also can be\nprematurity related morbidity often starting\nAKPs with approval from mother and her family\nsoon after birth. It may take days to weeks\nmembers. The alternate KMC provider should be\nbefore the infant\u2019s condition allows initiation\nhaving the same attributes as that of mother when\nof KMC. Duration of KMC should be\noffering KMC.\ngradually increased based on tolerance of the\ninfant.\n3.A.3 Facilities and support expected\n(Recent studies have demonstrated that even\nfrom family members for HBKMC:"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 19, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 48, "chroma:document": "(Recent studies have demonstrated that even\nfrom family members for HBKMC:\nvery sick babies can be managed and\ninterventions and investigations can be done\n\u00fc A supportive family is a very important pre\nwhen the baby is in Kangaroo Position under\nrequisite for successful KMC:\nexpert supervision and guidance in neonatal\nintensive care units with many advantages l Family members should allow mother to do\nincluding further reduction of mortality). KMC frequently and for prolonged time as\nrequired.\n3.A.2 Who can provide KMC? l Provide her a clean, well ventilated place at\nhome for KMC with some privacy.\n\u00fc Best person is the mother:\nObserve the baby closely when the mother is\nl\nShe should be\nsleeping either with the baby on her chest in\nkangaroo position or the baby lying next to\nMedically and physically \u0000t, in good health,\nl\nher in the same bed.\nfree from serious medical problems.\nBaby is covered well and kept warm and\nWilling and capable of holding the baby in l\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 19, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 49, "chroma:document": "Baby is covered well and kept warm and\nWilling and capable of holding the baby in l\nl\nclean when not undergoing KMC.\nKMC position continuously for at least 20\nhours a day or at least one and half hour per\nBe an AKP and relieve the mother for some\nl\nsession and have such frequent sessions in a\ntime and help in providing KMC to the baby.\nday and carry on for many days as required.\n|12|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: dbb8aa7b-b1fb-43db-9428-4292a7814718
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 20, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 50, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nTry to learn about the early signs of danger house, without exposure to direct drafts of\nl\nsignals in babies and refer to the hospital wind, can be selected. If mud \u0000oor is there,\nimmediately. fresh cow dung plastering may be avoided for\nsome weeks prior to delivery. As far as\nHelp mother with routine domestic chores and\nl\npossible, only wet mopping of the \u0000oor must\nto take care of other children, if any.\nbe promoted. Direct dusty sweeping should\nl Take mother for regular follow up as per be avoided wherever a newborn is being\nschedule for routine check -up of growth and cared for. Mother with a newborn should be\nimmunizations and special neuro away from cattle sheds as much as possible\ndevelopmental follow up, screening for ROP, and also from poultry. Rat holes should be\nhearing etc. \u0000lled and cleared away. Cockroaches, lizards\nshould be cleared as much as possible."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 46751ba5-71db-4544-8560-631d149fbd58
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 20, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 51, "chroma:document": "hearing etc. \u0000lled and cleared away. Cockroaches, lizards\nshould be cleared as much as possible.\nProvide plenty of clean washed clothes,\nl\nEnvironment must be free of water logging\ndiapers for the use of the baby and also for the\nand \u0000lth to minimize the menace of\nuse of the mother.\nmosquitoes, \u0000ies and other insects.\nProvision of food and other personal\nl\nIf a cot is available, \u0000ne. If not, a mattress or\nrequirements, including soap, clothes and\nmat can be spread on the \u0000oor. Two pillows\nother needs.\nmay be provided so that the mother can adopt\nl Provision of water and nearby facilities for a reclining position while lying or sleeping\ntoilet, bath etc. for mother are desirable. with the baby in kangaroo position. While\nproviding KMC, the mother can rest against a\nwall or a pillar with the help of pillows or cloth\n3.A.4 Advance Preparations for KMC\nbundles for support, if a reclining chair\nat Home:\n(preferably with a footrest) is not available."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: be3f7281-a45b-4c19-bbf2-8c348773df1e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 20, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 52, "chroma:document": "bundles for support, if a reclining chair\nat Home:\n(preferably with a footrest) is not available.\nThe number to call an emergency ambulance\nl Use of mosquito nets must be encouraged.\nl\nto be displayed prominently in the house so\nUse of mosquito repellent coils and chemical\nthat when need arises, immediate contact can\npreparations should be avoided.\nbe established.\n\u00fc Supplies needed during KMC to be arranged\nThe address and the directions of the\nl\nbeforehand:\nhospital to be referred in case of emergency\npreferably including the phone numbers of *Clothing for the baby:\nl\npersons to be contacted during emergency.\nCaps two, socks and mittens two pairs, if\nl\nl Selection and preparation of a place for possible. (If not available, cotton cloth pieces\nKMC at home very often, the homes are very can be used to cover head as well as feet and\nsmall and congested. Even in such homes, hand depending on the season).\nwherever possible, a well ventilated, clean\nFront open baby cloth/zabla \u2013 four (No"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: dcb3da4e-f657-4482-81a6-211d345e7515
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 20, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 53, "chroma:document": "wherever possible, a well ventilated, clean\nFront open baby cloth/zabla \u2013 four (No\narea can be prepared for mother and her l\nhooks should be used in clothes for babies to\nbaby to remain together. Cobwebs, dirt and\navoid injuries).\ndust to be removed. If possible, simple\nwhitewashing of the walls can be done before (Extra pairs are recommended for use, in case\nl\nthe arrival of the baby. A well -lighted, of wetting or soiling by baby).\nventilated area adjoining a window in the\nBlanket/shawl to cover from above.\nl\n|13|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c489ea65-0016-497d-958e-fe0e09c9f56d
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 21, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 54, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nIn case, a support binder is not available, an inches x 15 inches, about 12 to 15 pieces are\nl\nextra dupatta, bedsheet or shawl for \u0000xing the collected in advance. If possible, the edges\nbaby properly in Kangaroo position. may be stitched to avoid tethering. For use as\na washable diaper, the cloth can be folded in\n*Diapers for babies:\nl\nthree or four layers depending on the size of\nl Disposable diapers are not very often the baby. A waist band should be tied to the\navailable, or these may not be affordable for baby and this folded cloth can be tucked as a\npoor families. Very often because of the cost diaper in front and back. This multi layered\ninvolved, even when they are used, frequent fold of cloth helps in preventing direct soiling\nchanging is not done leading to local of the mother's chest and abdomen. It can be"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e8a3fb38-47c2-4bbd-93a1-6f9fb54b55da
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 21, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 55, "chroma:document": "changing is not done leading to local of the mother's chest and abdomen. It can be\nirritation, rashes and skin infections. easily tucked and removed after use. After\nTraditional loin cloths used for babies are soiling, the cloth can be easily unfolded,\noften single layered and do not help in washed and dried. They are de\u0000nitely very\npreventing wetting or soiling. Quite a few helpful to mother. They also help in reducing\nmothers do not opt for KMC because of the pollution due to disposable diapers.\ndislike of soiling and wetting by the baby\n*Support garment such as a Kangaroo Bag\nl\nwhen KMC is being done. Even when they do\nor different types of wraps for KMC. Their\noffer KMC, the duration is shortened because\nuse is not an absolute must. But any such\nof frequent wetting of the mother's chest and\nextra supporting garment helps in keeping the\nabdomen by the baby. Keeping all these\nbaby secure in KMC position and also\nfactors in mind, following improvisation is"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3555788a-6bd5-45a2-86c5-e10c739727aa
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 21, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 56, "chroma:document": "baby secure in KMC position and also\nfactors in mind, following improvisation is\nprovides additional safety from slipping down\nsuggested.\nor sudden undue \u0000exion or extension of the\nl Cotton cloths made up of smooth absorbent neck of the baby and preventing very rare\nand easily washable material of about 15 chances of life -threatening catastrophes for\nFig. 6: Home made reusable cloth diapers.\n|14|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 0e5d9ca1-6623-41a3-8d63-da94809b8048
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 22, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 57, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nthe delicate small, pre -term baby. The use of Mother must practice the technique of hand\nl\nsuch support garments help mothers to have washing properly before handling her baby.\nsome safe mobility with baby in kangaroo\nShe should take a good bath and attend to her\nl\nposition and at least one hand of the mother\npersonal hygiene before starting KMC.\ncan be free with which she can perform a few\nsimple tasks at home (drying clothes, washing l Wherever possible, KMC can be offered by\nsmall items, cutting vegetables, simple AKPs till mother\u2019s infections are cleared.\ncooking or even some recreation activities\nMother should know how to detect early signs\nl\n(like playing sitting games with cards, reading\nof danger signals in her small baby and take\netc.).\nimmediate remedial measures as much as\n*Clothing for mother: possible.\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: bf2509ef-9858-4347-8ac9-091ce7b0881b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 22, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 58, "chroma:document": "etc.).\nimmediate remedial measures as much as\n*Clothing for mother: possible.\nl\nl Any front open, culturally acceptable, l She should remove her jewellery like chains or\ncomfortable garment can be used by mothers threads from the neck, bangles, ring, wrist\nfor KMC. It can be traditional saree and watches, pins, clips to avoid accidental injury\nblouse, kurta, gowns and even men\u2019s shirts. to her baby. Her hair should be tied up\nPreferably cotton, well washed and sundried, properly.\nto be changed every day after bath.\nMother can be trained to keep the record of\nl\nAll the bed sheets or old cotton dhotis/ sarees how many hours of KMC she had offered in\nl\netc. which are to be used for mother and baby 24 hours.\nin post -partum period, along with baby and\nMother must prepare a place, preferably in\nl\nmother\u2019s clothes and diapers to be collected\nher own bed to keep the baby clean, warm\nwell in advance, well washed, sun dried and\nand safe and free from mosquitoes, \u0000ies,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1a4048e5-b5d8-4678-8e51-8b33f319fdee
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 22, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 59, "chroma:document": "well in advance, well washed, sun dried and\nand safe and free from mosquitoes, \u0000ies,\nkept aside for the use after the birth of the\ncockroaches, rats etc., when she is not\nbaby.\noffering KMC and at times, baby may have to\nbe kept alone for a short while when mother\nDuring COVID 19 pandemic following additional\nhas to go for bath, food.\nitems should be collected in advance:\n\u00fc *Preparation of baby for Kangaroo Position\nAbout four to \u0000ve masks prepared from cotton\n(KP)/KMC:\ncloths (for washing and reusing).\nAll the preparations must be done in a warm\nSoap and provision of water for frequent hand\nand clean area, away from direct wind and\nwash; Sanitizers if possible.\ndraughts.\nBaby\u2019s clothes must be removed or opened\n3.A.5 Immediate preparations just l\nfrom the front, only the back may be covered.\nbefore the actual start of KP/KMC:\nBaby is to be clad only with an appropriate\nl\n\u00fc *Preparation of mother before actual start of size diaper and cap to cover the head."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1bd9a953-9fab-4e22-b04f-a86f42d0ca30
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 22, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 60, "chroma:document": "l\n\u00fc *Preparation of mother before actual start of size diaper and cap to cover the head.\nKP/KMC: (Considerable amount of body heat (about\n10% of total body heat in a neonate) is lost\nMother should be aware of the dif\u0000culties that\nl\nfrom the head. Hence it is very important to\nshe will face while providing KMC and should\ncover his/her head with a cap to prevent\nbe mentally prepared for the same. Help from\ncooling of the baby's body.\nfamily members will be a great relief to her.\n|15|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: b6080cd6-8881-409c-b77f-53f289ccd90a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 23, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 61, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nCooling of body parts and the resulting The arms of the baby should be bent/\u0000exed in\nl l\ncomplications are more in pre -term and LBW such a way that they lie above the breasts on\nbabies. the mother's chest and the two feet of the baby\nshould be just below the breasts in a bent/\nIf ready made diapers are not available/\nl\n\u0000exed position. The hips should be bent/\naffordable, locally improvised ones can be\n\u0000exed and stretched out/ abducted in a frog-\nused.\nlike position.\nIf available, a KMC bag/ wrap or such\nl\nsupporting garment can be used to hold the\nHead turned to\nbaby securely in Kangaroo Position and that Baby between one side\nmay allow the mother to move around. mother\u2019s breasts\nFrog-leg\n3.A.6 Actual procedure of Kangaroo Support baby\u2019s position\nbottom\nPosition:\nThe mother should sit or stand as per her\nl\nFigure: How to hold the newborn in Kangaroo\npreference, comfortably in a clean, warm,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: b791fcf4-a363-4af1-b37e-c2456493df15
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 23, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 62, "chroma:document": "l\nFigure: How to hold the newborn in Kangaroo\npreference, comfortably in a clean, warm,\nPosition (reproduced from Kangaroo Mother Care and\nwell ventilated place away from winds.\noptimal feeding of low birth weight infants: Operational\nHer chest in between her breasts, should be Guidelines, Ministry of Health and Family Welfare,\nl\nexposed by opening the hooks of the upper GOI, September 2014)\ngarment.\nMother should support the baby's bottom with\nl\nMother can have a bath before starting KMC.\nl one hand.\nSpecially washing the chest before KMC is not\nThe baby\u2019s body should be turned towards the\nneeded. l\nmother and held as much straight as possible\nThe baby should be carefully lifted with a\nl with as much maximum body contact as\nblanket on her/his back and the bare chest of\npossible.\nthe baby should be put in direct contact of\nThe head may be adjusted in such a way that\nmother\u2019s chest in between her breasts in such l\nmother and baby can have direct eye to eye"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 49a09279-1062-44d1-a38a-8eb59c1dc901
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 23, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 63, "chroma:document": "mother\u2019s chest in between her breasts in such l\nmother and baby can have direct eye to eye\na way that head of the baby lies just below the\ncontact.\nchin of the mother (at such a level that mother\ncan kiss baby\u2019s head on the top easily) in as Baby\u2019s abdomen should not be tightly bound\nl\nmuch vertical position as possible and the so that easy breathing is possible for the baby.\nhead of the baby is turned to any one side so\nMother\u2019s breathing stimulates the infant, thus\nthat baby\u2019s nose, mouth remain free and not l\nreducing the occurrence of apnoea (stoppage\ncompressed in mother\u2019s breasts or body fat.\nof breathing in between).\nNeck is slightly extended to make sure that the\nl\nA very useful check list has been suggested by the\nairway remains open.\nUnited States Institute for KMC training, which is\nl Head should be given support from the back very helpful for checking the safe positioning for\nof the neck in such a way that it is neither too skin to skin contact in KMC."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 23, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 64, "chroma:document": "of the neck in such a way that it is neither too skin to skin contact in KMC.\nmuch bent in front nor too much bent back.\n|16|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 46906759-2adc-40d4-a970-752eef877941
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 24, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 65, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nChecklist for safe positioning for skin to skin Whenever binders, bags or wraps are used for the\ncontact/ kangaroo positioning: baby for Kangaroo positioning, mother must be\ntrained to move the baby safely in and out of\nFace can be seen.\nl\nsupports with one hand placed behind the neck on\nl Head of the baby is in snif\u0000ng position so as back and lightly support the lower part of the\nmother and baby can have eye to eye contact. baby\u2019s jaw with her thumb and \u0000ngers to prevent\nbaby\u2019s head from slipping and blocking the\nNose and mouth are not covered.\nl\nairway when the baby is in upright position and\nl Head is turned to one side, neck is straight, not place the other hand under baby\u2019s bottom for\nbent. support.\nl Shoulders are \u0000at against Mom\u2019s chest. l Explain to the mother that she can breastfeed\nin the kangaroo position. In fact, it is easier to\nChest to Chest with Mom.\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c48bb7de-7e15-4638-a455-7fd57d6d3d6c
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 24, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 66, "chroma:document": "in the kangaroo position. In fact, it is easier to\nChest to Chest with Mom.\nl\nfeed in that position. Holding the baby near\nLegs are \u0000exed/ bent from knees.\nl the breast stimulates milk production.\nLittle upright, not \u0000at, on bed/chair.\nl Mother can take care of twins too. Each baby\nl\nCover the back with blanket or sheet. is kept on each side of her chest. She may\nl\nwant to alter their position. Initially she may\nBoth (Mother and baby) are being watched\nl feed one baby at a time. Later she will be able\nwhile sleeping.\nto feed them simultaneously from both the\nBaby is being monitored. breasts.\nl\nIf no one can watch you and your baby after l Mother can rest with the baby in the kangaroo\nfeeding and when sleep is likely- put your baby on position. When she is likely to fall into a deep\nhis / her back in a safe place. sleep, at home, it is advisable to keep the\nbaby at her side in the same bed or AKP may\nOnce a proper kangaroo position with or without"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d5e076f1-77a7-4e68-a3d7-f1e5557b181e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 24, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 67, "chroma:document": "baby at her side in the same bed or AKP may\nOnce a proper kangaroo position with or without\ntake over for KMC. When direct observation\nthe help of a kangaroo bag, lycra or some wrap is\nis not possible at home, it is better to interrupt\nachieved, the baby is to be kept in that position for\nKMC while the mother is sleeping, to be safe\nas long as possible, so that baby remains warm\nfor the baby.\nand calm, gets good sleep and gets all the bene\u0000ts\nof KMC. Baby needs to have a good cycle of quiet During follow up visits to mother, CHWs must talk\nsleep for about one hour, so that good brain to her and listen to her medical as well as personal\ngrowth happens. For the newborn to get one cycle social constraints and try to help her as much as\nof good sleep for one hour, the mother has to hold possible. Initially the mother may be frustrated\nthe baby in kangaroo position for at least one and because of feeding problems of the small baby."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: b15df256-e398-4f09-af9c-4a9049a11c2a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 24, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 68, "chroma:document": "the baby in kangaroo position for at least one and because of feeding problems of the small baby.\nhalf hours. The longer sessions in KMC are very She should be guided for feeding the baby with\nmuch useful. Ideally KMC should be done for all expressed breast milk and the different feeding\nthe 24 hours of the day continuously to get the best techniques and encouraged to continue KMC.\nresults. If support from family members or Support in the initial stages are of great\nalternate care providers is available, KMC can be importance for the successful continuation of\ntried for as long as possible. Disruptions in shorter KMC.\nintervals and frequent handling of the newborn\nshould be avoided. That will not do good for the\nsmall babies.\n|17|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8239d13d-0281-4f62-9938-2f2bc93f32e0
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 25, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 69, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\n3.A.8 Monitoring the infant during\nKMC:\nBabies should be monitored carefully during\nHBKMC, particularly in early stages.\nInfant\u2019s airway is clear.\nl\nBreathing is regular.\nl\nColour is pink.\nl\nBody temperature is maintained well.\nl\n3.A.9 Danger signals of the baby\nduring KMC and actions to be taken:\nDuring every home visit, the CHWs should have a\nthorough check up of the baby and monitor for\nfollowing parameters herself and also make sure\nthat mother and family members including AKP\nFig. 7: HBKMC by mother.\ncan recollect about how to recognize the same.\nTemperature.\nl\n3.A.7 Caring the baby in Kangaroo\nBreathing pattern.\nl\nPosition at homes Heart beats.\nl\nColor of the baby.\nAt homes, the mothers do not have constant l\nOverall activity and movements.\nguidance or supervision from any health care l\nFeeding.\nfunctionaries. Hence it is important to provide l"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 859d19c1-e3db-40ed-a57c-057ff06842df
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 25, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 70, "chroma:document": "Feeding.\nfunctionaries. Hence it is important to provide l\nsome tips for care during KMC. l General well being.\nMost of the necessary care of the baby including \u00d8 Body temperature of the baby is recorded by\nfeeding is possible while in kangaroo position. measuring axillary temperature with a\nBaby has to be moved out only for changing the thermometer (Preferably with a digital\ndiapers, hygiene and cord care and whenever thermometer).\nrequired for cup feeding. S/he has to be taken out\nIf a thermometer is not available, body\nl\nof KMC for at least one complete check -up during\ntemperature can be assessed by a palpatory\nthe home visits of the CHW. If the baby is secured\nmethod, by palpating soles of feet and\nwell in Kangaroo Position, during daytime, mother\nabdomen with dorsum of the examiner\u2019s\ncan walk about and do some of her light daily\nhand.\nchores and recreational activities with some care.\nIf feet and abdomen, both are warm to touch,\nThroughout, attention must be paid for providing l"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 0e4b3342-9a22-48ab-8681-7214ba8d18b3
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 25, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 71, "chroma:document": "If feet and abdomen, both are warm to touch,\nThroughout, attention must be paid for providing l\nnothing to worry.\nappropriate support to the baby's neck and\nbottom to prevent any accidents due to undue neck\nIf the feet feel cooler and the abdomen/body\nl\nmovements and slipping of the baby.\nis warm, the baby is likely to have thermal\n|18|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 00aa49a7-c44f-456c-9989-69da136add35
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 26, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 72, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nstress and immediate skin to skin contact in\nKMC and covering with a blanket from above,\nwill help to warm up the baby.\nIf the feet and abdomen/body both feel cold,\nl\nthe baby is likely to be in moderate to severe\nhypothermia and immediate action must be\ntaken to rewarm the baby.\nPutting the baby only in kangaroo position\nl\nwill not help when the baby is a moderate to\nsevere cold as KMC may take some time to\nwarm up the baby. Ideally, the baby has to be\nput under a warmer.\nIn situations when warmer or some heating\nl\ndevices are not available at homes, if\npossible, a cotton bundle of cloth can be\nwarmed by rubbing on a heated thick iron\npan (\u201ctawa\u201d (used in Indian homes for\nmaking chapati/roti) and the heated pad of\ncloth is \u0000rst tested for the degree of heat by\nrubbing on mother\u2019s/care takers\u2019 own cheek\nand if found tolerable, then applied on baby\u2019s\nbody (abdomen or thighs)to rewarm the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c96b66ce-f688-4133-9ce2-57299843305c
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 26, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 73, "chroma:document": "and if found tolerable, then applied on baby\u2019s\nbody (abdomen or thighs)to rewarm the\nbaby. This may have to be repeated several\ntimes to rewarm the baby adequately. Care\nmust be taken to act quickly and safely so as\nnot to cause burns on the baby's delicate chest\nand abdomen and also to rewarm the baby\u2019s\nbody.\nIf the baby fails to rewarm despite efforts for\nl\nmore than one hour, the possibility of severe\ninfection (sepsis) should be considered and\nurgent steps for referral to a hospital must be\ntaken. If that is not possible immediately, the\nlocal ANM may be requested to give\ninjectable Gentamicin one dose and then\narrange for transfer to the proper hospital.\nDo not use a hot water bottle or bag for\nl\nkeeping the baby warm. Use of hot water\nbottles in these situations is not encouraged\nmuch due to possibilities of accidents and\nproblems. Chances of availability of a proper\nFig. 8: Palpatory method of temp\nassessment of the newborns. rubber water bag are less in these places. If a\n|19|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e84a64aa-6a6a-4789-b336-d79d77120851
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 26, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 74, "chroma:document": "assessment of the newborns. rubber water bag are less in these places. If a\n|19|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: fbf2e041-bda9-454f-8f28-1fa03231e459
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 27, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 75, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.A KANGAROO POSITION)\nglass bottle with hot water is used, it may Explain that if breathing stops for 20 seconds\nl\nbreak causing injuries or the lid of the hot or more, the baby becomes blue (Blue lips and\nwater bottle may be loosely closed allowing face), this may be a sign of serious illness.\nwater to leak out and cause burns to baby or\nTeach her to stimulate the baby by gently\nl\nwetting the baby and causing hypothermia\nrubbing the back or head or tickling the soles\ndepending on the temperature of the water\nof feet and by rocking movements until the\n\u0000lled in the bottle/bag.\nbaby starts breathing again. If the baby is still\n\u00d8 Observing breathing rate, depth and not breathing, the mother should go to a\nregularity: Usually the breathing rate in a hospital immediately.\nnewborn is around 40 per minute and\nvariable. If the respiration rate is less than 20\na) Flicking the soul"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3936c996-634a-4db4-8fbf-e389b1da03b4
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 27, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 76, "chroma:document": "variable. If the respiration rate is less than 20\na) Flicking the soul\nper minute or more than 60 per minute, it is a\nsign of a serious problem. It is also suggested\nto observe the pattern of breathing of the\nbaby. If breathing is laboured or very shallow,\nit indicates a problem. If the rhythm of\nbreathing is very irregular or breathing stops\nfor a few seconds continuously, described as\napnoea, it also indicates a problem. If\nbreathing stops for more than continuous\ntwenty seconds and may or may not be\nb) Rubbing the back\nassociated with changes in heart rate and\nbluish discoloration, it indicates serious\nproblem. Preterm babies often get frequent\nsuch temporary episodes of stopping of\nbreathing described as apnoea. If immediate\naction is not taken, brain damage can occur\nleading to many long term consequences like\n\u0000ts, delayed brain development or even death\ndue to lack of oxygen.\nWhat to do in cases of apnoea?\nFig. 9: Physical stimulation for neonatal apnea cases"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 05b9e77e-393b-47d5-a5df-7c189ba6766b
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 27, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 77, "chroma:document": "What to do in cases of apnoea?\nFig. 9: Physical stimulation for neonatal apnea cases\nTeach the mother to observe the baby\u2019s\nl\nbreathing pattern and explain normal\nbreathing which appears regular and easy\nVery fast or slow breathing and laboured\nbreathing without any undue efforts.\nbreathing as seen by chest indrawing,\nExplain what a temporary stoppage of grunting and nasal \u0000aring are also signs of a\nl\nbreathing / apnoea means and what ill serious problem in a baby.\neffects it has on a baby. It could be a sign of\n\u00d8 Excessive frothing from mouth and even\nserious illness for the baby.\nnose: Froth or secretions should be\nimmediately wiped with a clean cloth\nwrapped around the index \u0000nger of the\n|20|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 45fcfce9-d3ff-41d3-acd7-310adbf1c4bd
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 28, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 78, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\nattendant and sweeping through mouth and of suspected serious infections/ sepsis before\nnose gently and turning the head to one side referral.\nand even lifting the head slightly above and\n\u00d8 Danger Signs\nslightly tilted back so that airway remains\nopen. A simple algorithm is suggested for easy\nremembrance of most of the danger signals.\n\u00d8 Dif\u0000culty in feeding: it may be in different\ngrades. Baby may stop feeding totally or may A - Apnoea- Breathing stops for more than 20\nbe slow or drowsy to feed or vomits frequently seconds continuously. Frequent and long\nor excessive crying while feeding. spells.\n\u00d8 Abnormal movements of body and B - Breathing dif\u0000culty- very fast or slow/\neye/convulsions: Whenever a neonate has Irregular rate and rhythm.\nabnormal movements or eye movements, the\nC - Chest indrawing, grunting, froth from mouth.\nattendant should roll the baby on his/her side"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 61f027ab-d65f-4d16-af8a-b9891f23924b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 28, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 79, "chroma:document": "C - Chest indrawing, grunting, froth from mouth.\nattendant should roll the baby on his/her side\nand position in such a way that the airway C - Cold hands and feet.\nremains open and report to the HCP.\nC - Convulsions/abnormal movements or\n\u00d8 Frequent loose motions/diarrhoea: behaviour.\nDehydration should be prevented. Increase\nD - Decreased feeding, stops feeding or vomits.\nfrequency of breast feeding and if quantity of\nD - Decreased activity, weakness or lethargy.\nurine passed in previous 12 hours is less and\ncolour of urine becomes dark yellow due to\nD - Diarrhoea/loose watery stools.\nconcentration, which could be a sign of severe\nD - Distension/ fullness of abdomen.\ndehydration, use of ORS in between feeds to\nbe given. H - Hypothermia (Cold limbs/body),\nHyperthermia (Fever).\n\u00d8 Boils and pustules over the skin- Oral\nCotrimoxazole can be given by Anganwadi\nworkers or ANMs if less than 5 boils are\n3.B Kangaroo Nutrition:\npresent."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 2ee3de0c-4af7-45a0-a2f3-9e2a94e60a6c
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 28, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 80, "chroma:document": "workers or ANMs if less than 5 boils are\n3.B Kangaroo Nutrition:\npresent.\n\u00d8 Yellow discolouration of eyes and Feeding of New-born in HB KMC-Special\nskin/jaundice* Considerations.\n\u00d8 Undue fullness of stomach/abdomen with or (The CHW is advised also to read manuals of\nwithout vomiting* Infant and Young Child Feeding and guidelines\nfor feeding of the newborns in facility based\n\u00d8 Excessive bleeding from umbilical cord or\nKMC for more details).\nfrom any other parts of the body*\nIn this manual, only the salient points of optimal\nIn all these situations, refer the newborn to a\nfeeding of LBW and preterm babies in home\nhospital. Recently community-based nurses\nsituations are mentioned.\nlike Auxiliary Nurse Midwives are being\ntrained for giving injection Vitamin K to The most important component of KMC is to\nprevent bleeding in neonates (Haemorrhagic promote exclusive breast milk feeding.\ndisease of newborn) and Injection Appropriate feeding of LBWI improves their"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 28, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 81, "chroma:document": "disease of newborn) and Injection Appropriate feeding of LBWI improves their\nGentamicin as the \u0000rst treatment for the cases chances of survival and is important for their\n|21|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: fdf9bf30-1f25-4221-b8b9-4ef0cd67f638
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 29, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 82, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\noptimum growth and development. The nutritional babies breastfeeding should be started before\nneeds of infants with similar birth weight may vary one hour of birth and exclusive breastfeeding\ndepending upon whether the infant is appropriate should be continued for six months.\nfor gestational age (AGA) or small for gestational\nBreastfeeding should be continued for babies\nl\nage (SGA). Broad principles of feeding the baby\nhaving birth weight more than 1800g and\nduring HBKMC are the same as those of hospital\nborn more than 34 weeks of gestation as\nbased KMC. But depending on the resources and\ncalculated from the \u0000rst day of the last\nexpertise available with the attending HCP, certain\nmenstrual period.\nmodi\u0000cations have to be made. Only such\nsituations are highlighted here. l In the weight group of 1200 to 1800 gm\nbabies who are mature, may be able to take"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1cbf8e3a-33b6-40d8-aee0-6cc73e6134b0
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 29, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 83, "chroma:document": "babies who are mature, may be able to take\nIn this chapter following aspects have been\ndirect breast feeding\ndescribed:\n\u00d8 Immediate skin to skin contact, delayed cord\n\u00d8 3.B.1 Steps for successful breastfeeding for\ncutting, initiate early breast feeding.\nstable LBW and preterm babies.\nSoon after the delivery, put the baby directly\nl\n\u00d8 3.B.2 Feeding of unstable (sick) and too small\nin skin to skin contact on the mother's\nbabies (VLBWI/ELBWI).\nabdomen even before cutting the cord.\n\u00d8 3.B.3 Skills required for feeding LBWI during Immediate drying may not be required at this\nHBKMC. stage.\nEvery effort should be made to provide breast If the baby does not start breathing or crying\nl\nmilk to LBWI. immediately within the \u0000rst few seconds after\nbirth, urgent resuscitation will have to be done\non priority basis as per the guidelines.\n3.B.1 Steps for successful breast\nThen cut the cord after about one to three\nfeeding for stable low birth weight l\nminutes or when cord pulsations stop\nbabies:"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1548ef1d-9212-4800-9e6e-6f2d7d825f35
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 29, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 84, "chroma:document": "feeding for stable low birth weight l\nminutes or when cord pulsations stop\nbabies:\nnaturally (Physiological cord cutting) and then\nquickly dry/ mop the baby with a clean warm\n\u00d8 What to feed and how to give?\ntowel and discard the wet towel and place the\nBreast milk is the best choice for all the\nbaby on mother\u2019s abdomen, who will crawl to\nbabies.\nthe chest in between her breasts and attach on\nIt is ideal food for all infants including those the breast nipple and start sucking. A mature\nwho are LBW. baby can have a breast crawl seeking for the\nbreast nipple on the mother's chest.\nWHO recommends that all LBWI,\nirrespective of their gestation, be fed with l Let the baby remain on the mother's chest in\nbreast milk. between her breasts for at least one to one\nand half hours continuously.\nThe goal is to enable every LBWI to receive\nfeeding directly and exclusively from \u00d8 Soon after birth, breast feeding should be"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 874aa297-701f-4060-b8b4-1400f9ca48ce
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 29, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 85, "chroma:document": "feeding directly and exclusively from \u00d8 Soon after birth, breast feeding should be\nhis/her mother\u2019s breast at the earliest. initiated as early as possible, within half to\none hour for following reasons.\nHBKMC is started for all the stable and even\nl\nThe newly born is very alert and active within\nl\nmildly sick babies and in all the newborn\nthe \u0000rst half to one hour of birth.\n|22|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9dfba718-b104-4863-b17e-1dcdb7c10e89
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 30, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 86, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\nFig. 10: Direct breastfeeding and burping\nIn the immediate period after birth, baby\u2019s There is strong bonding of love and sentiments\nl l\nsucking is quite powerful and that increases between mother and baby.\nthe chances of successful breast feeding.\nThere is a rapid decrease in vaginal bleeding\nl\nNewborn gets colostrum through early breast in the mother after delivery, rapid shrinking of\nl\nmilk, which contains many disease preventing uterus and reduction in breast engorgement\nfactors, therefore is considered as the \u0000rst and swelling.\nvaccine for the newly born baby.\n|23|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ffc72ede-7717-4b62-a491-246152c3d452
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 31, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 87, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\n\u00d8 Continue exclusive breast feeding till the \u00d8 Proper method of holding the baby for\nbaby completes six months of age. breastfeeding (Positioning).\n\u00d8 Do not give even water in between the feeds l The whole body should be supported.\nduring \u0000rst six months because.\nThe head, neck and back of the baby remain\nl\nBy giving other liquids, the amount of breast in straight line.\nl\nmilk taken by the baby reduces and nutrition\nMother is comfortably positioned while sitting\nl\nsuffers.\nor lying down.\nBaby is liable to get serious infections through\nl\nHer eyes should be \u0000xed on the baby.\nl\ncontaminated water (used for diluting the milk\nor cleaning the vessels of feeding) and \u00d8 Proper method of attaching the baby to\ndevelop loose motions. mother\u2019s breast (Latching).\nIn the \u0000rst six months after birth, even in hot Four signs of proper latching:\nl\nsummer months, the baby does not require"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 368c3777-7d71-48fc-a736-93148d7eab0a
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 31, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 88, "chroma:document": "l\nsummer months, the baby does not require\nBaby\u2019s mouth is wide open.\nl\nadditional water. Frequent breast feeding can\nbe given, which has enough water content for l The lower lip is turned outside.\nthe baby's requirement.\nChild\u2019s chin is touching the mother's breast.\nl\n\u00d8 There is no need for prelacteal feeds. The black areola around the breast nipple is\nl\nTraditionally giving sugar water, jaggery, mostly in the baby's mouth.\nl\nhoney, ghee etc. as pre lacteal feeds, delays\nIn short, we can remember following simple\nestablishment of breast feeding and increases\nrules:\nthe chances of infection and loose motions\nB to B: Take the baby to breast rather than\nand other serious illnesses in the baby. l\nbringing the breast to baby by bending of\n\u00d8 Promote breast feeding by proper\nmother which is very uncomfortable for\nattachment or latching of the baby to breast.\nprolonged breast feeding.\nBy proper latching, nipple sores/swelling,\nl T to T: Hold the baby in such a way that the\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a1c15ebe-efd4-43b0-a9b3-9fd0a61ef068
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 31, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 89, "chroma:document": "By proper latching, nipple sores/swelling,\nl T to T: Hold the baby in such a way that the\nl\ntherefore, breast engorgement and pain do\nbaby's tummy remains on the mother's\nnot occur.\ntummy.\nDuring each feeding, the baby should feed on\nl N to N: Put the baby on the mother's breast so\nl\none breast till it is empty and then shifted to\nthat the baby's nose touches the mother's\nanother breast. Next time, feeding should\nnipples.\nstart from the other breast \u0000rst.\n\u00d8 Factors that can in\u0000uence proper\nDuring 24 hours of a day, the newborn should\nl breastfeeding:\nbreastfeed at least 10 to 12 times including\nregular night feeds. It should be given as l Feeding given through bottle.\nmany times as the baby indicates by signs of\nInexperienced mother.\nl\nhunger. Some babies demand frequent feeds,\nMother does not have the support of an\nwhereas some babies may take less and only l\nexperienced person.\nwith some effort, take more. But forced\nfeeding should not be done.\n|24|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e2045629-10b1-48c6-9606-a6e2f363904e
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 32, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 90, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\nRetracted nipples are often considered a Chances of infections increase because of\nl l\nproblem for proper breastfeeding. But we unhygienic handling of the paci\u0000ers.\nshould encourage the baby to suck on areola,\n\u00d8 Gripe waters and various traditional herbal\nthe black area surrounding the nipple, rather\npreparations etc. Not needed at all.\nthan only on nipple. Retracted nipple is not a\nproblem if proper latching on areola is \u00d8 What is to be done after breastfeeding?\nachieved. Due to negative pressure created\nAfter breastfeeding, the baby should be\nl\nwhile sucking on the areola, the embedded\nburped well by holding straight on mother\u2019s\nnipple does come out.\nshoulders and patting gently on the baby's\n\u00d8 In case, the baby is not properly latched, back.\nfollowing problems can occur.\nOnly after the baby burps (takes out the\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3121c46a-1236-419b-b5c3-f98703995e07
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 32, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 91, "chroma:document": "following problems can occur.\nOnly after the baby burps (takes out the\nl\nMother gets sore nipples or cracked nipples swallowed wind), should the baby should be\nl\nand severe pain. laid \u0000at on his/her back.\nl Breast is not fully emptied leading to breast l Before allowing the baby to lie down on its\nengorgement (Filled with too much of milk) back (Supine position) the baby can be turned\nand breast becomes very hard and dif\u0000cult to on its tummy (prone position) in such a way\nsuck and/or swelling, redness and pain that the baby's nose is not being pressed and\ndevelop further making breastfeeding s/he is able to breathe comfortably and\ndif\u0000cult. allowed to remain in that position for some\ntime.\nBaby does not get enough milk to satisfy\nl\nhunger and continues to suck frequently on l Mother must observe her baby frequently, if\nnipples leading to cracks, bleeding and the baby is put on the tummy to avoid\nsevere pain. suffocation."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 865388c1-b963-48cc-ba45-211f2a967b7a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 32, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 92, "chroma:document": "severe pain. suffocation.\nl Due to improper emptying, further breast milk l Keep the baby next to the mother in the same\nsecretion reduces, baby keeps crying, and bed or continue in Kangaroo position, so that\ndoes not feed well resulting in less weight it is easier for frequent breastfeeding and the\ngain. baby also remains warm.\n\u00d8 Breast feed the baby as many times as it \u00d8 The more the baby feeds, more breast milk\ndemands and even during nights because. will be produced.\nl By proper latching and frequent l If the mother is con\u0000dent, healthy and calm\nbreastfeeding more milk is produced. while breastfeeding, the baby has no\nproblems.\nBy demand feeding and frequent feeding,\nl\nbreast engorgement/swelling does not occur.\n3.B.2 Feeding of unstable(sick) and\nNight feeding increases the secretion of\nl\ntoo small babies (VLBWI/ELBWI):\nbreast milk producing hormone prolactin and\nthe mother feels comfortable.\n(Babies with body weight less than"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d06a0f5c-8711-420b-8ae2-b78a25b8833b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 32, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 93, "chroma:document": "the mother feels comfortable.\n(Babies with body weight less than\n\u00d8 Do not give paci\u0000ers or Bottle feeding. 1500/1000g, often have cardio -respiratory\nproblems, temperature instability, abdominal\nBy giving paci\u0000ers/nipples, the baby has\nl\ndistension or serious acute illness such as\nproblems sucking on the breast.\nasphyxia or sepsis).\n|25|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 684cc8e5-6449-485b-ab54-79c55207122e
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 33, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 94, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\na) Offer expressed breast milk by cup/spoon/ general, we can divide the babies according\npaladai etc.; (Provided IV \u0000uids or Tube to their birth weight (wherever weighing is\nfeeding is not possible and consider transfer possible) in three broad categories and\nto higher centre, if possible). decide the method of feeding.\nb) As the infant improves, put her /him directly \u00fc Category I: The babies with birth weight less\non the breast to stimulate milk production. than 1200g.\nc) Initiate KMC once the baby stabilizes or as \u00fc Category II: The babies with birth weight\nmore than 1200g and less than 1800g.\nearly as possible.\n(KMC/KP can be given even in many sick babies \u00fc Category III: The babies with birth weight\nmore than 1800g but less than 2500g.\nunder supervision and guidance of experienced\npersons.).\nWherever weighing is not possible, the worker has\nto decide according to the baby's apparent size"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 083de57c-4120-482b-9ed3-dc3c1e2ed256
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 33, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 95, "chroma:document": "Wherever weighing is not possible, the worker has\nto decide according to the baby's apparent size\nMany preterm infants have feeding dif\u0000culties\nand behaviour of sucking, swallowing and\ninitially because of:\nbreathing coordination.\nInability to coordinate suck, swallow and\nl\nbreathing. \u00fc The babies in category III, having weight\nmore than 1800g, are generally capable of\nImmature and sluggish gut.\nl direct breastfeeding like mature newborns,\nSystemic illness. with good coordination of sucking,\nl\nswallowing and breathing.\nFull term small for gestational age infants\nbecause of being weak or sick, may also \u00fc The babies in category I, having birth weight\nexperience: less than 1200g, will mostly have to start with\nexpressed breast milk (EBM), being given\nPoor attachment and sucking effort on the\nl with a cup, spoon or the traditional feeder\nbreast.\n\u201cpaladai\u201d. Some of these very small babies\nPoor swallowing. should ideally be given intravenous \u0000uids or\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 718821e2-5c2c-4ac7-8e4a-664ce5c2cbf3
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 33, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 96, "chroma:document": "Poor swallowing. should ideally be given intravenous \u0000uids or\nl\ntube feeding in the \u0000rst few days of life which\nEasy tiredness (And hence poor intake).\nl\ncan be given only in hospitals. Wherever it is\nl Vomiting, regurgitation or abdominal not possible, the only available option will be\ndistension. feeding with expressed breast milk from\nmother. The baby can be shifted to direct\n\u00d8 Lower the birth weight, greater is the\nbreastfeeding as early as possible.\nlikelihood of feeding dif\u0000culties.\n\u00d8 Feeding of category II babies with birth\nMost of the times, HBKMC is being continued\nl\nweight more than 1200g and less than\nfor more days only for small babies who are\n1800g:\neither pre -term babies (Born before full term\nof 37 to 41weeks and six days of gestation as The mode of feeding can depend on the\nl\ncalculated from the \u0000rst day of LMP) or those baby's ability of having good coordination of\nwho are full term and yet have birth weight sucking, swallowing, and breathing. Baby"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 33, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 97, "chroma:document": "who are full term and yet have birth weight sucking, swallowing, and breathing. Baby\nless than 2500g. At times, CHW may \u0000nd it may be put directly on the mother's breast. If\ndif\u0000cult to differentiate these categories the baby is having good sucking efforts and\naccording to their maturity. Therefore, in coordination of sucking and swallowing,\n|26|"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 34, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 98, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\ndirect breastfeeding can be continued.\nSometimes it should be tried several times in\nthe \u0000rst two/ three days to judge the capacity\nof the baby for direct breastfeeding. So, in\nbetween, the baby may have to be given\nexpressed breast milk directly with a cup, by\nspoon from cup or some suitable method.\nSome babies in this weight group do not have\ngood coordination of sucking and swallowing\nfor a longer time. In that case, feeding with\nEBM has to be continued for a longer time.\nThe efforts should be to shift to direct\nbreastfeeding as early as possible.\nFig. 13: Method of expressing breast milk\nFigure 11: Collection of EBM\nFigure 12: Paladai Feeding Figure 14: Spoon Feding\n|27|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 35, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 99, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\nEvery effort should be made to provide breast Very small babies should be given about 10 to\nmilk to LBWI. 12 feeds within 24 hours at 1 to 2 hours\ninterval including night feeds (which are very\n(Either as direct breastfeeding or as expressed\noften missed) as per the signs of hunger.\nbreast milk).\n\u00d8 The smaller the baby the smaller is the\n\u00d8 How often to feed? interval in between feeds.\nAll Term and stable newborns: (Who had a In case of small babies/ very LBW/ very\nlusty cry soon after birth and apparently did preterm babies, the feeding schedule may\nnot have any other problem or defect like cleft start clockwise at \u0000xed time intervals and later\nlip or palate, which might affect direct gradually shift to demand feeding. Whenever\nbreastfeeding) Ideally these neonates must be top feeding is being given, the baby may be"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a6e34d32-3005-4698-b2c2-1dedbf087fc6
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 35, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 100, "chroma:document": "breastfeeding) Ideally these neonates must be top feeding is being given, the baby may be\nput to mother\u2019s breast and feeding started as put to breast \u0000rst and try for suckling and then\nearly as possible within half to one hour of top milk can be given. This will enable breast\nbirth. It will ensure colostrum feeding and no milk \u0000ow to continue and facilitate early direct\npre lacteal feeds are required). breastfeeding.\nOther small babies: (with delayed cry, \u00d8 What to do if mother\u2019s milk is not available or\ndif\u0000culty in breathing or some problem) may is less than the required amount?\nhave to be given feeds as early as possible\nAll efforts must be made to have own\nafter birth once they are stabilized in terms of\nmother\u2019s milk for baby\u2019s feeding.\nheart rate and respirations. First feed for very\nsmall babies may not be delayed for more Ensure continued \u0000ow of breast milk in the\nthan four hours after birth to ensure colostrum mother who has a small baby. Because of the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: aadfae82-c317-49ff-a722-6deafedf5c1f
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 35, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 101, "chroma:document": "than four hours after birth to ensure colostrum mother who has a small baby. Because of the\nfeeding. If for some reason feeding of breast poor or no sucking effort by the LBWI (due to\nmilk is delayed in very small babies, problems sickness, weakness or poor re\u0000exes) and\nmay occur because of less energy and less maternal anxiety, the breast milk output may\nsugar content in the baby's blood and the remain low. Breast milk inadequacy must be\nbaby may get \u0000ts in the form of abnormal prevented and tackled by frequent\nmovements of body and limbs and eyes counselling of mother and her family\nleading to brain damage and other members. In addition, breast milk should be\ncomplications. To avoid such serious expressed frequently ( both during day and\nimmediate and long-term complications, the night) to provide EBM to the baby including\nbaby may be given either some donor mother during nights and help to increase the milk"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f2296dc7-b1c5-409a-9472-059e26d56e62
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 35, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 102, "chroma:document": "baby may be given either some donor mother during nights and help to increase the milk\nmilk/animal milk/ formula and attempts to \u0000ow. The expressed milk can be stored in\nfeed its own mother\u2019s milk should continue. room air only for about 4 to six hours.\nDuring HBKMC, continued supervision and (In refrigerators, in regular compartments, it\nguidance to CHWs is not possible. Hence can be stored for 24 hours and in a deep\nmothers may be advised to give breast milk freezer, it can be kept for two to four weeks. In\nalternatives in the beginning, only for very resource restricted regions this facility is\nsmall and very premature babies, to avoid generally not available).\ncomplications due to less sugar/energy in\n\u00d8 Whenever, due to some reason, mother\u2019s\nblood.\nown milk is not available or inadequate,\n|28|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: bacdfd09-9920-4dc5-bbee-1ff3fdb9e80f
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 36, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 103, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\nother options may have to be tried in order of In some cases, the recorded weight is not very\nl\npreference: accurate and makes further monitoring\ndif\u0000cult.\nDonor mother\u2019s milk (Facility of breast milk\nl\nbanks are mostly not available in these When monitoring day-to-day weight is dif\u0000cult,\nregions) (Wet nursing if possible). the worker may have to assess the adequacy of\nfeeding by recording the approximate quantity of\nFormula milk (Preterm formula may not be\nl\nurine passed in previous 24 hours, cry of the baby,\navailable easily).\nduration of quiet sleep, nature of stools the baby\nl Processed dairy milk (May not be available has passed and general well-being of the baby.\nin many regions).\nIn case of newborns and more so in case of small\nl Animal milks like cow, buffalo, goat, camel babies, it is dif\u0000cult to assess in the \u0000rst few days as\netc. the baby may not pass urine within the \u0000rst 24 to"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 36, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 104, "chroma:document": "etc. the baby may not pass urine within the \u0000rst 24 to\n48 hours some -times. In the \u0000rst few days, the\nExcept in the case of buffalo milk containing high\nbaby may be losing weight despite adequate\nfat, all other animal milk can be given after boiling\nfeeds. Usually, the newborn babies lose up to 7%\nwell and without further dilution.\nof the birth weight in the \u0000rst few days of life and\nIn case of buffalo milk, the cream has to be should not be exceeding 10% of birth weight at\nremoved after boiling and cooling and then it can any time.\nbe given without any further dilution. Animal milk\n\u00d8 The smaller the size of the baby and the more\nas substitutes are not very ideal. But in resource\npremature the baby, longer time will be\nrestricted situations, it could be the only available\ntaken to regain the original birth weight.\npractical solution. In many places, nowadays\nprocessed dairy milk pouches are available, in But latest by 10 to 15 days after birth, the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e2c54616-2ce1-4202-ab02-f0f621a07fe7
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 36, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 105, "chroma:document": "processed dairy milk pouches are available, in But latest by 10 to 15 days after birth, the\nwhich fat content is standardized and the milk is baby should have regained his/her original\npasteurized and stored. This is a preferred option birth weight. CHWs may have to rely more on\nrather than directly collected animal milk which is detailed history of feeding and general\nnot processed for fat content nor pasteurized. behaviour of the baby to assess adequacy of\nfeeding.\n\u00d8 How to decide whether a baby is getting\nadequate feed? \u00d8 Remedial measures if breast feeding is\nsuspected to be inadequate:\nRegular proper weighing is the best method to\nl\ndecide about weight gain pattern and decide First of all, establish that breast milk is really\nl\nabout the adequacy of feeds. But it has several inadequate and should not depend on the\ndif\u0000culties in home situations. perception of the mother or her family\nmembers.\nGood accurate weighing scales are not\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d0fd64e6-f902-4d5f-97d4-6c86108b7f9b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 36, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 106, "chroma:document": "members.\nGood accurate weighing scales are not\nl\navailable. For monitoring the newborn\u2019s daily Check for the correct technique of feeding in\nl\nweight \u0000uctuation in terms of a few grams like terms of positioning of the baby for\n5 to 10 g will have to be recorded. Such breastfeeding and attachment on the breast\nsensitive scales are not available for the use including areola and not just nipple sucking.\nduring home visits of HCPs.\nMake sure the night feeds are not missed. That\nl\nl In case of home deliveries and even in some is often the common reason for inadequate\nhospital deliveries, birth weight is not weight gain.\nrecorded or not possible soon after birth.\n|29|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 5f28ece1-ca30-4864-99ee-e34ebc99e140
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 37, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 107, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.B KANGAROO NUTRITION)\nCounsel mother and her family members and refrigerator (2 to 8degrees C) for 24 hours\nl\nbuild con\u0000dence of mother that she can get safely.\nadequate breast milk as per the needs of her\n\u00d8 What precautions must be taken during and\nbaby.\nafter feeds in very LBWI/ small babies with\nShe can be educated to know about early expressed breast milk?\nl\nsigns of hunger cues in the baby.\nThe mothers to have patience \u0000rst while\nRegular follow up and reassurance must feeding the small babies. The babies may take\nl\ncontinue during every home visit of the CHW. a long time to complete feeding in one\nIf possible, weigh the baby regularly. session.\nStrict hand washing before feeding the baby\n3.B.3 Skills required for feeding LBWI and proper cleaning of cup, spoon or\nwhatever utensils that are used for feeding\nduring HBKMC:\nmust be done with soap and water to prevent"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3c451d66-d451-4071-bb62-a869c440c55a
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 37, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 108, "chroma:document": "during HBKMC:\nmust be done with soap and water to prevent\na) Manual expression of milk and its storage: infections and loose motions sometimes with\nvomiting.\nStepwise instructions to mother:\nBottle feeding should be avoided all the time.\nWash your hands well with soap and water\nl\nIn poor set up, infections, regurgitation of\nbefore expressing breast milk.\nfeeds and other complications are most\nl Put a clean container under the breast for likely with the use of bottles.\ncollecting milk.\nBreast milk secretion also suffers following\nMassage the breasts gently towards the\nl\nnipple confusion during bottle feeding.\nnipple.\nWhen cup/spoon/paladai or such top\nPlace your thumb and index \u0000nger opposite\nl\nfeeding is being given, all precautions must\neach other just outside the dark circle around\nbe taken to prevent regurgitation and\nthe nipple (Areola).\naspiration.\nNow press back towards your chest, then\nl\nb) Feeding with a cup\ngently squeeze to release the milk."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ae506cda-8594-4d77-b592-641c427a4fd9
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 37, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 109, "chroma:document": "Now press back towards your chest, then\nl\nb) Feeding with a cup\ngently squeeze to release the milk.\nFollowing instructions are given to mother or\nRepeat the same step in different positions\nl\ncaregiver who will be feeding with cup or with\naround the dark circle surrounding the nipple\na spoon from cup\n(areola).\nThe baby should be awake and held sitting\nl\nIf expressed milk cannot be given immediately\nl\nupright on the caretaker's lap.\nafter collection, it has to be stored and used\nwhen necessary. EBM can be kept at room Take a measured amount of milk in a wide\nl\ntemperature for at least 6 hours without mouth container with rounded edges. Directly\nsigni\u0000cant risk of spoiling. Any milk not fed apply this cup with rounded edges containing\nwithin 6 hours after expression, should be milk on the upper lip of the baby. The baby will\ndiscarded if kept only at room temperature. In open the mouth and actively start sucking the\nrefrigerator (if available) EBM can be stored milk."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ca237a07-0a67-4ebf-bac7-549b65dca6de
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 37, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 110, "chroma:document": "refrigerator (if available) EBM can be stored milk.\nin the main compartment of a regular\n|30|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ee6e93d4-4a3a-47af-9720-b8ed6637794b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 38, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 111, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\nc) Feeding with spoon from cup In case a baby gets regurgitation of feeds\nl\nthrough nose or mouth, immediately the baby\nTake a small quantity of milk from the\nl\nmay be held vertically and with a clean cloth\ncontainer in a spoon.\nwrapped around the caretaker's index \u0000nger,\nl Hold the spoon so that it touches the upper lip the mouth and nose may be wiped clean and\nof the infant and the mouth is opened. milk and other \u0000uids should be removed. The\nbaby may be put in a prone position for a\nThe baby may start sucking the milk or tilt the\nl\nshort while and patted on the back to remove\nspoon so that milk reaches the infant's upper\nthe aspirated milk from the baby's breathing\nlip.\npassages.\nIf possible, allow the infant to take the milk by\nl\nA mucus sucker may be given to the mother\nhim/herself and do not pour it into the infant's l"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9218bbff-b2e9-421c-bd00-9cbe37026654
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 38, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 112, "chroma:document": "l\nA mucus sucker may be given to the mother\nhim/herself and do not pour it into the infant's l\nwith proper instructions to use. It must be\nmouth. Feed the infant slowly, make sure that\nsterile, disposable and readily available for\nmilk already given, is swallowed fully before\nuse in case of sudden aspirations of being fed\ngiving anymore.\nby the baby.\nWhen the infant has had enough, S/he will\nl\nThe CHW makes sure that mother knows the\nclose his/her mouth and will not take any l\ncorrect use of the same. (Her training must be\nmore.\nproper, and the procedure must be directly\nl Do not force feed the infant observed carefully before allowing mother to\ndo the suction with the mucus sucker) If the\nEstimate the amount of milk taken in the same\nl\nworker does not know about proper use or\nway as for cup feeding.\nmother cannot be taught well about the use of\nFeeds must be given from an angle of the\nl mucus sucker, it should not be used at all.\nmouth slowly. Direct pouring of large"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8e47a7dd-6147-4d53-a891-bd0d80ae1f25
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 38, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 113, "chroma:document": "l mucus sucker, it should not be used at all.\nmouth slowly. Direct pouring of large\nquantities in the baby's mouth should be\n3.C Kangaroo Discharge and Follow\navoided.\nUp of newborn receiving HBKMC:\nThe quantity of feed must be gradually\nl\nincreased. Early discharge and regular follow up together\nform the third most important component of KMC\nSoon after feeding a very LBWI, the baby\nl\nshould not be immediately put on his back This component needs to be promoted very much\n(Supine). After feeding, at least for a short especially in the context of Home Based Newborn\ntime, the baby can be lifted vertically for a few Care (HBNC) including KMC to achieve the\nminutes (Burping done) and then the baby successful outcome for the small and sick\nshould be put on his/her tummy (Prone) or newborns.\nrolled on his/her left lateral side. The left\nFollowing aspects are discussed in this chapter:\nlateral position may be given with the support"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 5de299c9-e8a9-40fa-b750-3cfef0d901b6
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 38, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 114, "chroma:document": "Following aspects are discussed in this chapter:\nlateral position may be given with the support\nof a small pillow or a roll of clothes even when \u00d8 Planned early discharge and random early\nthe baby has to be left alone at home and discharge.\nmother has to go for a bath or some other\n\u00d8 General schedule for home visits of ASHA\npurpose and there is no one to watch the\nworkers.\nbaby.\n|31|"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 39, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 115, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\n\u00d8 Activities of the ASHA/HCPs during the l No other major problems in the baby.\nhome visits of a baby in HBKMC.\nMother is con\u0000dent of continuing care of the\nl\n\u00d8 Checklist for activities during follow up home small baby at home as guided in the hospital.\nvisits of ASHA/CHWs.\nFamily members are willing to support the\nl\n\u00d8 Suggested timetable of key activities of mother for KMC at home.\nHBNC of ASHA workers with special\n\u00d8 Random early discharge in hospital\nreference to HBKMC including promotion of\ndelivered baby:\nbreastfeeding.\nIn Indian context, many mothers do have\n(* Group I: Hospital delivered, and hospital\ninstitutional deliveries, but after delivery, do not\ncared for babies including KMC and\nstay in the hospital for even the minimum required\ndischarged as per the hospital policy.\ntime for the care of small and weak babies due to"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 39, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 116, "chroma:document": "discharged as per the hospital policy.\ntime for the care of small and weak babies due to\n* Group II: Hospital delivered babies but left several reasons and get early discharge and go\nearly without satisfying the discharge home. This is what we describe as random early\ncriteria of the hospital. discharge in case of group II against the planned\nearly discharge in case of group I. In case of\n* Group III: Home delivered and home cared\ngroup III who are home delivered, the\nfor babies.)\nconsiderations of discharge are not relevant.\nThe follow up of mother and baby with KMC\n3.C.1 Planned early discharge of\nshould be done as a part of HBNC, when hospital\nhospital delivered baby:\nvisits are not possible, through home visits by an\nASHA who are trained in KMC and breastfeeding\nThe component of discharge is relevant more for\nand detection of danger signs. The follow up visits\nthe group I babies who have delivered in the\nare mandatory-\nhospitals and received care including KMC and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 6d4333a5-c68a-44c3-9173-150429702061
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 39, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 117, "chroma:document": "are mandatory-\nhospitals and received care including KMC and\nthen discharged after ful\u0000lling proper criteria laid To monitor general wellbeing and adequate\nl\ndown by the hospital. In case of KMC they get physical growth.\nplanned early discharge after making certain\nTo assess neurological development.\nl\ncriteria for the continued safety of babies after\nleaving/ being discharged from the hospital. l To detect illness at an earlier stage and initiate\nproper management.\nThese minimum criteria include the following:\nTo ensure that mother has understood all the\nl\nThe preterm or LBWI infant is able to maintain\nl\ninstructions regarding administration of\nbody temperature with KMC and no external\nsupplementary micronutrients like iron,\nsources of additional heating are required.\ncalcium, phosphorus and vitamins.\nBaby is capable of oral feeding as direct\nl\nFor routine immunization of the infant.\nl\nbreastfeeding or expressed breast milk.\nTo make sure that mother can recognize\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 31a901b6-bc21-42a2-8196-0e057f414e4e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 39, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 118, "chroma:document": "l\nbreastfeeding or expressed breast milk.\nTo make sure that mother can recognize\nl\n(Or other alternative top feeds)\ndanger signs and seek prompt care at the\nl Before discharge, baby had satisfactory earliest.\nweight gain of at least 15 g/Kg /day for a\nminimum of three consecutive days.\n|32|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f1ac8951-226d-4dc9-b6c6-9e1c6c4bd03a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 40, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 119, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\n3.C.2 General schedule for home visits\nof ASHA workers is as follows:\nAntenatal visits as per schedule.\nl\nPostnatal visits.\nl\nIn case of home deliveries- seven visits.\nIn case of hospital deliveries- six visits.\n1st visit - at the time of birth, if possible or as\nl\nearly as possible after birth within \u0000rst 48\nhours.\nl 2nd visit- on 3rd day after birth. Fig. 15: Home visits by health worker\n3rd visit- 7th day after birth.\nl\nIn case of feeding with expressed breast\nl\n4th visit- 14th day after birth.\nl milk, check for the technique of expression,\n5th visit- 21st day after birth. collection and storage of milk, hygienic\nl\nhandling, quantity of milk expressed,\n6th visit- 28th day after birth.\nl\nfrequency of feeds including night feeds, any\n7th visit \u2013 42nd day after birth. other dif\u0000culties related to breast milk\nl\nfeeding."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: eb37dcbe-323c-4d03-897d-d7ed3d377fb3
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 40, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 120, "chroma:document": "7th visit \u2013 42nd day after birth. other dif\u0000culties related to breast milk\nl\nfeeding.\n3.C.3 Activities of the ASHA/CHWs Adequacy of feeds can be judged by amount\nl\nduring the home visits of a baby in of urine passed after the \u0000rst few days of\nbirth, quality of sleep and stools and mainly\nHBKMC:\nby the weight gain pattern.\nDuring every home visit, CHW should have a\nIn the \u0000rst few days the baby may be losing\nthorough check of the baby and carry out the\nweight. At no stage, the weight loss should be\nfollowing:\nmore than 10% of birth weight. Generally, by\nReinforcement of knowledge and skills 10th day after birth in case of a full term baby\nl\nrequired for essential newborn care. and by 14th day after birth in case of preterm\nbaby, the birth weight is regained. Thereafter\nDepending on the stage of requirement,\nl there is daily weight gain of about 15 to 20 g\ncounselling for the KMC for initiation,\nper KG of weight. Quite often, the CHW do\ncontinuation of breastfeeding."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 0554ac2c-ac44-467c-9c3c-4858dacf65b3
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 40, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 121, "chroma:document": "per KG of weight. Quite often, the CHW do\ncontinuation of breastfeeding.\nnot have good sensitive weighing scales\nFor increasing the duration of KMC, in those suitable for monitoring small weight\nl\ncases where KMC is to be continued. \u0000uctuations of newborns. Hence their\njudgement is often based on the general well\nTo ensure support from family members as\nl\nbeing of the baby and history of amount of\nAKPs.\nurine passed and sleep and behaviour of the\nBreast feeding- technique, adequacy of baby.\nbreast feeds and weight gain.\n|33|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 41, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 122, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\nCorrect method of hand washing and other During a follow -up visit:\nl\ninfection prevention measures.\nWeigh a baby.\nl\nTo make sure that mother and family members\nl\nObtain a history from mother.\nl\nincluding AKP recollect about detection of\ndanger signs preferably in early stages and l If she is doing KMC at home: Proper plotting\naware of immediate actions to be taken. of KMC duration by hours and number feeds\nand weight on KMC chart.\nTo explain to them about the importance of\nl\nregular follow up at nearby hospitals. l Breastfeeding and other feeding options as\nappropriate.\nTo guide them, wherever possible, when and\nl\nwhere to refer in case of emergency or for l Whether there are any danger signs in the\nspecial check -up of eyes and ear hearing and baby.\nassessment for brain development and how to\nAsk the mother if she has any other related\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 41, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 123, "chroma:document": "assessment for brain development and how to\nAsk the mother if she has any other related\nl\ntransport the baby in direct skin to skin\nconcerns.\ncontact on chest (Kangaroo Position) to\nPerform a general physical and systemic\nsuitable facility. l\nexamination of the baby.\nEducation and empowerment of mother\nl\nEncourage mother and family members to\nregarding feeding problems and detecting l\ncontinue KMC and prolong the duration as\nsignals at the early stages, infection control\nlong as possible and advise them to seek\nmeasures and her other questions and\nimmediate care when there are any danger\nanxieties.\nsigns.\nTo ensure proper childcare practices of the\nl\nMake sure they know what actions to be taken\nmother such as baby bath, body sponging, l\nimmediately before taking the baby to\nchanging the clothes, diapers, play and\nhospital in case of apnoea, vomiting,\nstimulation activities.\naspiration of feeds etc, and avoid all possible\nAdvice regarding Immunizations."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 58fd01e4-c898-4008-aef9-061ed03e02f5
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 41, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 124, "chroma:document": "aspiration of feeds etc, and avoid all possible\nAdvice regarding Immunizations.\nl delays in referral and how to carry the baby in\n(If possible, advise regarding micronutrient skin-to-skin contact while travelling to the\nl\nsupplements to LBWI/PT babies for Vitamin health centre. Mother should know where to\nD, Iron, calcium and phosphorus as go and whom to contact.\nMultivitamin preparations and Iron and\nPraise the mother for taking care of the baby\nl\nCalcium drops as learnt from the doctors or\nand schedule the next visit.\nnurses during monthly health and nutrition\nmeetings at village level).\n|34|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ead7926c-ded8-43b2-ad00-1759a88010cb
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 42, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 125, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\nRemoving Bangles Cutting Nails Palms\nFingers Thumb Nails\nWrist Washing Knuckles\nDrying\nFig. 16: Steps of handwashing\n|35|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: b68c2d88-2332-4bf2-8948-f5a495564b59
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 43, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 126, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\n3.C.4 Checklist for activities during follow up home visits of ASHA/CHWs.\nFollowing components must be checked during the follow up visits:\nKMC * Check the KMC position.\n* Duration of direct skin to skin contact (history regarding KMC hr. per day).\n* Continuation of night KMC.\n* Filling up the KMC chart correctly.\n* Clothing.\n* Body temperature.\n* Support for the mother and baby from family.\n* Does the baby show any signs of KMC intolerance?\n* Is it time to wean the baby from KMC?\n(Usually around 40 weeks of gestational age or just before) depending on\nenvironmental temperature, encourage the mother and the family to\ncontinue KMC as much as possible.\nBreastfeeding * Is it exclusive?\nIf the baby is on direct breastfeeding, during early visits, check for the\nproper positioning, latching and feeding during KMC; at the end, praise the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 7192d2da-f4aa-47a8-9554-47eb7050e973
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 43, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 127, "chroma:document": "proper positioning, latching and feeding during KMC; at the end, praise the\nmother and encourage her to continue breastfeeding.\nIf she is giving expressed breast milk or top milk, ensure number of feeds,\nensure regarding night feeds, amount at each feed and the technique of\ngiving the milk. In case of expressed breast milk, check for the method of\nexpression, collection and storage also.\n* Advise if there are any breast problems?\n\u0178 Inverted nipple.\n\u0178 Cracked nipple.\n\u0178 Engorged breast.\n\u0178 Abscess on breast tissue.\n\u0178 Any other.\nIn case of top milk, hygienic handling during feeding also must be ensured.\n* If she is giving milk supplements, advise her on how to increase\nbreastfeeding and decrease supplements.\n* Check for adequacy of feeding.\n* Ask about and look for any feeding problems and provide support.\n(*If the baby is taking formula supplements or other feeds, check their safety,\nadequacy; make sure that the family has enough supply)."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3fd77beb-91d1-4930-8b5b-e5451c9e1cd6
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metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 43, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 128, "chroma:document": "adequacy; make sure that the family has enough supply).\nGrowth * Weigh the baby at every visit and compare weight gain from the last visit.\nmonitoring & If weight gain is adequate, i.e. at least 15g/kg/d. on average, praise the\nAnthropometry mother. If it is inadequate, ask and look for possible problems, causes and\nsolutions; These are generally related to inadequate KMC, missing feeds at\nnight, inadequate feeding or illness. (To check KMC hours/d and feeding\namount for adequate daily weight gain, please refer to KMC chart if\navailable).\n* Record on growth charts, if provided.\n* Head circumference may be recorded every week if possible.\n* Length may be recorded once in two weeks if possible.\n|36|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a5ee0d0b-f3c3-4e3c-9ee9-70e859765bb3
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 44, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 129, "chroma:document": "CHAPTER THREE\nPRACTICE GUIDELINES FOR HOME BASED KANGAROO MOTHER CARE (3.C KANGAROO DISCHARGE AND FOLLOW UP OF NEWBORN RECEIVING HBKMC)\nIllness * Physical and systemic examination of baby.\n* Ask and look for signs of any illness either reported by mother or not\nreported.\n* Manage any illness according to local protocols and guidelines.\nIf required, help from ANM may be taken for Inj. Gentamicin or oral\nmedications.\n* In cases not on exclusive breastfeeding, ask and look particularly for signs\nof diarrhea or any feeding problem.\nCounselling * Hygiene and infection prevention measures are advised\nDo not miss the opportunity to reinforce about KMC, exclusive\nbreastfeeding and mother\u2019s awareness of danger signs\nCounsel for hand washing and other infection prevention measures\nincluding those for COVID prevention\nDiscuss other aspects of care like baby bath, clothing, early stimulation etc.\nNeurodevelopment * Neurodevelopmental assessment- Follow RBSK protocols in MCP card."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 44, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 130, "chroma:document": "Neurodevelopment * Neurodevelopmental assessment- Follow RBSK protocols in MCP card.\n& Neurosensory * Neurosensory assessment.\nAssessment * Arrange for:\n\u0178 Eye examination: for the preterm babies for detection of Retinopathy of\nPrematurity (ROP) by third/fourth week after birth.\n\u0178 Screening for Hearing assessment: Clinical evaluation at 40 weeks of\npost menstrual age and in case questionable, repeat at 6 weeks of\nchronologic age.\nDrugs * If the infant has been prescribed any drugs from the hospital in case of\ngroup I or II babies, make sure the mother follows the advice and gets\nsuf\u0000cient supplies. (e.g. Caffeine, antibiotics etc.) If possible preterm and\nsmall babies can get Vit D3, Calcium, Phosphate and Iron supplements from\nANM.\nImmunization * Check that the baby is immunized as per the immunization schedule of GOI.\nMother's concerns * Ask the mother about any other problem, including personal, household\nand social problems."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 44, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 131, "chroma:document": "and social problems.\n* Try to discuss with family members also and \u0000nd the best solution for all of them.\nNext follow up visit * Always schedule or con\u0000rm the next visit.\n* Do not miss the opportunity to check and advice on hygiene.\n* Reinforce the mother\u2019s awareness of danger signs that need prompt care.\nSpecial Follow * If these are required for other medical or physical problems.\nup visits * If abnormal neurodevelopment - encourage the mother to attend the special\nclinic and refer to Physiotherapy/Occupational therapy.\n(Wherever possible)\n* If the baby is found to be normal in terms of Growth & Development,\nencourage the mother to attend the special follow up clinic till one year of\nage to detect any deviation from normal in development.\n* If possible, USG skull at discharge and at 40 weeks of post menstrual age/\nfull term to rule out periventricular leukomalacia and other abnormalities for\nthose who can go to hospital with these facilities."}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 44, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 132, "chroma:document": "those who can go to hospital with these facilities.\n* X-ray or USG hip in all preterms at 3 mo. to rule out congenital dislocation of hip.)\n|37|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3ca340e0-2b91-4acb-ae74-f75602c8ed67
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 45, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 133, "chroma:document": "CHAPTER FOUR\nCOMMUNICATION AND COUNSELLING FOR\nPROMOTING HBKMC\nIntroduction: l Multiple sessions at multiple stages are\nrecommended.\nThe World Health Organization de\u0000nes\nIt is very helpful to have responsible family\ncounseling as a well-focused process, limited in l\nmembers with the mother during counselling\ntime and speci\u0000c, which uses the interaction to\nsessions. Encourage mother to bring her\nhelp people deal with their problems and respond\nmother/mother-in-law, husband or any other\nin a proper way to speci\u0000c dif\u0000culties in order to\nresponsible adult family member. It helps to\ndevelop new coping strategies. Community health\nbuild a positive attitude of the family and\nworkers should learn the art of counselling\nensure family support to the mother, which is\nproperly.\nparticularly crucial for home based KMC.\n\u00d8 During the sessions of communicating and\nRecognizing and supporting LBWI is very\ncounselling with mother and her family l\nchallenging in resource restricted regions."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9f55210b-32f1-48ed-a4d5-ac3d2decf731
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 45, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 134, "chroma:document": "counselling with mother and her family l\nchallenging in resource restricted regions.\nmembers, the counsellor should follow a few\nPoor access to health care and infrequent\ngeneral rules.\npostnatal contacts with community healthcare\n\u00fc GALPAC workers necessitate that caregivers are\nequipped with basic knowledge on evidence\nGreet them \u0000rst and talk to them courteously.\nl\nbased, life-saving neonatal care practices at\nAsk questions in such a way that the client is\nl home.\nwilling to have a frank discussion with you.\nIt helps to overcome the socio-cultural barriers\nl\nListen to what they have to say with interest.\nl and anxiety regarding handling of a small,\nHave direct eye to eye contact during\ndelicate LBW infant both by the mother and\nconversations. While they are talking please\nalternate care providers from the family.\ndo not divert your attention to some other\nAlso helps in developing better rapport with\nactivity like talking on phone, writing l\nthe CHW and ensuring better family support"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4080463c-1b45-4159-8558-84aa38b84168
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 45, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 135, "chroma:document": "activity like talking on phone, writing l\nthe CHW and ensuring better family support\nsomething or not being attentive.\nand involvement in the care of the newborn\nPraise \u0000rst for whatever good thing they might\nl and regular follow up including\nhave done. Do not start with some negative\nimmunizations.\npoints. They should feel relaxed talking to\nyou. \u00d8 Who should be counselled?\nAntenatal and pre birth( Just before the birth\nAdvise them what best they can do in the l\nl\nof the baby) counselling to all the pregnant\ngiven situation and convey the messages the\nwomen and family members.\nway they will understand.\nPostnatal to the mother and other responsible\nCheck and con\u0000rm that they have understood l\nl\nfamily members (father, grandmothers, sister\nyour instructions properly and it is possible for\netc.)/ Alternate KMC providers (AKP).\nthem to do.\nCounselling is ideally done for an individual\nEffective counselling is the most important\nl\nmother. Occasionally group sessions can be"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: feb46bd2-ac73-49a1-bffe-e13765aea9ff
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 45, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 136, "chroma:document": "Effective counselling is the most important\nl\nmother. Occasionally group sessions can be\nprerequisite for a successful KMC including\nconducted in the community.\npromotion of early and exclusive\nbreastfeeding.\n|38|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: cb2a6687-122f-4492-8bcb-e4a574052371
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 46, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 137, "chroma:document": "CHAPTER FOUR\nCOMMUNICATION AND COUNSELLING FOR PROMOTING HBKMC\n\u00d8 Following sessions are recommended for l To develop good rapport, if not done already\ncounselling:\nTo alleviate any fear and clear any queries\nl\n1) Antenatal Counselling: that they may have regarding care of\nnewborn.\n(During antenatal period, during monthly\nnutrition and health days, or home visits of Messages during this counselling:\nCHWs in the \u0000rst trimester of pregnancy for\nWhat is KMC?\nl\ndistribution of iron folic acid tablets, tetanus or\nTd injections, health check-up sessions of l Why should it be done? (Bene\u0000ts).\nmothers etc.). At that time, along with other\nWho can provide KMC?\nl\ntopics of pregnancy and delivery, mother\nmust be given following messages related to: l How to provide KMC/- proper KMC position?\nGetting mother and baby ready.\n* What is KMC and its bene\u0000ts.\nWhen and how long to provide KMC?\nl\n* Need of KMC for LBW infants.\nMonitoring during KMC.\nl\n* Immediate early skin to skin contact of"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 5af5f6b7-d185-448d-85a8-90905acf15b5
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 46, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 138, "chroma:document": "l\n* Need of KMC for LBW infants.\nMonitoring during KMC.\nl\n* Immediate early skin to skin contact of\nbaby on mother\u2019s chest soon after l Mother and her family members must be told\ndelivery. about the possible danger signals and how to\nidentify at the early stages and what actions\n* Signi\u0000cance of promotion of breast crawl\nshould be taken immediately.\nand early initiation of breastfeeding.\n3A session of counseling is very much desirable\n2) Pre-Initiation counselling:\nduring the time when mother is continuing with\nOne session should be held just before the KMC. This will help in improving the quality of\ninfant is ready for KMC, along with KMC in terms of prolonged duration and\nresponsible members of the family encourage mother\u2019s efforts to successfully continue\n(Obligatory) (Along with routine essential KMC till the baby is ready to be weaned from KMC\nnewborn care including cord care, feeding,\ndanger signals etc.)\n|39|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f4ae843e-f59d-4edf-9510-5466cdf8008d
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 47, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 139, "chroma:document": "CHAPTER FIVE\nREPORTS OF HOME BASED KANGAROO\nMOTHER CARE\nHealth care workers are expected to include a few What is the average duration of KMC in 24\nl\ndetails about the practice of KMC also in their hours for each baby?\nexisting records and reports of Home Based\nCalculated as the total duration for 24 hours\nl\nNewborn Care (HBNC).\nfor two consecutive days prior to stopping\n\u00d8 Why are these records needed? KMC?.\nA properly maintained quality record re\u0000ects What was the reason for not completing\nl l\nthe quality of services given. KMC?\nThe information provides an idea about the * Baby develop some illness or problems?\nl\nprogress made so far, what gaps need to be\n* Mother became ill or had some physical\naddressed?\nproblems? (backache / Stitch pain? /FP\nAlso gives some ideas about why mothers are operation? etc.)/Mother had\nl\nnot able to comply and how we can help them. family/social/cultural problems.\nFollowing simple information can be easily What was the type of feeding during KMC:\nl l"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d496875a-f221-4dac-bcb7-e98fd72cfd0a
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 47, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 140, "chroma:document": "Following simple information can be easily What was the type of feeding during KMC:\nl l\ndocumented by ASHA or ANM, who conduct breastfeeding or expressed breast milk/top\nthe home visits for follow up of mothers with milk?\nnewborns as per their planned schedule.\ni) Type of feeding when the baby started on\nAWW can also help for recording the\nKMC?\ninformation.\nii) Type of feeding for at least two days prior\n\u00d8 How many LBW babies are being given KMC\nto stopping KMC?\nin your service area?\nWeight of the baby when started on KMC and\nl\nNumber of total live births in your area/ total\nl\nwhen KMC was stopped.\nlive births.\nWhether the baby had any problems while\nl\nNumber of live babies whose birth weight is\nl\nbeing given KMC?\nrecorded.\n\u00d8 This baseline information will be helpful\nOf them, how many were having LBW (Birth\nl\nweight less than 2500g. l To know about the progress , quality and\noutcome of KMC.\nOf the total number of LBW babies, how many\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ed86d3d1-d530-47cf-98a9-ec1682a6bd57
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 47, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 141, "chroma:document": "outcome of KMC.\nOf the total number of LBW babies, how many\nl\nLBW babies were given KMC? l To \u0000nd out the gaps in terms of training,\nmanpower, supplies etc.\nOn which day of life KMC was started for\nl\neach baby? l To help \u0000nding any remedial solutions.\nHow many mothers could complete KMC for To begin with, a simple home based format is\nl\nthe baby? being suggested here. With proper guidance,\nmothers/ family members with elementary\nTill baby reaches 2500g of wt. /40 weeks\nl\neducation should be able to \u0000ll in on their own,\nafter the \u0000rst day of Last Menstrual Period\nwhich can be compiled by the ASHAs. Suggested\n(LMP).\nformats for recording are given in the annexure.\n|40|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ad664d16-fca2-4deb-9b99-58a7ccb8393d
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 48, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 142, "chroma:document": "CHAPTER SIX\nPRACTICE OF HOME BASED KMC DURING\nCOVID PANDEMIC\nBackground: required and can keep the baby with her. No\nreason to separate the baby from her/his\nAlmost since Dec. 2019, COVID 19 pandemic has\nmother.\ndevastated the world. It is once in a 100 year crisis\nAll the mothers who are having a history of a\nand progress made in decades has been reversed. l\nclose positive contact at home or in the close\nDespite many efforts, the pandemic continues in\nfamily or neighbourhood also can continue\nthe world. Vaccines developed against the virus\nwith breastfeeding and KMC and continue to\nhave been administered in India. Prevention\nkeep the baby with them.\nstrategies in terms of avoiding gathering of\npeople, physical distancing, use of masks in public If many cases are being reported from the\nl\nplaces, hand washing and Covid 19 vaccination region and routine tests of all mothers are not\nneed to be continued. Professional agencies like done, it is better to treat each case like a"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: cc89c2d5-0b27-475f-8fe0-73d56e34b96a
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 48, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 143, "chroma:document": "need to be continued. Professional agencies like done, it is better to treat each case like a\nFederation of Obstetrics and Gynaecological positive case and take full precautions from\nSocieties of India, Indian Academy of Pediatrics, the beginning rather than wait for the test and\nNational Neonatology Forum and Ministry of further con\u0000rmation.\nHealth and Family Welfare, Government of India\nAll the precautions of respiratory hygiene,\nhave maternal and newborn practices during l\nincluding use of masks, frequent hand wash,\nCovid 19 pandemic.\ncleaning all the contact surfaces and all other\nl Considering the possible risk of baby getting infection prevention measures should\ninfection and suffering because of this disease continue in each and every case irrespective\nagainst the multiple problems that occur due of mother\u2019s status of COVID test.\nto separating the baby from his/her mother, it\nIf the mother is tested positive and very sick, if\nhas been observed that bene\u0000ts of keeping l"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a7cbd316-6eb8-4104-bd87-c19920d03a1a
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 48, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 144, "chroma:document": "If the mother is tested positive and very sick, if\nhas been observed that bene\u0000ts of keeping l\npossible, her breastmilk can be expressed\nthe mother and her baby together and\nand given to the baby. All the procedures\nencouraging breastfeeding in all babies and\nincluding expression of breast milk,\nKMC in LBW babies are much more and\ncollection, storage and administration should\nbreastfeeding and KMC need to be\nbe done with strict precautions of infection\nencouraged. Only in a few situations that may\ncontrol.\nnot be possible. In that case decisions can be\nmade depending on the given context. If mother is very sick and even expressed\nl\nbreast milk is not possible, the baby may be\ngiven alternate feeds like other known donor\u2019s\nCurrent guidelines:\nmilk, or animal milk whichever is available, in\nIrrespective of the status for COVID 19 order of preference. Wherever possible\nl\npositive, in all mothers soon after birth the standardized processed milk from known"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 67f42d47-82dd-4028-aa6a-81f405446115
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 48, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 145, "chroma:document": "l\npositive, in all mothers soon after birth the standardized processed milk from known\nnewborn can be given for early direct skin to diaries as pouches should be preferred to raw\nskin contact. All precautions for infection animal milk. But in remote areas that option or\ncontrol must be strictly followed. formula milk may not be possible. Mother\u2019s\nown milk should be given as early as possible.\nAll the mothers who are tested positive and\nl\nAt times attempts for re-lactation by the\nhaving no symptoms or mild symptoms should\nmother to continue breastfeeding after some\ncontinue with breastfeeding and KMC as\nbreak will be necessary.\n|41|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: b2a7b8db-f57d-4faa-8dca-2a637af83990
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 49, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 146, "chroma:document": "CHAPTER SIX\nPRACTICE OF HOME BASED KMC DURING COVID PANDEMIC\nAs far as possible, a sick mother or her baby proper. It must cover the nose and mouth\nl\nshould be taken to a hospital for further care. including chin to prevent droplet infection.\nOnly if that is not possible, management The masks can be prepared at home or\nshould continue at home with the help of procured. Generally, they are of double\nANMs. layered cotton material (Can be prepared at\nhome from used clothes like bedsheets,\nAll the suspected cases or the contacts of\nl\nsarees, handkerchiefs etc.) All the family\nsuspected or positive cases should be\nmembers also should wear masks when\nreported for further appropriate measures by\ncoming near the mother or baby. Masks\nthe concerned department of health.\nshould be washed daily and can be reused. At\n\u00d8 Infection prevention measures during COVID least four masks should be there for the mother\n19 pandemic so that they can be frequently washed and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 644c4ec9-e171-4b95-9e8b-101034f1803f
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 49, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 147, "chroma:document": "19 pandemic so that they can be frequently washed and\nused. Masks should not be used for the\nMost important advice is that all mothers,\nnewborn baby and other children below \u0000ve\nfamily members and health care providers\nyears of age in the family. It may be harmful.\nshould follow strict infection prevention\nmeasures. As far as possible, use of sanitizers which\nl\ncontain alcohol are to be avoided when small\nMother must wash her hands properly with\nl\nbabies are being handled for breastfeeding.\nsoap and water at least for forty seconds\nOnly in situations where soap and water\nbefore picking up the baby or before and\nfacilities are not available, sanitizers may be\nafter touching any other objects. She must be\nused.\ntrained to follow all the steps of handwashing\nmethodically and her technique may be\nobserved several times to make sure she does\nit well. (Mothers may not have a wristwatch or\nclock for timing the handwash. In that case a\nsimple useful tip: she can recite some poem or"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4f8ab174-c401-43b3-bde1-c8b4a2cb3ff5
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 49, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 148, "chroma:document": "clock for timing the handwash. In that case a\nsimple useful tip: she can recite some poem or\nher favourite religious or non -religious\nsong/jingle or some count by which roughly\n40 to 60 seconds are marked mentally)\nIt is not required to wash the mother's breasts\nl\nbefore feeding every time. A good daily bath\nand use of washed and preferably sun dried\nclothes is adequate for personal hygiene of Fig. 17: HBKMC during Covid times\nmother or her helpers including AKPs, if there\nare. If a mother who is tested positive,\nPhysical/ social distance to be practiced as\nl\naccidentally happens to cough or sneeze on\nmuch as possible within homes, preferably a\nher chest, she has to wash her chest with soap\ndistance of at least 6 feet or at least minimum of\nand water before giving breast feeds.\n3 feet is maintained from visitors and even\nOtherwise, it is not necessary.\nfamily members who are likely to be contacts.\nMother (or those who take care of the baby)\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 7581b9a0-4e9f-4677-b905-f46270bab33c
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 49, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 149, "chroma:document": "family members who are likely to be contacts.\nMother (or those who take care of the baby)\nl\nMother should follow other rules of cleanliness\nshould wear masks when feeding the baby l\nand infection prevention and control measures\nor offering KMC. The use of mask must be\nsuch as keep minimum necessary items near her\n|42|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 50, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 150, "chroma:document": "CHAPTER SIX\nPRACTICE OF HOME BASED KMC DURING COVID PANDEMIC\nand avoid cluttering with many items. Keep all If you have a cough, fever or dif\u0000culty in\nl\nthe items clean and especially after someone breathing, immediately contact your doctor. Or\nhandles them. (eg. Vessels, clothes, medicine visit the nearby hospital where all facilities for\nbottles, papers, items for personal use etc.). testing and management are available.\nThe health care provider also should observe During hospital stay, it is specially recommended\nl l\nall these rules like wearing the mask during her to keep the mothers with COVID 19 positive\nhome visits and even during her travel to the status and their newborns together in a separate\nvillage. They should observe physical distancing ward or place with some privacy. They should\nfrom other persons and even mother as much as not be grouped together with other COVID\npossible. She should preferably carry her own positive persons in the same ward. It helps in"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 50, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 151, "chroma:document": "possible. She should preferably carry her own positive persons in the same ward. It helps in\nsoap and sanitizer and wash her hands every many ways including promotion of successful\ntime before entering for home visit. As far as exclusive breastfeeding in all cases and quality\npossible soap and water should be used for KMC for low birth weight babies.\nhand wash.\nPostnatal anxiety and depression are common\nl\nIt is also important to improve ventilation by among parents and family members with\nl\nusing exhaust fans or promoting cross COVID positive test, \u0000nancial dif\u0000culties, social\nventilation for prevention of Covid 19. distancing and birth of a low birth weight or\npreterm baby. The family should be offered\nAvoid using public transport.\nl\npsychosocial support for handling the situation.\nAvoid contact with persons suffering from\nl\nIf the newborn is ill, s/he requires specialized\nl\ncough, fever, dif\u0000culty in breathing etc.\ncare in NICU. Mother must be allowed to visit"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 97fd40f4-0d12-4d37-994f-28222144c748
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 50, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 152, "chroma:document": "l\ncough, fever, dif\u0000culty in breathing etc.\ncare in NICU. Mother must be allowed to visit\nl Avoid touching the mouth, nose and eyes as her baby with proper IPC measures.\nmuch as possible.\nFig. 18: KMC during Covid times Fig. 19: KMC during Covid times\n|43|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a6f98335-222a-4d58-89f2-74c21127549a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 51, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 153, "chroma:document": "CHAPTER SEVEN\nEXPERIENCE OF HOME BASED KMC IN\nGUJARAT AND MAHARASHTRA\nA. Gujarat: mothers for KMC and they will be ready to do\nKMC in subsequent deliveries also. A few\nWe introduced the Facility based KMC for the\nmothers did have some minor problems. But\n\u0000rst time in India at the neonatology division\nmost of them are easily manageable. We\nof Civil hospital, Ahmedabad, as a part of an\npresented different aspects of this study in four\nInternational multicentric study in the year\ninternational KMC conferences (Kigali,\n1993. The \u0000rst KMC ward was created. The\nRwanda, Trieste, Italy and Port Elizabeth,\nKMC program has continued and scaled up\nCape Town, South Africa and Manila,\nsuccessfully since then.\nPhilippines) and in various national\nIn the year 2005, for the \u0000rst time in India, conferences in India.\nHome based (Community based) KMC was\nSimilar studies are also available from urban\nintroduced in the rural project of SEWA Rural,\nslums of Gujarat.\nZagadia, a reputed voluntary service"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 51, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 154, "chroma:document": "slums of Gujarat.\nZagadia, a reputed voluntary service\nIndian Council of Medical Research\norganization, as a part of their project of\nconducted a similar multicentric study in\nhome based newborn care. Following\nGujarat, Maharashtra and Odisha, and\nfavourable experience over many years in\nreported good results, \u201cCommunity based\nthat project, we introduced HB KMC through\nKangaroo Mother Care and Low Birth Weight\nmany other voluntary health care\nbabies.\u201d which was published in Indian\norganizations of Gujarat working in rural\nJournal of Scienti\u0000c Research.\nareas.\nHBKMC is continuing successfully in all these\nIn the year 2014 and 15, a systematic, well\nblocks in Gujarat with very good results and\nplanned research project was conducted for\nnow coverage is gradually increasing. We\none full year through \u0000ve voluntary service\nhave a draft guideline, job aids and teaching\norganizations of Gujarat {SEWA Rural\nslides prepared in local languages of Gujarati\nJhagadia (Rural/Tribal), Tribhuvan"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 51, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 155, "chroma:document": "slides prepared in local languages of Gujarati\nJhagadia (Rural/Tribal), Tribhuvan\nand Oriya and recently one updated version\nFoundation, Anand ( Rural), Bhansali trust,\nin English for the state of Maharashtra.\nSami block of ICDS ( Rural), Gram Sewa trust,\nKharel (Rural/Tribal) and JNPCT at A special issue of newsletter of KMC\nDharampur, a very backward tribal area} to Foundation, India has been brought out on\nstudy the safety, feasibility and acceptability HBKMC in resource restricted regions of India\nof HBKMC in resource restricted regions of including Gujarat with a special plea to\nGujarat. The study area covered 146 villages promote home based KMC as a part of home\nand a population of more than 2 lakhs, (97 based newborn care in deprived sections of\ndeliveries with 102 LBWI including \u0000ve sets of the communities in India as soon as possible.\ntwins were included). Mothers\u2019 perception In the current situation it has a very great"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 926c2f5b-8eef-4d54-b09b-56379470d5b0
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 51, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 156, "chroma:document": "twins were included). Mothers\u2019 perception In the current situation it has a very great\nabout KMC was collected through interviews. potential to save many more newborns in our\nThe results were very encouraging. country.\nMajority of mothers expressed that they were Recently WHO has realized the signi\u0000cance\nvery happy doing KMC and willing to keep of promotion of HBKMC in communities and\ntheir babies with them and if need be, they will have initiated multicentric pilot projects in\nbe happy to advise and encourage other\n|44|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f02d83d7-c5c1-4ee2-ab7c-4c97ee30d2e4
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 52, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 157, "chroma:document": "CHAPTER SEVEN\nEXPERIENCE OF HOME BASED KMC IN GUJARAT AND MAHARASHTRA\nstates of UP, Karnataka and Haryana. The Initial few days expressed breast milk was\nstudy from Haryana has shown very given by a spoon from the cup and gradually\nencouraging results, acclaimed well and shifted to direct breastfeeding. KMC\npublished in the reputed journal The Lancet. continued for almost 6 to 8 hours per day and\nmother and her mother-in-law alternated for\nA few case histories from Gujarat are given\nKMC. Vaccination of the baby was done. The\nhere which will highlight the situations in\nbaby was given KMC for almost 40 days and\nwhich HBKMC has been found to be not\nexclusive breast milk feeding continued. The\nmerely useful but also lifesaving! We now\nAWW worker guided them throughout with\nhave many more such stories to share and\nmultiple home visits. The baby is thriving well\nhave followed up data for many years on\nto date. Today the child is doing well and\nquite a few of these babies given HBKMC."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 958260e0-acb0-4880-9d95-e1e88ca6009a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 52, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 158, "chroma:document": "to date. Today the child is doing well and\nquite a few of these babies given HBKMC.\nattending school. No neurologic or\ndevelopmental problems have been noted so\n1. An extremely LBW baby weighing 600 far.\ngrams alive and thrive following HBKMC.\nA primi mother Sitaben had a spontaneous\nnormal vaginal delivery in the very early\nhours of the day in a Government SNCU in a\nsmall district, near the city of Patan in Gujarat.\nand had an ELBW baby , the exact LMP not\nknown. The baby cried well immediately and\nweighed only 600 grams at birth. The Nurse\nattended the delivery. The duty doctor was\ninformed about the delivery of an ELBW baby.\nFig. 20: An extremely low birth weight baby saved\nHe did not expect this tiny baby girl to live through home based KMC\nlong. So, he did not even examine the neonate\nand advised the family members to take the\n2. LBW twin babies saved following HBKMC:\nbaby to a bigger hospital as facilities for the\n(Source: Tribhuvandas Foundation, Anand)."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 7336bba1-08aa-4744-b0a1-24838dd2c033
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 52, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 159, "chroma:document": "baby to a bigger hospital as facilities for the\n(Source: Tribhuvandas Foundation, Anand).\ncare of such a small baby were not available\nin that hospital. As the relatives expressed Twin babies of father Laljibhai and mother\ntheir inability to go to the bigger hospital even Manjuben.\nthough all services were available free of cost,\nParents are very poor farm labourers. Twins\nthe doctor advised them to take the baby\nwere born at home with a birth weight of 1.2\nhome. The village Anganwadi worker, trained\nKg. and 1.6Kg weight. Due to economic\nfor essential newborn care including KMC, at\nconstraints, they could not afford to lose their\nSami ICDS project of Bhansali Trust, was told\ndaily wages and take the twins to a bigger\nabout the mother returning home with a very\nhospital even though the hospital was nearby\ntiny baby. She immediately went to the house\nand all the services were free of cost. The\nof Sitaben and advised her and her mother -in\nCommunity Health Worker advised the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 1d856c84-0060-4e4b-b4f1-313782703e36
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 52, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 160, "chroma:document": "of Sitaben and advised her and her mother -in\nCommunity Health Worker advised the\n-law about KMC and breastfeeding. She\nparents about KMC and breast feeding and\ncounselled them and motivated them to take\nhad regular home visits. Father and mother\ncare of the baby as long as it is living. Luckily,\nboth offered KMC by taking turns and breast\nmother-in-law agreed and started KMC and\nfeeding was given. Both the kids are thriving\neven made the mother also provide KMC.\nwell without any neurological problem.\n|45|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e298c3f8-a766-449c-b21c-50d15ebcd619
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 53, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 161, "chroma:document": "CHAPTER SEVEN\nEXPERIENCE OF HOME BASED KMC IN GUJARAT AND MAHARASHTRA\nWe have several such examples of home\nbased KMC in poor families in remote\nresource constrained regions in communities\nwhere KMC including breast milk feeding\nhave helped for the good nurture and well\nthriving.\nB. Maharashtra:\nIn Maharashtra, the Department of Public\nFig. 21: LBW twins cared through HBKMC Health has been leading the roll out of the\nHome Based KMC in 78 tribal blocks since\n2019. The state level training of the trainers\n3. An extremely LBW baby weighing 920\nwas conducted by the senior trainers of KMC\ngrams saved through HBKMC in the project\nFoundation of India, Department of Public\nareas of Sewa Rural, the rural-tribal block of\nHealth, Government of Maharashtra and\nZagadia.\nUNICEF on 5 December 2019. This was\nfollowed by the block level trainings, which\nDuring home visits, the community health\nwere supported by UNICEF.\nworker detected a very small baby weighing\n920 grams. Parents were advised for"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 73f64797-a7a0-4d1d-9c1c-e4be16954496
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 53, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 162, "chroma:document": "worker detected a very small baby weighing\n920 grams. Parents were advised for\nThe 136,000 KMC bags were procured and\nhospitalization in SEWA Rural hospital, all\n50,000 KMC Cards were printed utilizing\nservices including transport free of cost. But\nfunds from the National Health Mission. As\nparents could not agree because of their own\nper HBKMC report during 2020-21, home\nproblems. The CHW got instructions about\nbased KMC was provided to 42660 low birth\nKMC through the mobile app \u201cM Techo\u201d\nweight newborn babies from 78 tribal blocks.\ndeveloped by the NGO for the Government of\nIn the case of 1369 babies, KMC was given\nGujarat. Accordingly, she advised the mother\nby members other than the mother herself.\nand the family. KMC and breast milk feeding\nwere given and the baby had regular home\nvisits by the CHW. The baby reported to be\nthriving well.\nFig. 22: ELBW saved through HBKMC Fig. 23: Training of ASHAs for HBKMC in Maharashtra\n|46|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: aa180525-0b21-402e-9f04-904e6472d88f
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 54, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 163, "chroma:document": "CHAPTER SEVEN\nEXPERIENCE OF HOME BASED KMC IN GUJARAT AND MAHARASHTRA\nFig. 24: HBKMC in Gadhchiroli district of Maharashtra\nRiya is a healthy and active child, sleeping\ncomfortably as mother provides her for Kangaroo\nmother care. She was born at 8 months and was\nweighing only 1.7Kg at birth. Riya\u2019s mother,\nGeeta was living in Nagpur with her husband.\nWhen COVID 19 pandemic started, she and her\nhusband came back to her village in the month of\nMay 2020. She delivered a baby at the 8th month\nof her pregnancy at the local Primary Health\nCenter. She was counselled on breastfeeding and\nKMC and was provided with KMC bags by Ms.\nSulochana Marskolhe, ASHA, who continued to\nmonitor the newborn during the HBNC visits. She\nencouraged Geeta and her family members for\nKMC. Riya is a beautiful child who turned 3 month\nold. She weighs 4.6 kilograms.\n|47|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8483436c-76e9-4694-b14b-de0a5e522466
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 55, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 164, "chroma:document": "REFERENCES\n1) \u201cKangaroo Mother Care: A practical guide\u201d. 8) Reeta Rasaily, Ganguly K K, Roy M, Vani S N,\nDepartment of Reproductive Health and Kharod N et al \u201cCommunity Based Kangaroo\nResearch, WHO, Geneva, 2003. Mother Care for LBWI \u2013 A Pilot Study\u201d Indian\nJ. Med. Res. 2017 Jan; 145(1): 51-57.\n2) Cattaneo A, Davanzo R, Worku B, Surjono A,\nEcheverria M, Bedri A et al \u201cKangaroo Doi: 10.4103/ijmr. IJMR 603.15.\nMother Care for Low Birth Weight Infants: A\nrandomized controlled trial in different 9) Home Based Newborn Care -Operational\nsettings\u201d. guidelines (Revised 2014) MOHFW, GOI.\nActa Paediatrica 1998: 87(9): 976-985. 10) KMC training modules prepared by KMC\nFoundation, India 2018 (Unpublished).\n3) Cattaneo A, Davanzo R, Bergman N,\nCharpak N. \u2013 \u201cKangaroo Mother care in Low 11) Kangaroo Mother Care and Optimal Feeding\nincome countries.\u201d International network in of Low Birth Weight Infants- Operational\nKangaroo Mother Care, J. Trop. Pediatr.1998 Guidelines-for Program managers and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 6fdf7cd1-4ed2-4e96-ade0-01f96cb92aa9
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 55, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 165, "chroma:document": "Kangaroo Mother Care, J. Trop. Pediatr.1998 Guidelines-for Program managers and\nOct; 44(5): 279-82. Service Providers -Sept 2014, Child Health\nDivision Ministry of Health and Family\n4) Goel A, Vani S N.- \u201cKangaroo Mother Welfare, GOI.\nMethod for the care of low birth weight\ninfants- An Indian experience\u201d A bstracts xviii 12) Vani S N, Kharod N M and Mehta Rajesh:\nAnnual Convention of National Neonatology Guidebook and Training Module for Essential\nForum, Nov 6-8th 1998. Newborn Care in Community for Female\nHealth Workers (English and Gujarati) for\n5) Modules for ASHA workers no. 6 and 7 for Government of Gujarat with support of CARE\nmother and newborn care: published by India 2006.\nNational Rural Health Mission, GOI.\n13) Vani S N, Kharod N M and Mehta Rajesh:\n6) Vani S N, Kharod N M et al: \u201cA study of Guidebook and Training Module for Essential\nSafety, Feasibility and Acceptability of Home Newborn Care in Community for Anganwadi"}


created_at: 2025-05-02 10:00:24
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created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 56, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 167, "chroma:document": "REFERENCES\n16) \u201cMalawi National Guidelines for Kangaroo Cochrane database of Systematic Reviews\nMother Care\u201d Ministry of health, Republic of 2016, Issue 8 Art. No: CDO.\nMalawi, March 2009.\n26) Kumar V, Shearer JC, Kumar A, Darmstadt\n17) \u201cTechnical Guidelines for the Implementation GI- \u201cNeonatal hypothermia in low resource\nof a Kangaroo Mother Care Program in settings- A review\u201d; J. Perinatol 2009;29:\nColombia\u201d Colombian Ministry of Social 401 -402.\nProtection together with United Nations\nWorld Food Program (WFP). 27) Nguah et al: \u201cPerception and practice of\nKangaroo Mother Care after discharge from\n18) \u201cKangaroo Mother care (KMC) Tool Kit\u201d- hospital in Kumasi, Ghana: A longitudinal\nKangaroo Foundation, Bogota, Colombia. study \u201c- BMC Pregnancy and Childbirth\n2011; 11:99.\n19) \u201cKangaroo Mother Care Implementation\nGuide\u201d MCHIP-USAID March 2012. 28) Karlsten Lunze: \u201cThermal Protection of\nnewborn in resource limited environment\u201d-"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 56, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 168, "chroma:document": "newborn in resource limited environment\u201d-\n(Maternal and Child Health Integrated Journal of perinatology (2012)32, 317-324.\nProgram).\n29) Shuler C, Ntow G E, Agbozo F- \u201cMothers'\n20) Udani Rekha, Nanavati Ruchi, Rao Suman, experiences with neonatal care for low birth\nBajaj Naveen, Parikh Tushar, Shah weight infants at home; A Qualitative study\u201d-\nDharmesh, Chinta Srinivas \u201cTraining Manual Journal of Paediatric Nursing.\non Kangaroo Mother Care\u201d S e t h G . S . http:/doi.org/10.1016/J.Pedn2018,\nMedical College and KEM Hospital, Mumbai 12.017.\n2006.\n30) Shanker M J, Neogi S B, Sharma J, Chauhan\n21) Kangaroo Mother Care Facilitator's Guide: M, Srivastava R, Prabhakar P K, Khera A,\nACCESS 2009. Kumar R, Zodpey S, Paul V K \u201cStatus of\nNewborn Health in India\u201d J. Perinatol.2016\n22) WHO/UNICEF Joint Statement- Home visits\nDec: 36 (Suppl.3) S3-S8 Published online\nfor the newborn child: a strategy to improve\n2016, 7.DOI: 10.1038/jp2016.183.\nsurvival 2009."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 56, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 169, "chroma:document": "for the newborn child: a strategy to improve\n2016, 7.DOI: 10.1038/jp2016.183.\nsurvival 2009.\n31) \u201cThe Lancet Neonatal Survival Series\u201d The\n23) Udani Rekha et al: Evaluation of Kangaroo\nLancet 2005; 365, No. 9474, P1845.\nMother Care Services in India, 2013.\n32) Lawn JE, Cousens S, and Zupan J \u201cFour\n24) Learner's manual for KMC certi\u0000cation course\nmillion neonatal deaths: When, where, why?\u201d\n2015 9th edition By Susan Ludington-Hoe,\nPh.D., RN, CNM, FAAN Kathy Morgan, BSN, Lancet 2005; 365: 891-900.\nRN, NNP, Barbara Morrison, Ph. D., RN, NM,\nFNP Gene C. Anderson, Ph D., RN, FAAN. 33) Lawn JE, Mwansa-Kanbafwile J, Horta BL,\nBarros FC, Cousens S. \u201cKangaroo Mother\n25) Conde Agudelo A, Diaz Rossello JL Kangaroo Care\u201d International Journal of Epidemiology\nMother Care to reduce Morbidity and 2010 Vol. 39 Issue Suppl I: 144-154.\nMortality in Low Birth Weight Infants\n|49|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 57, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 170, "chroma:document": "REFERENCES\n34) \u201cEvery Child Alive- The urgent need to end 42) Bhutta Z A, Darmstadt G L, Hasan B S, Haws R\nnewborn deaths. A report\u201c \u2013 UNICEF, A \u201cCommunity based interventions for\nSwitzerland publication February 2018. improving perinatal and neonatal health\noutcomes in developing countries: A review of\n35) Udani Rekha, Hinduja Anupa, Rao Suman, evidence\u201d Pediatrics 2005: Feb, 115\nKabra N. \u201cRole of Kangaroo Mother Care in (2 Suppl) 519-617.\npreventing neonatal morbidity and mortality-\nA review article.\u201d Journal of Neonatology 43) Lincetto\u2013 \u201cKMC with limited resources\u201d,\nOct. 2014: 28(4): P.29-36. J. Trop. Pediatr.; 2000; 46: 293-295.\n36) Dragovich D, Tamburlini G, Alisjabana A, 44) Quasam I, Sloan N- \u201cAdaptation of KMC for\nKambarami R, Karagulova J, Lincetto, Vani S Community \u201c, Perinatal 2003; 23: 646-651.\nN et al ``Thermal Control of newborn: The\nknowledge and practice of health 45) Dawar R, Nangia S, Thukral A, Chopra S,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 57, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 171, "chroma:document": "knowledge and practice of health 45) Dawar R, Nangia S, Thukral A, Chopra S,\nprofessionals in seven countries.\u201d Acta Khanna R, \u201cFactors Impacting Practice of\nPediatr. 1997; 86: P645-650. Home Kangaroo Mother Care with Low Birth\nWeight Infants Following Hospital Discharge\u201d\n37) Mullany I C. \u2013 \u201cNeonatal Hypothermia in low J. Trop. Pediatr.2019 Feb 14 pii: fmz007.doi:\nresource settings\u201d Semin Perinatol 2010; 10-1093/ trop ej / fmz007.\n36:426-433.\n46) Mazumder S, Taneja S, Dalpath SK, Gupta R,\n38) Charpak N, Ruiz- Pelaez JG, Charpak Y. Dube B, Sinha B, Bhatia K, Yoshida S,\n\u201cRey Martinez Kangaroo Mother Program; Norheim OF, Bahl R, Sommerfelt H, Bhandari\nAn alternate way for caring for Low Birth N, Martians J. \u201cImpact of Community\nWeight Infants -One year mortality in a two Initiated Kangaroo Mother Care on survival\ncohort study\u201d; Paediatrics: 1994: 94:804- of Low Birth Weight Infants\u201d Study protocol\n810. for a randomized controlled trial. Trials 2017\nJun 7: 18(1):262 doi:10.1186/s13063-"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 57, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 172, "chroma:document": "810. for a randomized controlled trial. Trials 2017\nJun 7: 18(1):262 doi:10.1186/s13063-\n39) Darmstadt G I, Kumar V, Yadav R, Singh V, 017-1991-7.\nSingh P, Mohanty S et al. \u201cIntroduction of\ncommunity -based skin to skin care in rural 47) Mazumder Sarmila , Sunita Taneja et al\nUttar Pradesh, India\u201d J .Perinatol 2006;26: \u201cImpact of Community Initiated Kangaroo\n597-604. Mother Care on survival of Infants with low\nbirthweight: a randomized controlled trial\n40) Singh M, Rao G, Malhotra A K, Deorari A K- L a n c e t O c t 0 4 2 0 1 9\n\u201cAssessment of newborn baby's temperature DOI:https://doi.org/10.1016/SO140-\nby human touch: A potentially useful primary 6736(19)32223-8.\ncare strategy\u201d- Indian Pediatr.1992; 29: 449-\n452. 48) Daga Subhashchandra:\u201d Reinforcing\nKangaroo Mother Care uptake in resource\n41) Bang AT, Bang R A, Baitule S B, Reddy M H, limited settings\u201d Maternal health Neonatol\nDeshmukh MD- \u201cEffect of home based Perinatol 2018; 4:26 Doi: 10,1186/s"}


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created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 58, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 174, "chroma:document": "REFERENCES\n49) Lawn Joy E., Dickson Kim E, Mathai Matthews 53) Ahmed, S., Mitra, S., Chowdhury, A., et al\nand Moxon Sarah G: Every Woman, Every Community Kangaroo Mother Care:\nNewborn Vol. 15, Supplement 2, Sep. 2015. Implementation and potential for neonatal\nsurvival and health in very low income\n50) Participant's manual- Newborn care at the settings. J . Perinatol 31, 361-367 (2011)\nFacilities- Training of Staff Nurses and http://doi.org/10.1038/jp.2010.131.\nAuxiliary Nurse Midwives (ANMs) 2017. By\nGovernment of Gujarat, Public Health 53) Uwaezuoke S N,\u201d Kangaroo Mother Care in\nFoundation of India and Micronutrient resource limited settings\u201d Dove press open\nInitiative. access journal (2017) Vol.2017:7Pages 11-\n18, http:// doi.org / 10.2147 /\n51) Navjat Shishu Suraksha Karyakram- Basic RRN.S138773.\nNewborn Care and Resuscitation Program\nManual. 54) My Techo- a mobile phone application for the\nuse of Community based health care"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 58, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 175, "chroma:document": "Manual. 54) My Techo- a mobile phone application for the\nuse of Community based health care\nMinistry of Health and Family Welfare, providers of women and children Details\nGovernment of India. Available from from\u201d techo@gujarat.gov.in\u201d.\nh t t p : / n r h m . g o v . i n / n r h m -\ncomponents/rmnch-a/childhealth- 55) Conde Agudelo A, Diaz \u2013Rossello JL.\nimmunization/child-health/guidelines.html. Cochrane Database of Systematic Review\n2016 Issue 8.\n52) Kangaroo Mother Care \u2013 Implementation\nguide (2012) MCHIP, Save the Children and 56) UNICEF, WHO, World Bank, United Nations.\nothers. Levels & Trends in Child Mortality: Report\n2020.\n|51|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 59, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 176, "chroma:document": "ANNEXURES\nANNEXURE 1: SUGGESTED RECORDING & REPORTING FORMATS FOR HBKMC\nA) HOME BASED DAILY RECORD OF NEWBORN\nName of Mother:\nName of Baby: Date of Birth:\nPlace of Delivery: Mode of Birth:\nDiagnosis / Problems:\nDate of Starting Home Care:\nB) REPORTING FORMAT FOR HOME BASED KMC BY ASHAS\nName of Asha worker:\nAddress:\nSr. Name Name DOB Birth Gestational Visit on Duration Breast Weight Danger\nNo. of of Weight Age which (hours) feeding Gain sign\nthe the day of done Daily Yes/\nBaby Mother after KMC every No\nbirth given two\nevery hours?\nday\n|52|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 60, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 177, "chroma:document": "ANNEXURES\nANNEXURE 1: SUGGESTED RECORDING & REPORTING FORMATS FOR HBKMC\nC) CASE SUMMARY OF BABY WHO HAD KMC BY ASHA/CHW\nName of ASHA/CHW:\nAddress of Family:\nSerial Number: Name of Mother:\nName of baby:\nLMP: Date of Birth: Time:\nMode of Delivery N/CS/Assisted:\nFt/PT/LBW: Early STSC in LR Y/ N EIBF Y/ N\nWt. at Birth: Wt at start of KMC:\nWt. end of KMC:\nMode of feeding DBF/EBM Other At KMC start: At KMC End:\nAverage duration of KMC per 24 hours: for last two days before stopping MC Any help by AKP?\nAny problem for baby before KMC?\nAny problem during KMC?\nTotal number of visits by ASHA/CHW\nAny problems noted during home visits\nKMC completed? Y/ N Spl Follow UP Neuro exam Y/ N\nIf no, what are the reasons?\na) Problem in baby:\nb) Problem in Mother ILLness/personal/social reasons:\nROP check-up Y/ N When and Where?\nHearing screening Y/ N When and where:\nAny other comment:\nSignature of CHW:\n|53|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 61, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 178, "chroma:document": "ANNEXURES\nANNEXURE 1: SUGGESTED RECORDING & REPORTING FORMATS FOR HBKMC\nD) HOME BASED KMC REPORT FORMAT FOR COMPILATION FROM SUB-CENTER / URBAN WARD TO DISTRICT\nLEVELS\nName of District/block/PHC/subcenter/urban ward (for compilation from lower to higher levels):\nMonth\nSl No Indicator\n1 Total live births\nOut of total live birth,\n2 Low Birth Weight Children\n(Less than 2.5 kg)\nOut of Total Low Birth\n3 Weight Children how many\nreceived KMC at Facility\nOut of Total Low Birth\n4 Weight Children how many\nreceived KMC at Home\nOut of the children who\nreceived KMC at Home\n5 how many children receive\nKMC from a member other\nthan Mother\nHow many children received\n6 KMC more than 20 hours\neveryday\nHow many children received\n7 KMC between 10 to 20\nhours everyday\n|54|"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 62, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 179, "chroma:document": "ANNEXURES\nANNEXURE 1: SUGGESTED RECORDING & REPORTING FORMATS FOR HBKMC\nD) HOME BASED KMC REPORT FORMAT FOR COMPILATION FROM SUB-CENTER / URBAN WARD TO DISTRICT\nLEVELS\nName of District/block/PHC/subcenter/urban ward (for compilation from lower to higher levels):\nMonth\nSl No Indicator\nHow many children received\n8 KMC for less than 10 hours\neveryday\nOut of toal children given KMC,\n9 how many had weight gain\nas per HBNC guidelines\nOut of children who received\nKMC at Home how many\n10\nchildren identi\u0000ed with\ndanger signs\nOut of low birth weight\nchildren how many mother\n11\ncounselled for KMC by\nANM/MO\nOut of the mother's who give\n12 KMC, how many mothers had\ndif\u0000culty in breastfeeding\nOut of children who received\nKMC at Home how many\n13\nchildren died at home or\nin facility\n|55|"}


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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 63, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 180, "chroma:document": "ANNEXURES\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\n1) What is KMC? accepted even when this time of care through\nskin to skin contact is offered by AKPs like father,\nKMC is a method of holding the baby on\ngrandparents, neighbour etc.\nmother\u2019s chest in between her breasts so that\nmother and baby can have direct skin to skin,\nchest to chest or body contact- a loving body 4) When will my baby, who has been started on\nhug, which has several bene\u0000ts to newborn, KMC, be discharged from the hospital?\nmother, community, hospital and ultimately to\nYour baby will be discharged with proper\nthe nation.\nplanning, when you are keeping the baby in\nKMC for a longer duration like almost the whole\n2) Why is it called Kangaroo Mother Care? day with the help of your family members. Baby\nis breastfeeding well or you are able to express\nThis method of holding the baby in skin to skin\nmilk and feed the baby orally with the help of a"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: efc59c22-a94f-4eac-b5cb-3d057ff06263
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 63, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 181, "chroma:document": "This method of holding the baby in skin to skin\nmilk and feed the baby orally with the help of a\ncontact and providing warmth, breastfeeding,\nsmall cup, spoon or traditional feeders like\npromoting bonding and non-separation of\npaladai. Baby is doing well on KMC and able to\nmother and her baby are similar to the method\nmaintain body heat well and also starts gaining\nof care the animal Kangaroo offers to its baby\nweight of about 15-20g/Kg body wt./day for\nby keeping it in her pouch in the abdomen. The\nat least three consecutive days. As a mother, you\nPaediatrician from Bogota, Columbia, Dr Edgar\nare quite con\u0000dent of taking care of your baby\nRay conceptualized this method of care and\nat home as guided by doctors and the nurses.\nnamed it Kangaroo Mother Carebecause of\nYour family members must assure all support for\nthese similarities.\nthe care of your baby for giving KMC when\nneeded, helping with daily chores at home and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8a593890-9d27-423d-8b19-25586f302fc1
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 63, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 182, "chroma:document": "the care of your baby for giving KMC when\nneeded, helping with daily chores at home and\n3) Does it mean that KMC has to be given only by helping you to go to hospital for follow up visits\nthe mother as the name suggests? as required.\nNo, it does not mean that this method of care\nhas to be given only by the mother. KMC 5) What should be the weight of my baby at the\nincludes three main components- Kangaroo time of discharge?\nPosition (keeping the baby on mother\u2019s chest),\nThere are no \u0000xed criteria for weight for\nKangaroo Nutrition (Promoting feeding of the\ndischarge.\nbaby with exclusive breast milk either as direct\nbreastfeeding or as expressed breast milk) and\nKangaroo discharge and follow up (Planned 6) How long should KMC be done in a day?\nearly discharge and regularly scheduled follow\nKMC should be continued as long as possible,\nup for breastfeeding, growth, Immunizations\neven up to 24 hours a day with the help of AKPs\nand neurodevelopment including neuro sensory"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 76ede43f-b598-4859-a0f9-8de149a77980
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 63, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 183, "chroma:document": "even up to 24 hours a day with the help of AKPs\nand neurodevelopment including neuro sensory\nat home. One session should be for a minimum\nand behavioural development even after KMC\nof continuous one hour of effective KMC (for\nhas been stopped. The \u201cM\u201d component\nensuring one hour of effective skin to skin\nindicates the signi\u0000cance attached to breast milk\ncontact, KMC should be advised for at least one\nfeeding in KMC and breast milk only mother can\nand half hours). It is not meant that mother\nproduce, hence the term KMC is conventionally\n|56|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 3ec20e68-96bd-4668-b90b-093cf044f4f4
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 64, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 184, "chroma:document": "ANNEXURES\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\nshould stop KMC at the end of One and a half 11) How many times a day should the baby be\nhour. She can continue as long as she is breastfed?\ncomfortable in one session for more than one\nA LBW baby should be fed every 2 hours at least\nhour also.\n12 times a day. Initial few days you may offer\nfeed at decided time intervals. As the baby\n7) Why should KMC be given continuously for a grows, after an initial few days ideally, you\nminimum of one to one and half hours? should be guided by the hunger cues of the baby\nand gradually shift to demand feeding.\nDuring KMC the baby gets a sound sleep and\nduring that time the brain functions develop\nbetter. One sleep cycle is generally one hour. If 12) Should the baby be fed at night too?\nthe baby is disturbed in between the sleep cycle,\nYes, the night feeds should not be missed as milk\nthe baby is stressed and the development of the\noutput increases during night. Even when"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e062d95a-06c6-4ae4-af33-d4a621a564ba
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 64, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 185, "chroma:document": "the baby is stressed and the development of the\noutput increases during night. Even when\nbrain is likely to suffer. To achieve one good hour\noffering expressed breast milk, night feeds\nof undisturbed sleep cycle, we advise for at least\nshould not be missed, which is very often the\none and half hours taking into account some\ncase.\ntime taken for the mother and baby for adjusting\ninitially on chest to chest contact and then baby\nto go for sound deep sleep. 13) Doctor, I am really very scared to take such a\nsmall baby home. Will you please tell me what\nI should watch for and when I should bring the\n8) What is the best time of day to do KMC?\nbaby urgently?\nKMC can be done all through the day and night.\nAlways make sure that the baby\u2019s nose is open\nand the baby is breathing comfortably. When\n9) If I am able to give KMC for only a few hours in baby is in Kangaroo position, (observe all the\na day, will it be of any bene\u0000t to the baby? instructions as per the checklist given to you)"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 6365f7b5-cc48-4cb2-a087-e6f3a3f19a80
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 64, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 186, "chroma:document": "a day, will it be of any bene\u0000t to the baby? instructions as per the checklist given to you)\nkeep a watch on baby\u2019s breathing and\nDe\u0000nitely, the longer you can give KMC, more\nmovements. In case of change in the pattern of\nbene\u0000ts will be there. But even a few hours of\nbreathing, stoppage of breathing or any change\nKMC also are of some bene\u0000t. So it is worth\nin the movement of the baby, contact a local\ngiving even a few hours in a day. Efforts must\nhealthcare provider immediately. In case of\nalways continue to increase the sessions and\nstoppage of breathing for more than 20 seconds\ntotal duration of KMC as early as possible and\nat a stretch, \u0000rst try to stimulate the baby by\nas much as possible. If you can keep a record of\n\u0000icking on the sole of feet or rubbing on the back\nthe number of hours you are giving KMC it will\na few times. The baby will start breathing most of\nhelp you to improve further.\nthe time. Only after that, call for further help."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 5a8708b0-c62b-4276-b892-dd895820258f
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 64, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 187, "chroma:document": "help you to improve further.\nthe time. Only after that, call for further help.\nAlso watch for any feeding problems, baby feels\n10) How should the baby be fed while on KMC?\ntoo hot or cold on touch, yellow colouration of\nMother should try to directly breast feed her skin or eyes, any swelling or discharge from\nbaby while providing KMC. In case the baby is cord or eyes or abnormal behaviour or\ntoo weak to suckle, breast milk should be movements of hands and body (Convulsions),\nexpressed and given to the baby with a cup, loose, watery motions, refusal to take feeds and\nspoon or paladai. any such abnormal presentations. In other\nwords, when you feel that the baby is not doing\n|57|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8222c6b2-c9a4-44d4-8dec-4de590ec6516
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 65, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 188, "chroma:document": "ANNEXURES\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\nwell, seek help from the health care worker or kicking the abdomen or cries or fusses every\npreferably go to the hospital, if possible. You time you try to keep the baby in kangaroo\nmay carry the baby in KMC position if possible, position. It means the baby does not require\nduring transport. KMC anymore. For a few more weeks, the baby\nmay like to be in Kangaroo position for a short\nwhile just before sleeping or soon after bath or\n14) What should I do if the baby stops breathing?\nduring a cold environment.\nStimulate the baby by \u0000icking on the soles of feet\nor rubbing on the back of the baby to see\n18) Who can give KMC at home after discharge\nwhether the baby responds. If not, immediately\nfrom hospital?\ncall 108 and reach out to the health facility with\nan emergency paediatric unit. If frequent such Apart from mother, any responsible and willing\nepisodes of stoppage of breathing occur in a adult family member like husband,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 2634cedf-ded2-43f9-a03c-71329854d3ee
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 65, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 189, "chroma:document": "episodes of stoppage of breathing occur in a adult family member like husband,\nbaby, it will be useful to admit the baby in grandmother, aunt, or even a willing\nhospital for a few days. neighbour/friend can serve as Alternate KMC\nProvider (AKP). The AKP must observe all the\nprecautions of safety and personal cleanliness\n15) What should I do if my baby appears lethargic\nincluding cutting the nails, remove ring, bangles,\nor not taking feeds properly?\nchains etc. have a good bath, wear clean\nIf the baby shows any signs mentioned earlier, washed clothes, proper handwashing and all\ninform ASHA or ANM or take the baby to the possible measures of infection prevention. Know\nhospital. the correct technique of holding the baby in KP\nand feeding with expressed breast milk, if\nrequired. They must be able to watch for the\n16) What medicines should I give to the baby after\nearly signs of danger and take suitable\nbringing it home?\nmeasures. They should not be smoking or taking"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8403194f-3da7-4eb6-ae1b-ec9a4c00425e
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 65, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 190, "chroma:document": "bringing it home?\nmeasures. They should not be smoking or taking\nAt the time of discharge from the hospital,\nalcohol or any drugs.\ndoctors would have explained to you. Or else\nthe ANM will tell you during health and nutrition\n19) Can I do my household chores after going\ndays or during her home visit to you. You will\nhome with the baby?\nneed to give iron which helps for making blood,\nVitamin D, calcium and phosphorus for making If the baby is securely placed on your chest with\nthe bones of the baby stronger and if your baby the help of a dupatta or shawl or some special\nhas any other problem, she might be given KMC bag or wrap, you can move about with the\nsuitable medicine according to the problem. The baby and carry on with simple domestic chores.\ndetails of giving the medicine will be explained During your movements you should always\nto you. support the neck of the baby from behind to\nprevent sudden jerks and excessive bending of\nthe neck in front or back. This may be very"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 87192309-a3a5-44a9-8860-a5d74d54d582
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 65, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 191, "chroma:document": "prevent sudden jerks and excessive bending of\nthe neck in front or back. This may be very\n17) Till what age should I continue KMC?\ndangerous at times. Also support the bottom of\nThe baby will decide the time of stopping KMC.\nthe baby from below to prevent accidental\nThis usually happens when the baby reaches\nslipping and fall. All strenuous work may be\naround 37 to 41 weeks after LMP or weighs\navoided. During that time help of AKP can be\nabove 2500 grams. At this time, the baby starts\navailed of, if available. If no help is available, it\n|58|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: fd1cf48b-9447-4859-b787-5825337a69cb
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 66, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 192, "chroma:document": "ANNEXURES\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\nwill be safer to keep the baby in his/her bed the stitches may not hurt. Mother can adjust\nproperly covered and away from the direct draft herself to a position of comfort so that stitches\nof wind and then do the domestic work. may not hurt.\n20) What precautions should be taken at home 24) During summer I feel hot and uncomfortable\nduring KMC? when I keep the baby in KMC. What should I\ndo?\nPlease do not keep the baby horizontally in\nKangaroo Position, do not handle the baby If you feel hot/too warm and humid when the\nexcessively, do not give bottle feeds, do not baby is kept in Kangaroo Position, you may\npermit contact with any sick persons, do not give cover the baby well and switch on the fan if\nbath to the baby till weight gain above 2500 g is available. If you perspire more, just wipe off the\nachieved, but only sponge the baby with soft, sweat over the chest with a clean dry cloth and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: cf2c34ca-eedb-479b-b2c7-adfaa2ddbd6e
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 66, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 193, "chroma:document": "achieved, but only sponge the baby with soft, sweat over the chest with a clean dry cloth and\nclean cotton cloth soaked with lukewarm water then continue KMC.\nin a warm cozy place.\n25) Won\u2019t the baby feel hot?\n21) Can I use something to tie the baby to me?\nNo, the baby will not feel hot when kept in KMC.\nYes. A soft and strong, clean dupatta, shawl or Rather they are predisposed to become cold due\nsuch cloth can be used for securing the baby on to the following reasons:( Specially the preterm\nmother\u2019s chest during KMC. It should not be tied babies)\ntoo tightly. That may sometimes suffocate the\n* They have a higher ratio of skin surface to\nbaby. The use of specially prepared KMC bag or\nbody weight.\nwrap is very helpful, if available. It adds to the\nsafety and comfort of the baby and mother also * They have decreased subcutaneous fat with\nfeels secure to move around with the baby in less insulation capacity.\nKMC on direct skin to skin /chest to chest"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 68ace5cb-ef3e-4da9-89d3-f84b13a31ff6
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 66, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 194, "chroma:document": "KMC on direct skin to skin /chest to chest\n* They have limited capacity to shiver and\ncontact. But it is not a must.\nconserve body heat. In premature babies\nstores of a special type of brown fat is less\n22) Can I do KMC with my clothes on my chest? developed and therefore body heat\nproduction is less.\nNo, mother/AKP cannot do KMC with blouse,\nshirt or any layer of clothing of the mother on * The small babies are unable to consume\ntheir chest. This disrupts the direct skin to skin enough calories to provide nutrients for\ncontact between mother/AKP and the baby and body heat production and growth.\ndoes not help for keeping the baby warm and\n* Oxygen consumption is limited in some\nget many other bene\u0000ts.\npreterm babies because of lung immaturity.\n* There is increased heat loss due to extended\n23) My stitches hurt when I have to sit with the\nposture and immature skin.\nbaby in KMC?\nThey tend to lose body heat easily due to several\nBy keeping the baby on the mother's chest and\nmechanisms."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: eca03f85-94ff-419b-8b0e-3b66dd41746c
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 66, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 195, "chroma:document": "By keeping the baby on the mother's chest and\nmechanisms.\nreclining for about 35 to 45degrres while sitting,\n|59|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ccb4eaf5-797e-4086-97c7-afaa7afca74b
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 67, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 196, "chroma:document": "ANNEXURES\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\n26) What is the normal body temperature of the the mother for KMC and give her privacy to put\nbaby? the baby in the KMC position. A healthy adult of\nthe family can provide KMC to give mother\nNormal body temperature of a newborn baby is\nsome time off. Family members can take over\n36.5 to 37.5 degrees C.\nother tasks of mother, so that she can devote\nexclusive time to her infant.They can help for\n27) Can I do KMC, if my baby has fever? regular follow up and take mother for special\nfollow up.\nYes, KMC can be done even when the baby has\na fever. If baby\u2019s body temperature increases by\none degree C, the mother's body temperature 31) What can be done if a family does not support\ndecreases by 1 degree C. The reverse also can the mother for providing KMC?\noccur This is called thermal synchrony during\nIt is important for the whole family to be aware\nKMC. In hot summer time when environmental"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 083eef9c-4efe-4be7-afb9-12d752817b22
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 67, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 197, "chroma:document": "It is important for the whole family to be aware\nKMC. In hot summer time when environmental\nof all the bene\u0000ts of KMC. Family should be\ntemperature rises, many newborns also have\ncounselled for this in the hospital where the baby\nhigh body temperature. In such situation, a few\nwas started on KMC or by ASHA or ANM at\nobservers in the Indian set up have noted that\nhome. Family should be made to understand\nKMC helps in preventing the rise of body\nand contribute towards the wellbeing of the\ntemperature of the baby. More studies are to be\nbaby.\nundertaken to con\u0000rm these \u0000ndings.\n32) When do we need to have a repeat checkup\n28) When can I give a bath to the baby?\nfor the baby?\nGive a bath to the baby when the baby's weight\nYou will be given a regular schedule of follow up\nreaches around 2500g, and no other problems\ndepending on the condition of your baby. You\nare noted. Use lukewarm water for bath in a\nwill be told to come to the hospital as early as\nwarm environment and dry the baby"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9abfe371-edb5-4338-b7a5-e55b7decbaa7
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 67, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 198, "chroma:document": "will be told to come to the hospital as early as\nwarm environment and dry the baby\npossible. Till the baby reaches about 37 weeks\nimmediately.\nafter LMP, twice a week checkup will be\nrequired. After that, till 40 weeks after LMP, and\n29) If I have to interrupt KMC for a short duration, /or till wt. reaches above 2500g. at least once a\nwhat precautions should I take? week, a checkup will be required.\nThe baby should be adequately clothed-head\ncap, socks, mittens and well covered body and 33) What checkup will be done during these visits?\nkept in a clean, warm bed, in supine\nThey will check up the weight, length and the\nposition/prone position with head turned to one\nhead circumference to make sure that the baby\nside as shown by the CHW/ in hospital.\nis getting adequate feeding and growing well.\nGeneral checkup of the baby will be done to\n30) How can family members offer support for make sure that the baby does not have any\nKMC? problems. Suitable vaccinations will be done"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d2b94059-b78f-4c30-978e-d6cdb0449eba
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 67, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 199, "chroma:document": "KMC? problems. Suitable vaccinations will be done\nand if you have any concerns, that will be\nA supportive family is a prerequisite for the\naddressed. Then they will check up for brain\nsuccessful KMC. Family should give\ndevelopment of the baby by doing a special\npsychological support and encouragement to\nexamination. They will make sure you are giving\n|60|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 7dcab9ee-5f8e-443c-adfa-9c6324529720
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 68, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 200, "chroma:document": "ANNEXURES\nANNEXURE 2: FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT KMC\nproper KMC and exclusive breastfeeding. In a few districts, developmental and early\nAdvice will be given for how to improve the intervention centers (DEIC)have been started by\nquality of care better and also check up whether health departments. Their help can be taken for\nyou are able to watch for the danger signals and the developmental checkup of the preterm and\nknow whom to contact and how to reach the LBW babies. Your local CHW will be able to\ndoctor. guide you and help for these special checkups\nfor your small babies.\n34) In case I am not able to go to the hospital for a\nrepeat checkup, what should I do? 35) How can I travel with my small baby for\nhospital visits? Is it safe for my baby?\nWhen hospital visits are not possible, you can\ncall your hospital doctor, if available and consult If you take proper precautions to cover your"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f700befc-b987-4d6b-b55a-5452ec996003
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 68, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 201, "chroma:document": "call your hospital doctor, if available and consult If you take proper precautions to cover your\nfor further care. If that is also dif\u0000cult, then local baby properly with cap, diaper, socks and\nCHW like ASHA or ANM can be contacted. mitten and cover well with blankets and\nMostly, they will contact you and give advice constantly observe your baby during travel, it\nregarding essential newborn care including will be safe to travel with the baby. Always be\nKMC and breastfeeding and help you for further with your baby during hospital visits. In case you\nreference if some serious concern is there. are very sick and not able to accompany the\nbaby, some responsible adult family member\nIn case of preterm babies/or LBW babies with\ncan carry the baby. In that case, please try to\nless than 1750g birth weight or those babies\ngive expressed breast milk for feeding on the\nwho had some serious problem and required\nway in a clean container. If long distance travel is"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f7e4c345-e56a-45d5-be66-7ffc37ea053c
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 68, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 202, "chroma:document": "who had some serious problem and required\nway in a clean container. If long distance travel is\noxygen treatment for a few days, special eye\nthere in a vehicle, preferably the vehicle should\ncheck-up (ROP) must be done before one month\nbe stopped and only then feeds should be given.\nof age of the baby. This helps in taking prompt\nThis helps to avoid possible milk aspiration in a\nearly treatment in case of some eye damage\nmoving vehicle.\nwhich may occur following oxygen treatment\nand prevent blindness in future. This is very Carrying the baby in Kangaroo Position/KMC\nimportant and if facilities are not available and breastfeeding is very safe during travel and\nlocally, all efforts must be done to visit bigger ideal for the babies who are otherwise normal\nhospitals where such an expert facility is and healthy or mildly sick. Even for seriously ill\navailable. babies, KMC during transport is much better\nparticularly when a specially equipped transport"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c817aeb0-f58d-46a4-8707-0c5a4a767208
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 68, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 203, "chroma:document": "particularly when a specially equipped transport\nSimilarly, it is advisable to get a checkup for\nteam is not available. KMC transport helps to\nhearing done before 40 weeks of age from LMP.\nprevent body cooling, chances of infections and\nIf some problem with hearing is detected early\nunnecessary jolts during travel leading to serious\nand suitable treatment given to the baby, long\nproblems of head injuries and other\nterm problems including speech problems can\ncomplications.\nbe avoided. This facility for hearing checkup of\nthe tiny babies is available only in very few\nhospitals. Your CHW may guide you for that.\n|61|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a2522d26-a624-49ad-9509-611f423b843f
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 69, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 204, "chroma:document": "ANNEXURES\nANNEXURE 3: KMC PRETEST (SAMPLE QUESTIONNAIRE)\nANNEXURE 3: KMC PRETEST (SAMPLE QUESTIONNAIRE)\nQ. 1 : What does KMC stand for? Q. 5 : In Kangaroo Position, the baby should be\nplaced\na. Skin to skin contact.\na. On mother\u2019s chest in between the breasts.\nb. Prolonged skin to skin contact.\nb. On mother\u2019s chest in between the breasts in\nc. Kangaroo Method of Care.\nas much vertical position as possible and\nd. Kangaroo Mother Care. lower limbs \u0000exed in frog leg position.\nc. On mother\u2019s chest in between the breasts\nQ. 2 : Where did KMC start? so that baby\u2019s chest and abdomen are in\ncontact with the mother\u2019s chest and baby\u2019s\na. Australia.\nneck slightly extended to have open airway\nb. England.\nand eye to eye contact with the mother and\nc. Colombia. limbs in frog like position.\nd. India. d. Baby on mother\u2019s chest and feeding on\nbreast.\nQ. 3 : Why is KMC given to the Newborn?\nMention if the following statements are true (T) or\na. To prevent hypothermia.\nfalse(F)"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e6057b35-c8b3-4ec3-a36d-17994dc544d4
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 69, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 205, "chroma:document": "Mention if the following statements are true (T) or\na. To prevent hypothermia.\nfalse(F)\nb. To prevent neonatal jaundice.\nQ.6: KMC has to be given only by mothers.\nc. To prevent infections.\nQ.7: It is dif\u0000cult to breastfeed while giving\nd. All of the above. KMC.\nQ.8: KMC can prevent neonatal infections.\nQ. 4 : Kangaroo Mother Care includes\nQ.9: KMC is not required for term babies.\na. Immediate skin to skin contact after birth of\nQ.10: KMC is not required in hot and humid\nthe baby.\nweather.\nb. Early and prolonged skin to skin contact for\nQ.11: Mother cannot work while giving KMC.\nthe baby.\nQ.12: KMC can prevent only hypothermia in the\nc. A loving, systematic hug of the baby by\nbaby.\nmother.\nQ.13: KMC helps with neurodevelopment.\nd. A loving, systematic hug of the baby\ncombined with breast milk feeding as much Q.14: KMC can be given during neonatal\nas possible and planned discharge and transport.\nregular follow up.\n|62|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4f3dba3f-15fb-41e6-aada-9d2e49fc7400
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 70, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 206, "chroma:document": "ANNEXURES\nANNEXURE 3: KMC PRETEST (SAMPLE QUESTIONNAIRE)\nQ.15: KMC cannot be given without special Q.20: KMC helps in reducing neonatal mortality.\nbinders.\nQ.21: KMC makes breastfeeding dif\u0000cult.\nQ.16: Early skin to skin contact soon after delivery\nQ.22: Home based KMC needs preparation in\nis the same as KMC.\nthe facility.\nQ.17: Home based KMC is not very ethical and\nQ.23: It is important to tell mothers about danger\nsafe.\nsignals in their newborn .\nQ.18: The longer the duration of KMC in a day\nQ.24: National guidelines help in promoting\nthe better is the effect on the baby.\nKMC in a country.\nQ.19: KMC can help in relieving mild to\nQ.25: Implementation of KMC at national level\nmoderate pain in newborns.\ndoes not involve any expenses.\nAnswer Key to Pre-test\nQ1-d, Q2-c, Q3- d, Q4-d, Q5-c, Q6-F, Q7-F, Q8-T, Q9-F, Q10-F, Q11-F, Q12-F, Q13-T, Q14-T,\nQ15-F, Q16-F, Q17-F, Q18-T, Q19-T, Q 20-T Q21-F, Q22-T, Q23-T, Q24- T, Q25-F\n|63|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 843fe28f-d413-40c6-bdc4-c1599db4273e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 71, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 207, "chroma:document": "ANNEXURES\nANNEXURE 4: QUESTION BANK FOR SELF-LEARNING EXERCISE (AND FOR PRE AND POST-TESTS)\nANNEXURE 4: QUESTION BANK FOR SELF-LEARNING EXERCISE (AND FOR PRE AND POST-TESTS)\n(Answer key given in the end) Q.4. How many feeds should a small baby\nreceive in a day?\nQ.1. Which of the following statements correctly\ndescribes a well small baby? a) Two to Four.\na) Feeds by cup, stays warm with skin to skin b) Eight to Twelve.\ncare, has abnormal movements.\nc) Five to Six.\nb) Feeds by cup, stays warm with skin to skin\nd) Twenty-Four.\ncare, weighs 1600g.\nc) Breastfeds poorly, breathes with dif\u0000culty,\nQ.5. Which of the following indicates feeding\nmaintains temperature with KMC.\nintolerance and the need for advanced care?\nd) Feeds by cup, weighs 1200g, maintains\na) Spitting up small amounts.\ntemperature only when KMC is given.\nb) Tense abdominal distension.\nQ.2. Which of the following is an important step c) Passing stools 6 to 8 times a day.\nin the care of a small baby?"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a1867476-d19b-4acd-abdf-48aa4eb328ba
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 71, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 208, "chroma:document": "in the care of a small baby?\nd) Crying before each feeding.\na) Teaching the mother to give bath to baby\nand keep the baby clean and dry.\nQ.6. When should the mother or other providers\nwash their hands in order to protect a small\nb) Giving the small baby lots of time in early\nbaby?\nmorning sunlight.\na) Before touching the baby and before\nc) Preventing infection by washing hands\npreparing a feeding.\nbefore touching the baby.\nb) Before greeting the family.\nd) Weighing the small baby twice a day.\nc) Before leaving home for follow up of the\nQ.3. Shortly after birth, the feet of the baby with baby.\n1800g weight feel cold. But the abdomen is\nd) Before preparing baby\u2019s bed.\nwarm to touch. After placing the baby in\nKangaroo position, the baby\u2019s temperature\nQ.7. A small baby needs to be referred for\nremains the same. Which of the following\nadvanced care to a hospital one hour away.\nactions should be taken?\nWhat should you do to prepare the baby for\na) Place the baby in sunlight.\ntransport?"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ff6a050c-92fb-432b-aace-b771b0d07032
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 71, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 209, "chroma:document": "What should you do to prepare the baby for\na) Place the baby in sunlight.\ntransport?\nb) Bathe the baby in warm water.\na) Change the clothes of the baby and keep\nexpressed breast milk ready to feed on the\nc) Call the health worker.\nway.\nd) Remove the wet diaper and cover the\nb) Communicate with health care providers at\nmother and baby in skin to skin on chest\nthe receiving facility and the family, and\nwith a blanket.\nprepare a referral note.\n|64|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 09dcdb0c-adca-49d9-b563-e29c92b2e520
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 72, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 210, "chroma:document": "ANNEXURES\nANNEXURE 4: QUESTION BANK FOR SELF-LEARNING EXERCISE (AND FOR PRE AND POST-TESTS)\nc) Mother can rest at home. Relatives can take b) Similar cost to the client.\nthe baby for further care.\nc) Longer duration of exclusive breastfeeding.\nd) Baby to be carried in skin to skin position\nd) It is easier for mother.\nduring travel by mother or any helpers\nfrom the family.\nQ.12. Baby Leela was born at home and is now\nbeing cared for with the KMC method. She is\nQ.8. Baby of Ganga weighs 1200 g after one\nable to take direct breastfeeding. But\nhour of birth He is more likely to have a\nbecomes tired frequently. Her weight is not\nproblem with\nincreasing. In order to ensure enough\na) Low blood sugar. nourishment to the baby the ASHA worker\nteaches the mother to:\nb) Warmth.\na) Give goat milk by paladai.\nc) Infections.\nb) Bottle feed expressed breast milk.\nd) All of the above.\nc) Give sugar water in between.\nQ.9. Baby of Anjana has a birth weight of 1400g. d) Give expressed breast milk by cup."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e5a82ee0-58ec-4da8-be88-bdd6d421ad21
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 72, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 211, "chroma:document": "Q.9. Baby of Anjana has a birth weight of 1400g. d) Give expressed breast milk by cup.\nHe will bene\u0000t most from:\na) A small amount of sugar water in the \u0000rst Q.13. While observing a mother expressing breast\nday of life. milk, the doctor notices that she massages\nthe breast from the outside toward the\nb) Prolonged skin to skin contact on mother\u2019s\nnipple. The doctor encourages the mother to:\nchest.\na) Massage the breast in the opposite\nc) Antibiotics by injection.\ndirection.\nd) Cord care by applying medicines on the\nb) Massage both the breasts at the same time.\ncut stump to prevent infection.\nc) Continue the correct technique.\nQ.10. Kangaroo Mother Care d) All of the above.\na) Should be given only by the mother.\nQ.14. Danger signs in LBW babies are:\nb) Should only be given in hospital under the\ndirect guidance of doctors. a) Different than for normal weight babies.\nc) Both a and b. b) Can be mostly managed at home."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 764f215d-e49c-4716-827b-74b8744af0a9
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 72, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 212, "chroma:document": "c) Both a and b. b) Can be mostly managed at home.\nd) Is a natural method for caring for LBW c) Serious and include feeding and breathing\ninfants. problems.\nd) Can be detected only by the nurses and\nQ.11. The most important advantage of KMC doctors.\ncompared to conventional care include:\na) Can be done by providers if mothers are\nbusy.\n|65|"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 73, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 213, "chroma:document": "ANNEXURES\nANNEXURE 4: QUESTION BANK FOR SELF-LEARNING EXERCISE (AND FOR PRE AND POST-TESTS)\nQ.15. Early feeding of LBW babies with only breast b) The mother should keep a hot water bottle\nmilk can result in: wrapped in cloth next to baby to keep the\nbaby warm on the way.\na) More dehydration and eventual\nhypoglycemia. c) The mother should carry the baby in skin to\nskin contact on her chest during travel.\nb) Superior rates of weight gain.\nd) The mother or her helper should ensure that\nc) High incidence of vomiting and diarrhoea\nthe baby is periodically given sugar water\nin preterm babies.\non the way.\nd) Slow gastric emptying in babies less than\n37 weeks.\nQ.19. How long should the baby be given only\nbreast feeding?\nQ.16. Essential newborn care for ALL babies,\na) First four months of life.\nregardless of weight, should include which\none of the following? b) First six months of life.\na) Cord stump should be kept clean and dry. c) As long as the mother wishes."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 73, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 214, "chroma:document": "a) Cord stump should be kept clean and dry. c) As long as the mother wishes.\nb) Intermittent KMC. d) As long as the baby can take.\nc) Preventive drugs for malaria.\nQ.20. During hot summer months, the baby of\nd) All of the above.\nMeena has developed a fever. Baby is\nbreastfeeding well. How will you manage\nQ.17. A mother has been practising KMC at home this child?\nfor four weeks. Her baby now weighs\na) Arrange for ambulance to take to hospital.\n2500grams. When she returns for a follow -\nup visit, the doctor advises her that she can: b) Call the ANM to give Inj. Gentamicin.\na) Continue KMC until the baby gains more c) Advise KMC and continue breastfeeding.\nweight.\nd) KMC cannot be given when the baby has\nb) Discontinue KMC if the baby is otherwise fever.\nwell, but fusses when kept in kangaroo\nposition.\n\u2022 Indicate true T or false F in the following\nc) Return after one week for follow up. statements\nd) Baby has to be sent for check up for ROP"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c99e8f3f-82b2-4906-a186-2dad5bf22927
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 73, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 215, "chroma:document": "c) Return after one week for follow up. statements\nd) Baby has to be sent for check up for ROP\nby specialist doctor. Q.21. Ideally Kangaroo Mother Care has three\nmajor components ie, Kangaroo Position,\nKangaroo Nutrition and Kangaroo\nQ.18. During home visit the CHW \u0000nds the baby is\nDischarge.\nnot taking feeds and appears unconscious.\nShe should encourage following except:\nQ.22. Kangaroo Mother Care can be given only by\na) Encourage mother to express breast milk in\nmother as suggested by the name.\na bottle to feed on the way to hospital.\n|66|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 669957db-8471-4bc7-8ee8-0667b3ca9a02
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 74, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 216, "chroma:document": "ANNEXURES\nANNEXURE 4: QUESTION BANK FOR SELF-LEARNING EXERCISE (AND FOR PRE AND POST-TESTS)\nQ.23. Hair on father\u2019s chest is not a barrier for Q.27. Expressed breast milk can be stored in room\ngiving skin to skin contact on father\u2019s chest. temperature for about ten hours.\nQ.24. Soon after birth, for baby of Nirmala, cord Q.28. Zero separation of mother and the newborn\nwas cut immediately, the baby was dried baby helps in improving the neuroprotection,\nwell by a clean dry towel, the wet towel was early stabilization of physiological\nremoved, the baby was covered well and parameters, and early start for successful\nkept in a separate cradle. This is the correct breastfeeding.\nsequence of caring for the baby in the \u0000rst\nfew minutes after birth.\nQ.29. Baby of Glory had to be given a heel prick\nfor collecting blood for investigations. Mother\nQ.25. Mother Hasina had twins. One baby had to kept her baby in KMC.It is good for the baby.\nbe given top feeds as mother cannot get"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 2fc49212-5810-4967-9c0a-bb86952ea863
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 74, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 217, "chroma:document": "be given top feeds as mother cannot get\nenough milk for two babies .\nQ.30. The best place for care of the preterm baby is\nthe mother's chest.\nQ.26. Baby of Leela is delivered by Caesarean\nsection and it is not possible to start\nimmediate skin to skin contact on the\nmother's chest and to start breastfeeding\nwithin one hour of birth.\nAnswer Key:\nQ1-b, Q2- C, Q3- d, Q4- b, Q5-b, Q6- a, Q7- b and d, Q8- d, Q9-b, Q10-d, Q11-c, Q12-d,\nQ13-c. Q14- c, Q15-b, Q16- a, Q17- b, Q18-b, Q19-b, Q20-c, Q21-T, Q22-F, Q23- T, Q 24-F,\nQ25-F, Q26- F, Q27- F, Q28- T, Q29-T, Q30- T\n|67|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ec1a28be-6abd-4928-993a-9f33edb6ec0e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 75, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 218, "chroma:document": "ANNEXURES\nANNEXURE 5: TRAINING FOR KMC SUGGESTED AGENDA FOR TRAINING CHWs FOR HBKMC\nANNEXURE 5: TRAINING FOR KMC SUGGESTED AGENDA FOR TRAINING CHWs FOR HBKMC\nIt can be as a continuous program for one or two (a loving hug between the neonate and the\ndays (Preferable) or split into few sessions a day and mother or Alternate KMC Provider AKP).\nspread over a few days. or one full day program and\nInitial counselling with mother and her family\nl\nreinforcement again during monthly meetings.\nmembers.\n(One session each time); (It should be always\nemphasized that KMC is one part of essential care of\nAdvanced preparations for HBKMC\nthe newborns with special emphasis on care of\nLBWI). l Collecting the supplies.\nSelecting and preparing the place.\nl\nSession I: Introduction -30 minutes\nv Welcome to the program and objectives of the Immediate preparations just before putting the\ntraining. baby on KP\nv Introduction of participants. l Preparing the neonate.\nv Pretest. l Preparing the mother."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 75, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 219, "chroma:document": "v Introduction of participants. l Preparing the neonate.\nv Pretest. l Preparing the mother.\nl Magnitude of problem of new -born care in l Actual positioning the baby on mother\u2019s chest\nIndia and challenges. and the precautions to be taken (Check list).\nl De\u0000nitions and classi\u0000cations of the l Monitoring during Kangaroo position.\nnewborns.\nIdenti\u0000cation of danger signals as early as\nl\nBasic principles of care of new-borns with possible.\nl\nspecial reference to LBWI including preterm\nTraining the AKP also for KMC.\nl\nbabies.\nPractice with dolls; (Video demonstration and visit to\nSession II: Basics and bene\u0000ts of KMC- 45 minutes\nKMC mother if possible).\nv What is KMC? Origin of KMC.\nSession IV: KMC Nutrition \u2013Important\nBene\u0000ts of KMC.\nl\nconsiderations\nBene\u0000ts to baby, mother, family, society,\nl\nPromotion of exclusive breast milk feeding as far as\nhospital and nation.\npossible and other alternatives as possible-\nBasics of KMC- De\u0000nition, Description,\nl"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 75, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 220, "chroma:document": "possible and other alternatives as possible-\nBasics of KMC- De\u0000nition, Description,\nl\nDiscussion and video presentation- 90 minutes.\nComponents, Scope.\nGolden rules of breastfeeding (early initiation,\nDuration in each session, Types (Intermittent, l\nexclusive breastfeeding for \u0000rst six months of life.\nContinuous), when to stop and other details.\nWhat to feed? How to feed? How much to feed?\nl\nSession III: Practical aspects of KMC How often to feed? How to assess adequacy of\nfeeds? Etc.\nKangaroo Position and hands on demonstration\nl\nand video- 90 minutes. l Supplementation of Micronutrients.\n|68|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 806addc3-3d33-46f5-90a2-c26d2e3227e5
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 76, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 221, "chroma:document": "ANNEXURES\nANNEXURE 5: TRAINING FOR KMC SUGGESTED AGENDA FOR TRAINING CHWs FOR HBKMC\nAlternatives to mother\u2019s own milk (when Session VI: Recording and reporting about KMC\nl\nabsolutely necessary). and use of MCP card-30 minutes\nTechnique of Expressed breast milk expression, Why is recording important?\nl l\ncollection, storage and administration by\nProper method of \u0000lling the records and reports.\nl\ndifferent modes ie cup, spoon, paladai etc.\nMethods to sustain lactation when direct\nl Session VII: Communication and Counselling for\nbreastfeeding is not possible and only EBM has\nimproving the quality of KMC- 30 minutes\nto be given.\nBasic objectives and signi\u0000cance of\nl\nHygienic handling of breast milk feeding and\nl communication and counselling.\ntop feeding.\nBasic principles of counselling \u2013 Greet, Ask,\nl\nAssessment for adequacy of feeding.\nl Listen, Praise, Advise and Communicate\nSkills for collecting EBM and different methods of (GALPAC).\nl\nfeeding can be shown by video clips; Technique"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 76, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 222, "chroma:document": "l\nfeeding can be shown by video clips; Technique\nWhen to counsel? What points should be\nl\nof handwashing by demonstration; Technique of\nemphasized during each session?\nweighing the baby by demonstration.\nMultiple stages of counselling:\nl\nSession V: Regular follow up of KMC babies-30 v During Antenatal care; * before delivery and just\nminutes before initiating KMC.\nl Why is follow up important? l During the practice of KMC.\nl Home based follow up frequency and checklist l During follow up home visits after completion of\nof activities during each follow up visit for both KMC.\nbaby and mother.\nIf possible, facility based regular follow up is Session VIII: Open house discussion on barriers and\nl\nideal; If not possible, at least for special follow up enablers /(problems and possible solutions) for\nfor neurological assessment, ROP and hearing practice of HB KMC \u2013 30 minutes\nscreening, follow up at facility.\nIntroduction, objectives of the workshop, Pre-test;"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 76, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 223, "chroma:document": "screening, follow up at facility.\nIntroduction, objectives of the workshop, Pre-test;\nRoutine follow up includes complete Post-test, certi\u0000cates, valedictory etc.- 45 minutes.\nl\nexamination of the baby, assessment of\nTwo tea breaks and one lunch break\u2014total one hour.\nbreastfeeding, growth, advice for vaccinations,\n(If it is a continuous one day program)\nand any other concern of mother, checkup for\ndanger signals if any. Total duration of minimum 8 hours.\nl How to establish link with the facility and notes PPT, Video, guidelines/module/ charts etc. will be\nand other details of referral and transfer/ used during training.\ntransport including skin to skin contact during\ntransport.\n|69|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 86de12a6-762d-4e3d-954e-5578b7a31ba1
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 77, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 224, "chroma:document": "ANNEXURES\nANNEXURE 5: TRAINING FOR KMC SUGGESTED AGENDA FOR TRAINING CHWs FOR HBKMC\nList of skills to be checked at the end of the training: mobile number/phone number of the referral\nhospital or the doctor, List of danger signals,\nTechnique of holding a small/ preterm baby and\nl\nMamta card or mother and child protection card\nthe precautions while handling a LBW baby.\n( MCP card) and how to use them.\nTechnique of weighing a small baby accurately.\nl\nCarrying the baby in Kangaroo position during\nl\nl Drying and wrapping the baby. referral visits to hospital or other places.\nPreparing a clean well -ventilated place for\nl\nHBKMC. Reference materials:\nCollecting the needed supplies. Manual for HBKMC for CHWs (by aKMCF and\nl l\nothers).\nPreparing the baby for Kangaroo positioning\nl\nTraining charts and videos (by KMCF and\nl\nUse of KMC bag/ wrap, if available.\nl\nothers).\nDemonstration of preparing washable,re -\nl\n** MOHFW GOI publications:\nusable cloth diapers for the baby."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8818c5d2-88b3-430a-983f-e854b0494d4e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 77, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 225, "chroma:document": "l\n** MOHFW GOI publications:\nusable cloth diapers for the baby.\n* Guidelines for KMC and optimal feeding\nKangaroo position.\nl\nfor LBWI.\nKeeping the baby warm and clean when not on\nl\n* Guidelines for Home based newborn care.\nskin to skin contact on mother\u2019s (AKP\u2019s) chest.\n* NSSK manual.\nMonitoring the baby and early detection of\nl\ndanger signals and immediate actions to be * ASHA training booklets.\ntaken.\n* IYCF training module.\nPositioning and latching for breastfeeding.\nl\n* Mother and Child protection Card.\nTechnique of hand washing and other infection\nl\n* Manual on early child development/care\nprevention measures.\nduring \u0000rst 1000 days.\nTechnique of Expression of breast milk,\nl\n* MCP card.\ncollection, storage and administration\nhygienically.\nNoting down the emergency ambulance service\nl\nnumber/ name, address, directions/route,\n|70|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f18997f1-1923-422a-a879-53e6eb421ba9
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 78, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 226, "chroma:document": "ANNEXURES\nANNEXURE 6: BUDGET FOR HB KMC ROLL OUT IN A DISTRICT (PROPOSED FOR 100 TRAINEES)\nANNEXURE 6: BUDGET FOR HB KMC ROLL OUT IN A DISTRICT (PROPOSED FOR 100 TRAINEES)\nUnit cost Total cost\nSr. Name of the item Total units\nRupees (INR)\n1. One day training of block level trainers (MOs/Block\nCommunity Mobilizers/District community mobilizers)\na. Travel@Rs.500/person for 100 persons 500 100 50,000\nb. Lunch/Tea @Rs. 200 per person for 100 persons 200 100 20,000\nc. Honorarium for 2 trainers ( @ Rs. 2000/per trainer) 2000 2 4000\n2. One day training of all ASHAs/ASHA facilitators\nA. Travel@Rs.100/person for 1000 persons 100 1000 100,000\nB. Lunch/Tea@Rs.200 per person for 1000 persons 200 1000 200,000\n3. KMC Bags\na 10,000 KMC bags@Rs.50 per bag 50 10,000 500,000\nb Printing of reporting formats 26,000 26,000\nc Health education and training materials 150 100 15000\nd Incidental Expenses 50 100 5000\nTOTAL 9,20,000\n|71|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f0c15967-0bce-4cf1-baa7-057a8c5eebd7
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 79, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 227, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (7.1 IMPORTANT SKILLS FOR USE OF SIMPLE INSTRUMENTS)\nANNEXURE 7: ADDITIONAL RESOURCES\n(7.1 IMPORTANT SKILLS FOR USE OF SIMPLE INSTRUMENTS)\nRecording of the weight of the newborn: Better method suggested:\nFor use in the community very accurate scales Do not undress the baby; Weigh the baby with\nl\nreading a minimum of 10 grams should be the clothes.\navailable. They must be easy to use and easy to carry\nThen undress the baby and quickly transfer the\nl\nduring home visits. Currently available scales are not\nbaby and in another set of warm clean clothes\nvery useful for monitoring the progress in newborns\nand cover well immediately.\nand particularly small babies who are being given\nLeave the original baby clothes on the weighing\nKMC. l\npan and weigh only the clothes.\nGenerally, two types are available: Deduct the weight of the clothes from that of the\nl\ntotal weight of the baby with the clothes and get\n1) Infant weighing scales with pans."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 877fa62a-6c96-4456-bc28-282290f97a41
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 79, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 228, "chroma:document": "l\ntotal weight of the baby with the clothes and get\n1) Infant weighing scales with pans.\nthe actual weight of the baby.\n2) Infant weighing sling scales with hook and bag.\nAdvantages of this method: No need to undress\nl\nUsing infant weighing scales with a pan: the baby and expose the baby on weighing\nscale.\nUsually a minimum of 100 or a few with 50 grams\naccuracy are available. l In case, the baby passes urine or stools while\nrecording the weight, that remains in the left out\nEnsure the weighing machine is placed on a \u0000at\nl\nclothes on the weighing pan and even helps for\nsurface and the pan is placed centrally.\naccurate weight calculation.\nAdjust the scale to zero each time before\nl\nEven in hospitals this method is very useful and\nl\nrecording the weight.\nsafe for the baby.\nPlace a clean towel or clean paper on the pan.\nl\nThis method is very useful especially for very\nl\nl Adjust the setting to zero. small babies and when digital scales are used."}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 79, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 229, "chroma:document": "l\nl Adjust the setting to zero. small babies and when digital scales are used.\nl Before undressing the newborn, make sure that l Strongly recommended for use in community for\nthe room temperature is maintained well. LBW and preterm babies.\nUndress and place the baby on the weighing\nl\nUse of colour coded sling weighing scale:\npan.\nHold the scale by the top bar, keeping the\nMake sure that the baby is placed centrally on l\nl\nadjustment knob at eye level.\nthe pan.\nTurn the screw until \u201c0\u201d is visible.\nRecord the reading on the case notes with l\nl\nmother and your register. Remove sling from the hook and place it on a\nl\nclean cloth.\nInform the mother about baby\u2019s weight.\nl\nPlace baby in the sling with minimum clothes on\nRemove the baby from the weighing scale and l\nl\nand put the sling back on the hook.\ndress back quickly.\nHold the top bar carefully, lift the scale and sling\nRemove the used towel or paper. l\nl\nalong with the baby, until the knob is at eye level.\nClean the pan if it is soiled."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 79, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 230, "chroma:document": "l\nalong with the baby, until the knob is at eye level.\nClean the pan if it is soiled.\nl\nRead the weight and record in register.\nl\nGently unhook the sling with baby.\nl\n|72|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 80, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 231, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (7.1 IMPORTANT SKILLS FOR USE OF SIMPLE INSTRUMENTS)\nRemove the baby from sling and hand over the The armpit of the baby should be cleaned and\nl l\nbaby to mother. dried before taking the temperature.\nRecord the weight and inform the mother. Make sure the thermometer is wiped and clean.\nl l\nIf the baby is born 1-2 months early or weighs\nl\nSteps:\nless than 1500g. refer to a facility for admission.\nUse digital thermometer.\nIf weight is not possible and baby looks very l\nl\nsmall, follow the guidelines for care of LBW l Place the tip of the thermometer under the baby\u2019s\nbaby at home by continuing KMC, keeping the arm, in the middle of the armpit against the bare\nbaby warm and feeding with expressed breast skin.\nmilk till baby is ready for breastfeeding. Proper\nGently hold the baby\u2019s arm against the body.\nl\nhandwashing and infection prevention\nKeep the thermometer in place at least for three\nmeasures must be practised. l\nminutes or till it beeps."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f86c3498-58e9-4dcd-a506-72609982b64a
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 80, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 232, "chroma:document": "measures must be practised. l\nminutes or till it beeps.\nRecording of axillary temperature of the baby: Remove the thermometer and read the\nl\ntemperature.\nNormal Temperature in a newborn is 36.5-37.4\ndegrees Celsius. Accurate recording of temperature Keep the thermometer in a sterile container after\nl\nis particularly desired when the baby is wiping it clean preferably with spirit swab if\navailable or with soap and water.\nSick.\nl\nRecord the temperature in baby\u2019s case notes with\nLow birth weight / Preterm. l\nl\nmother and records with the worker.\nWhen baby is suspected to be cold or very\nl\nWhenever thermometer use is not possible,\nwarm to touch. l\ntemperature assessment can be done by touch\nWhen the baby is being given warmth by\nl (Palpatory) method, which is already described\nkeeping in KMC.\nin detail.\nWhen feet of the baby felt cold to touch.\nl (** When the baby remains persistently very cold"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 80, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 233, "chroma:document": "When feet of the baby felt cold to touch.\nl (** When the baby remains persistently very cold\nWhen the baby is being cooled for having high (Both feet and abdomen feel cold to touch and do not\nl\nbody temperature when ill or during peak of the improve with simple measures like covering the body\nsummer with very hot environmental and hospital transfer is not likely or delayed, the\ntemperature or covered with many layers of following method can be tried.\nclothing.\nIn such dif\u0000cult situation at homes, if possible, a\nWhen accurate temperature is needed, use of a cotton bundle of cloth can be warmed by rubbing on\nthermometer is needed. The Health worker may a heated thick iron pan (\u201ctawa\u201d (used in Indian\ncarry one or even the family may have one. A homes for making chapati/roti) and the heated pad\ntemperature taken in the axilla (under the armpit) is of cloth is \u0000rst tested for the degree of heat by rubbing"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 80, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 234, "chroma:document": "one of the safest methods to record the temperature. on mother\u2019s/care takers\u2019 own cheek and if found\ntolerable, then applied on baby\u2019s body to rewarm the\nThe procedure of recording the axillary\nbaby. This may have to be repeated several times to\ntemperature.\nrewarm the baby adequately. Care must be taken to\nact quickly and safely so as not to cause burns on the\nPrecautions to be taken:\nbaby's delicate chest and abdomen and also to\nThe worker should wash hands before recording\nl rewarm the baby\u2019s body.\na baby\u2019s temperature.\n(Recommended only in desperate cases where no\nKeep the baby warm throughout the procedure.\nl other alternatives are possible.)\n|73|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 81, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 235, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (7.2 CLASSIFICATION OF THE NEWBORNS IN VIEW OF FURTHER MANAGEMENT)\nANNEXURE 7: ADDITIONAL RESOURCES\n(7.2 CLASSIFICATION OF THE NEWBORNS IN VIEW OF FURTHER MANAGEMENT)\nFig. 25: Different groups of neonates\nSr. No. Signs Full term (LBW) baby Pre-term baby\n1 Creases on the Deep and covering the whole sole. Lighter and often only in the\nsoles of feet anterior portions of the foot.\n2 Ears Fully developed. Normal shape & \u0000rm. Flattened, folded, shapeless,\nsoft and easy to bend.\n3 Breasts Well developed. Black, well pigmented Not so well developed. Small\nareola around the nipple. nipple and less pigmented,\nlight coloured areola.\n4 Genitalia Well-developed Creases on the Less developed Less creases.\noverlying skin. Dark colored skin. Light colored skin.\n5 Hair on scalp Dense / Thick Sparse.\n6 Lanugo hair on Usually only on the shoulders and All over the shoulder and\nthe body very less. soft hair.\n7 Nails on \u0000ngers Well developed Less developed."}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 81, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 236, "chroma:document": "the body very less. soft hair.\n7 Nails on \u0000ngers Well developed Less developed.\n8 Mode of Breast Can suck and swallow well. Dif\u0000culty in continuous sucking\nand not so well co-ordinated\nsucking, swallowing.\n9 Crying Vigorous Weak.\n10 General appearance Well \u0000exed joints of hands and feet Hands & feet (bending) \u0000exion\n(at elbow, wrist, hip, knee). Vigorous may not be complete.\nmovements when awake, Less activities and movements\nGood tone of muscles. Muscles tone much less.\n|74|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 82, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 237, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (7.2 CLASSIFICATION OF THE NEWBORNS IN VIEW OF FURTHER MANAGEMENT)\nFull term (LBW) baby Pre-term baby\nDeep and more sole creases Lighter and less sole creases\nWell developed ears Folded, soft ears\nWell developed breast nodule Less developed breast nodule\nWell developed genital organs Less developed genital organs\nFig. 26: Differences of Full term and preterm newborn babies.\n|75|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 83, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 238, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.3: MINOR PROBLEMS OF NEWBORNS)\nANNEXURE 7: ADDITIONAL RESOURCES\n(ANNEXURE 7.3: MINOR PROBLEMS OF NEWBORNS)\nFor the minor problems of the newborns, no special Stools:\ncare is required. But, we have to make sure that there\n\u2022 2 - 3 days after birth, the newborn passes 6 - 7\nare no signs of any serious illness. In case, some signs\nstools in 24 hours.\nof serious illness are observed, immediately the baby\nshould be taken to bigger hospitals. \u2022 To begin with it is dark green or brown in colour\nand then gradually turns yellow.\nVomiting: \u2022 Many healthy babies pass small quantities of\nstool frequently in a day.\n\u2022 At the time of birth, the baby can gulp down\nsome amount of amniotic \u0000uid and because of \u2022 Make sure about any other signs of serious\nthat gastric irritation can occur and the baby can illness, less quantity of urine, not taking feeds\nget vomiting in the \u0000rst 2 - 3 days after birth. properly, fever or very cold body, lethargic,"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 83, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 239, "chroma:document": "get vomiting in the \u0000rst 2 - 3 days after birth. properly, fever or very cold body, lethargic,\nabdominal distension etc.\n\u2022 This vomiting will stop spontaneously, No\nmedicines are needed. \u2022 If any of these serious signs are present, one oral\ndose of co-trimoxazole should be given before\n\u2022 Make sure whether there are any serious signs?\ntransporting the baby to a big hospital.\nfor e.g., not passing stool, abdominal distension,\ngreen bilious vomiting or blood in vomitus. \u2022 Are there any other signs of dehydration? In\ncase dehydration signs are observed, frequent\nbreastfeeding and oral rehydration solution\nRegurgitation of feeds:\nshould be given.\n\u2022 It is common for the newborn to throw out some\namount of milk soon after breastfeeding.\nConstipation:\n\u2022 If the baby is burped well by putting on the back\n\u2022 Many normal newborns pass stools only once in\nsoon after breastfeeding or the baby is made to\n5 - 6 days. The stool is normal in consistency and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 83, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 240, "chroma:document": "soon after breastfeeding or the baby is made to\n5 - 6 days. The stool is normal in consistency and\nlie down in a slightly head up position, a lot of\nthe child is otherwise normal. No treatment is\nrelief can be there for the baby.\nrequired.\n\u2022 Watch for any other signs of serious illness e.g.,\n\u2022 Verify whether any other serious problems co-\ncontinuous regurgitation of feeds, abdominal\nexist. e.g., vomiting, distension of abdomen,\ncolic, excessive crying and irritability, no proper\nexcessive crying, lethargy, refusal to take feeds\nweight gain or even actual weight loss.\netc.\nStool / Urine:\nFact to remember:\n\u2022 Generally, a baby passes stool within the \u0000rst 24\nDo not give any laxatives to newborn babies.\nhours after birth and urine within the \u0000rst 48\nhours after birth.\nFever:\n\u2022 If passing urine/stool are very much delayed\nthan the accepted time interval, the baby should \u2022 On the second and third day after birth, the"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 83, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 241, "chroma:document": "than the accepted time interval, the baby should \u2022 On the second and third day after birth, the\nbe taken to a bigger hospital for further newborn loses some amount of body \u0000uids and\nexamination. develops fever, known as dehydration fever.\n|76|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 84, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 242, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.3: MINOR PROBLEMS OF NEWBORNS)\nFrequent breastfeeding is the main treatment at Skin problems:\nthat stage.\n\u2022 Mild rashes (not pustules) on the head / neck /\n\u2022 In hot weather or in a very warm area, the body / axilla may be seen. No treatment is\nnewborn's body temperature increases. For the required.\ntreatment, the room temperature should be\n\u2022 If pus containing rashes are present less than 10\nbrought down (with the help of measures like\nin number, only antibiotic topical cream or\nhanging wet towels on the windows / use of\ngentian violet may be applied.\ncurtains). If too much clothing is put on the baby,\na few can be removed. (fan can be switched on But, if pus containing rashes (pustules) more than 10\nif available). are seen simultaneously or there is a big abscess,\noral antibiotics will be required.\n\u2022 Watch out for any other concurrent serious"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 84, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 243, "chroma:document": "oral antibiotics will be required.\n\u2022 Watch out for any other concurrent serious\nproblems like loose motions, vomiting, fast \u2022 Many times, skin over the scalp (head) peels off\nbreathing or any other dif\u0000culty in breathing, and face is congested and reddish, soon after\nnot breastfeeding well, lethargy, fullness of birth. If the baby is feeding well and no other\nanterior fontanelle etc. problem, no treatment is required. But, fever,\nweakness or refusal to feed are present, the\nbaby may be taken to a skin specialist or bigger\nExcessive Crying:\nhospital for further con\u0000rmation.\n\u2022 Newborns can cry if hungry, thirsty or wetting\n\u2022 Many times, bluish spots are seen on baby\u2019s\nthe diaper. This is a normal cry for the baby\nbuttocks soon after birth (Mongolian spots)\n(Sometimes, a baby can cry if very tight clothing\nwhich gradually fade away and no treatment is\nor tight elastic of socks or belt are used. Only\nrequired.\nloose comfortable clothing should be used for"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 84, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 244, "chroma:document": "required.\nloose comfortable clothing should be used for\nthe baby and a clean place for sleeping). There\nshould be no hooks or buttons in baby\u2019s clothes. Engorgement of baby\u2019s breast/s:\nOccasionally insect bites or antbites also can the\n\u2022 In the newly born boys, occasionally engorged\nreason for crying\nbreasts are seen. They subside within a few days\n\u2022 An experienced mother can identify from the and no treatment is required. The breast nodule\nnature of excessive crying of the baby, whether should not be squeezed, nor removal of milk\nthe baby is crying because of some discomfort attempted.\nor some illness.\n\u2022 Watch out for any concomitant signs of serious Common eye problems in newborn:\nillness: e.g., fever, hypothermia (cool hands, feet\n\u2022 Soon after birth, occasionally, a bloody spot\nand body of the baby) not taking breastfeeding,\nmay be seen in the baby's eye. No treatment is\nlethargy, fullness of anterior fontanelle, swelling\nrequired.\nover any part of the baby\u2019s body etc."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 84, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 245, "chroma:document": "lethargy, fullness of anterior fontanelle, swelling\nrequired.\nover any part of the baby\u2019s body etc.\n\u2022 At times, soon after birth, the baby's eyes stick\ntogether. Soon after delivery, eyes should be\nBleeding from vagina:\nproperly cleaned with boiled and clean water\nMany girls have bleeding or discharge from vagina and drops of breast milk can be put in baby\u2019s\n(Lower parts) in the \u0000rst week of birth. It is normal and eyes 2 -3 times in a day. If necessary, as per\ndoes not require any speci\u0000c treatment. doctor\u2019s advice, antibiotic eye drops or ointment\nmay be put.\n|77|"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 85, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 246, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.3: MINOR PROBLEMS OF NEWBORNS)\nHiccups: Watch out for serious signs like:\n\u2022 Hiccups are very common in the newborn \u2022 Jaundice noticed within the \u0000rst and second day\nperiod. No treatment is required. If necessary, after life.\nthe baby may be burped properly by holding it\n\u2022 Deep jaundice extending over palms and soles\nvertically and putting on his/her back.\nalso.\n\u2022 Either high or low body temperature.\nSwelling on the head:\n\u2022 Lethargic or lax baby.\n\u2022 During dif\u0000cult labour, some bleeding occurs on\nthe head and swelling is seen. This swollen part \u2022 Not breastfeeding properly.\nof the head will subside on its own gradually\n\u2022 Low birth weight, weak baby. (Referral required)\nand no special treatment is required.\n\u2022 Watch out for any concurrent serious signs eg.\nCord infection:\ndelayed crying soon after birth, the baby\nremains lethargic or unconscious, has \u0000ts, not \u2022 If there is pus discharge from the cord stump and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 85, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 247, "chroma:document": "remains lethargic or unconscious, has \u0000ts, not \u2022 If there is pus discharge from the cord stump and\nbreastfeeding, dif\u0000culty in breathing etc. Urgent redness and swelling around the skin of the cord\nreferral to hospital required. stump, it is necessary to apply antibiotic cream\nor ointment.\nTremors: \u2022 If the baby is very weak and low birth weight,\neven antibiotic injections may be required.\n\u2022 Tremors (shaking of hands and legs )are very\ncommon in newborns and not very serious. \u2022 At times, after the cord has dried and fallen, a\nsmall reddish swelling is noted (umbilical\n\u2022 Watch out for any concurrent serious signs, eg.\ngranuloma). It will shrink and subside if common\ncontinued tremors for a longer time, tremors\nedible salt is applied on it 2 or 3 times a day for\nwhile breastfeeding, fever or cold feel of the\nabout 5 to 7 days. All the hygienic precautions\nbaby\u2019s hands, feet, chest and abdomen, not\nshould be taken including proper hand wash\nbreastfeeding properly, laxity, swelling of"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4cfc562a-3edf-4f80-aa65-c512fe7bd617
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 85, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 248, "chroma:document": "should be taken including proper hand wash\nbreastfeeding properly, laxity, swelling of\nand use of clean salt.\nfontanelle (top of head) etc. (Referral required.)\nThrush in the mouth or on the tongue:\nJaundice (yellow discoloration of skin):\n\u2022 Whenever, baby is breastfeeding and if the\n\u2022 Jaundice means yellowish color of eyes and\nmaternal personal hygiene is not good, the baby\nskin.\nmay get a whitish patch on the tongue or mouth\n\u2022 In many newborns, yellowish discoloration of (called thrush)and breastfeeding becomes\nface, eyes and chest is seen after about 3rd day dif\u0000cult. Such patches also occur in the mouth of\nafter birth and gradually fades by about 6th or very sick and premature babies. This will\n7th day after birth. This is very common. If the subside after applying gentian violet lotion 2 - 3\nbaby continues to feed well, special treatment is times a day for about 3 to 5 days. Many times,\nnot required. whitish curd is seen soon after breastfeeding if"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 93f5dff3-d5a6-4dab-a3bd-1ec24a4d3c39
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 85, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 249, "chroma:document": "not required. whitish curd is seen soon after breastfeeding if\nsome milk remains in the mouth. This can be\neasily wiped clean with a cloth piece and the\nbaby does not have any problem in feeding.\n|78|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 815551b1-02b6-4960-9afb-477ab655ccd4
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 86, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 250, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.4: THE COMMON TRADITIONAL PRACTICES AFFECTING NEWBORN CARE)\nANNEXURE 7: ADDITIONAL RESOURCES\n(ANNEXURE 7.4: THE COMMON TRADITIONAL PRACTICES AFFECTING NEWBORN CARE)\nIn our community, several practices related to Harmful Practices:\npregnancy and newborn care are widely prevalent.\n\u2022 Not to take any care during pregnancy\nThese practices have originated from age-old\nconsidering it to be a normal and natural event.\ntraditions. Many times, these traditions appear to\nhave started with some good objective, but its effects \u2022 To ignore girls and not give enough nutrition.\nare not very bene\u0000cial today or could be even\n\u2022 Selective female feticide / termination of\nharmful. In newborn care, the elderly women\npregnancy.\nmembers of the family particularly, the mother-in-\n\u2022 Feeding the pregnant woman less,(especially in\nlaw or grandmother play an important role and often\nthe last trimester) thinking that it helps in keeping"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 5b687716-c592-4668-a370-fdb1081c88aa
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 86, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 251, "chroma:document": "the last trimester) thinking that it helps in keeping\nsupport by traditional birth attendants is very\nthe baby small and facilitates easy, normal\ndecisive. Many traditions have roots in old traditional\ndelivery.\nmedicine systems like Ayurveda. In our vast country,\nin different states, a wide variety of traditions are \u2022 Because of wrong beliefs not to give nutritious\nseen, which have been in\u0000uenced by the local foods like milk, banana, potato etc. to pregnant\ncommunity factors. Status of education, economy women.\nand community factors play an important part in\n\u2022 In the case of non-vegetarians, not to give eggs\nthese traditional practices.\nand meat to pregnant women.\nNot that, all our traditional practices are bad. But\n\u2022 Excessive physical strain during pregnancy.\nvery few systematic studies have been carried out.\nBecause of the general mentality that all that is old is \u2022 Not take iron / folic tablets, thinking it will give"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 50a18833-46f9-4212-b73b-d5744bed71b9
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 86, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 252, "chroma:document": "bad and all that is new is good, many of our good black complexion to the baby.\ntraditions have not been brought to attention. Hence,\nhere a list has been given which distinguishes good\nTraditional practices related to delivery of the baby:\nand harmful practices separately. We cannot claim\nthat this list is complete. But you can evaluate the local \u00fc Useful, good / bene\u0000cial practices:\ntraditional practices of your area by this approach.\n\u2022 To prepare a separate clean area in the house\nWe should preserve our good traditional practices. for delivery.\nWe should immediately stop all the harmful practices.\n\u2022 To warm up the delivery room with the help of a\nIf some practices are found to be not very harmful,\ntraditional oven.\nthen there is no objection in continuing the same.\n\u2022 To give warm fomentation to the mother after\nNow, many harmful modern practices have also\ndelivery.\nbeen started in our community and it is important to"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8c213930-a166-432e-9e07-9969c177665f
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 86, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 253, "chroma:document": "delivery.\nbeen started in our community and it is important to\nstop them also. By constant community contact and \u2022 Soon after delivery, if the newly born appears\nexperience, we can learn our local traditional, pale or bluish, then start the respirations by\ncultural practices and decide whether they are good blowing through the air passages.\nand bad and then attempt to create public awareness\n\u2022 Clean the baby\u2019s mouth by wiping with a cloth\nthrough community education.\npiece.\nFollowing details will be of help.\n|79|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f7f70c81-a965-4593-9e16-6b06433740e5
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 87, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 254, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.4: THE COMMON TRADITIONAL PRACTICES AFFECTING NEWBORN CARE)\nHarmful Traditional Practices: \u2022 To keep the room warm with a traditional oven,\nwhere mother and baby are kept.\n\u2022 To conduct delivery in a dark, ill ventilated area\nor even in a cattle shed. \u2022 To body massage the baby by applying oil or\nghee.\n\u2022 To conduct delivery by an untrained birth\nattendant and old lady. \u2022 To wrap the baby in 2 to 4 layers of cloth and put\na cap on the baby's head.\n\u2022 Not to wash hands before conducting delivery\nor even if the hands are washed, wipe them with \u2022 To massage the baby and keep in the morning\ndirty clothes. sunlight.\n\u2022 After delivery, use of dirty pads for the mother. \u2022 To prevent eye infection, put a few drops of\nbreast milk in the baby's eyes.\n\u2022 Adopt a traditional pushing method (Kalla) for\nspeeding up the delivery. \u2022 If the baby is not able to breastfeed directly,\nexpress the milk from the mother's breasts and"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 563aa003-a1ae-4349-aac7-90acf71e6d4d
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 87, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 255, "chroma:document": "express the milk from the mother's breasts and\n\u2022 Frequent intravaginal exams, with dirty hands\ngive it to the baby with a spoon or paladai from\nand applying \u201cGhee\u201d on the external surface of\na cup.\nvagina before delivery.\n\u2022 Use of a traditional cradle for laying the baby.\n\u2022 In order to expel the placenta, induce vomiting\nof the mother by putting her hair in the mouth. \u2022 Singing traditional lullabies and other songs to\nbabies at the time of sleeping.\n\u2022 To hold the baby upside down and hit the baby\nhard soon after birth, to make the baby cry.\nHarmful Practices:\n\u2022 In order to make the baby cry immediately after\nbirth, to blow hard in the baby's ears or make \u2022 Not giving nutritious foods to mothers like\nloud noises with vessels. banana, papaya, curds, cold milk (and in case\nof non- vegetarian families, \u0000sh) etc. considering\n\u2022 To use unclean items like old scissors, used\nthem \u201ccold\u201d foods, not to give legumes, potato\nblades, knife, sickle etc. to cut the baby\u2019s cord"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c638723c-2d22-46e9-9d5d-cd854d8b2b7c
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 87, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 256, "chroma:document": "them \u201ccold\u201d foods, not to give legumes, potato\nblades, knife, sickle etc. to cut the baby\u2019s cord\netc. as \u201cgas producing\u201d and such wrong beliefs.\nafter birth.\n\u2022 Soon after the delivery, within a short time, the\n\u2022 To apply unclean substances like Ghee, Cow\nmother is made to do heavy physical work at\ndung, ash etc. on the cut cord stump.\nhome, farm etc.\n\u2022 To use a dirty cloth piece to clean the baby's\n\u2022 Putting the mother and baby in a dark, ill\nmouth.\nventilated, not so clean area and not allowing\neven light exercises to the mother.\nTraditional Practices of newborn care after birth:\n\u2022 To ignore girl children.\n\u00fc Good and bene\u0000cial practices:\n\u2022 To hurry up for a baby bath, soon after birth.\n\u2022 After delivery, give traditional homemade\n\u2022 To throw away the early breast milk - colostrum.\ncalorie rich food to mother like groundnut laddu,\nmethi pak and such sweets.(Rich in Iron and \u2022 To give prelacteal foods such as honey, ghee,\ncalorie). jiggery etc."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 39944949-b020-4a01-b040-1a6e55bec169
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 87, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 257, "chroma:document": "calorie). jiggery etc.\n\u2022 To keep the mother and baby dyad isolated in a \u2022 Delaying the starting of breastfeeding under\nseparate room for about 40 days after birth. wrong notions and ideas e.g., bad omen, bad\ntime etc. Waiting for some rituals before starting\n\u2022 Breastfeeding the baby as a natural rule.\nthe \u0000rst feed.\n|80|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 48ed6746-3735-4272-b1db-811e18d0208d
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 88, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 258, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.4: THE COMMON TRADITIONAL PRACTICES AFFECTING NEWBORN CARE)\n\u2022 To give gripe water, water, tea, honey and other \u2022 Not allow pregnant women to go out during\ntraditional herbal preparations to baby along eclipse time.\nwith breastfeeding.\n\u2022 To feed the mother with certain special, calorie\n\u2022 To put oil drops in the ear and nose of the baby, rich food with an idea to increase the quantity of\nwith the wrong idea of cleaning the ear and breast milk (Halwa, coconut, ginger, garlic etc.)\neyes.\n\u2022 To believe in superstitions when the newborn is Facts to remember:\nsick such as \u201ccasting the evil eye\u201d (nazar utarna)\nTo begin with, encourage useful traditional practices.\n, tying threads on wrist etc.\nOnly after that explain about the harmful practices\n\u2022 To apply kajal, surma (dry soot powder) etc., in and motivate them to stop these practices. Do not\nbaby\u2019s eyes. worry about the harmless practices which are neither"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 88, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 259, "chroma:document": "baby\u2019s eyes. worry about the harmless practices which are neither\nuseful nor harmful for the time being, you can ignore\n\u2022 In cases of acute diarrheas or for putting the\nthem.\nbaby to sleep, use of opium products through\ntraditional preparations.\nModern newborn practices which are being blindly\n\u2022 To keep a knife under a baby's pillow for\nimitated and harmful to our newborns:\nprotection.\n\u2022 Use of feeding bottles for giving milk to babies.\n\u2022 To allow the use of paci\u0000ers and rubber nipples\nin the baby's mouth to stop crying. \u2022 Use of powdered milks/formula instead of\nbreastfeeding.\nSome traditional practices which are neither very \u2022 Use of commercially prepared cereal foods\nharmful nor much useful: rather than using home made fresh, clean,\nnutritious, cheap cereals included in the\n\u2022 Piercing nose and ears for girls and sometimes\ntraditional family food.\nfor boys also. In some communities, circumcision"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: c4de0f34-62d0-43fd-b32c-a686e509f0e5
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 88, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 260, "chroma:document": "traditional family food.\nfor boys also. In some communities, circumcision\nis a must for the boys. (If these procedures are \u2022 Use of expensive baby soaps, baby powder,\ndone with aseptic instruments, they can be baby shampoos etc.\nperformed about one month after the 3rd dose\n\u2022 Use of paci\u0000ers and nipples.\nof DPT vaccination).\n\u2022 Excessive, unnecessary use of drugs and tonics.\n\u2022 To massage the scalp on fontanelle, to straighten\nthe baby\u2019s neck etc. \u2022 Prenatal examination of sex of the foetus and\nselective female feticide.\n\u2022 To rear the baby with clothes borrowed from\nothers (or collected by \u201cbegging\u201d) (in cases of\nfrequent infant deaths).\n\u2022 To put a black dot on forehead or behind the ear\netc., to put a waistband or bangles, amulets etc\nto avoid the effect of \u201cevil eyes\u201d (nazar utarna)\n|81|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4007cb94-7a52-4d2e-bc22-01af5f8d483d
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 89, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 261, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.5: A FEW COMMON DIFFICULTIES OF BREASTFEEDING)\nANNEXURE 7: ADDITIONAL RESOURCES\n(ANNEXURE 7.5: A FEW COMMON DIFFICULTIES OF BREASTFEEDING)\nFlat / Small nipple:\n\u2022 Length of the nipple is not very important.\n\u2022 It is important that during breastfeeding, both the nipple as well as the surrounding dark area known as areola\nshould be pulled into the baby's mouth.\n\u2022 Console mother that \u0000at nipples will not be problematic for successful breastfeeding.\n\u2022 Explain to her the proper method of attachment / latching to the breast.\nSwelling or cracks on nipples:\nIf the baby is not properly latched to the mother's breast during feeding, nipple swelling or cracks occur.\nCauses of nipple swelling: Treatment of cracked nipples:\n\u2022 Improper latching \u2022 Continue breastfeeding.\n\u2022 Feeding only on nipples \u2022 Shift the baby a little from where\nit is sucking\n\u2022 Frequent use of soap and water \u2022 While feeding on breast ensure\nthat s urrounding dark areola is"}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 89, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 262, "chroma:document": "\u2022 Frequent use of soap and water \u2022 While feeding on breast ensure\nthat s urrounding dark areola is\nalso in baby\u2019s mouth along\nwith nipple.\n\u2022 Fungal infection on nipple \u2022 After completion of feeding, apply\na f ew drops of breast milk on the\nFlat nipple\naffected nipple and allow it to dry.\nFrequent washing is n ot required.\nEngorgement (or too much \u0000lling of milk) of breasts:\nAfter delivery more milk \u0000ows in the breast from 2nd, 3rd day onwards. At this stage, if the baby has either not\nstarted feeding or not properly latching on breast, the breasts are not emptied fully and milk \u0000lls in the breasts and\nengorgement occurs resulting in swelling and pain.\nMeasures for prevention: Treatment\n\u2022 Start breast feeding early. \u2022 Hot water fomentation.\n\u2022 Frequent breast feeding \u2022 Express breast milk very softly and once the\nbreast \u0000lling becomes less, start breast feeding\n\u2022 Proper method of latching attachment to\nby properly latching. (The expressed breast\nbreast."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 95fddbe9-4679-4882-91c6-464ba07fa324
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 89, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 263, "chroma:document": "\u2022 Proper method of latching attachment to\nby properly latching. (The expressed breast\nbreast.\nmilk can be fed to the baby with a spoon).\n\u2022 If there is too much pain, one tablet of\nparacetamol can be given to the mother.\n|82|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: a3b0b3c4-9392-4a13-b6b0-000305873fd7
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 90, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 264, "chroma:document": "ANNEXURES\nANNEXURE 7: ADDITIONAL RESOURCES (ANNEXURE 7.5: A FEW COMMON DIFFICULTIES OF BREASTFEEDING)\nPus formation in breasts (Abscess):\n\u2022 If the breast engorgement / swelling or cracked nipples are not managed properly in time, pus can form\nleading to breast abscess. Mother gets a high fever and severe pain. There may be pain in the axilla because\nof the swollen local lymph glands.\nManagement:\nPain killer tablets (Paracetamol), antibiotics (eg. cotrimoxazole) Incision and drainage of the pus will be required.\nContinue breastfeeding from the unaffected side.\nNot enough milk:\n\u2022 First con\u0000rm that the mother's complaint is valid.\n\u2022 If the baby is passing adequate urine and has satisfactory weight gain, only reassurance for the mother is\nneeded with proper counselling and guidance for the correct technique of breastfeeding.\nCauses of not enough milk:\nDif\u0000culty in feeding on breast Mother\u2019s mental condition\n\u2022 Late starting \u2022 Lack of self con\u0000dence\n\u2022 Tension, worry"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 83bfd0ff-6d98-4be8-b577-e6336956ffa8
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 90, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 265, "chroma:document": "\u2022 Late starting \u2022 Lack of self con\u0000dence\n\u2022 Tension, worry\n\u2022 Not giving frequent feeding\n\u2022 Not willing for breastfeeding\n\u2022 Not feeding during night\n\u2022 Tired\n\u2022 Every time, feeding for less time.\n\u2022 Improper latching/attachment. Mother\u2019s physical condition\n\u2022 Illness\n\u2022 Use of paci\u0000ers/nipples\n\u2022 Pain\n\u2022 Offering other \u0000uids (eg. water) along with\n\u2022 Smoking\nbreastfeeding.\nBaby\u2019s condition:\nSick and extreme preterm or LBW baby; Local defects in mouth like cleft palate and others Management includes\nregular frequent counselling and guidance, if the baby is getting not enough breast milk and suitable management\nfor the sick baby or the mother.\n|83|"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 32c9b67d-079a-4d4b-971f-da2b1f60b55e
encoding: FLOAT32
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{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 91, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 266, "chroma:document": "Proper hand washing Preparing the baby for KP in a warm Removing upper garment to\nclean area Cap, diaper and socks for baby bare the chest of baby\nAdjusting the baby on mother\u2019s bare Covering the baby and mother Baby comfortably adjusted in\nchest for direct skin to skin contact. together from above Kangaroo Position\nA loving body hug!\nMother relaxing comfortably Happy mother with Simple chores holding the baby in\nwith baby in KP her baby on her chest KP with due support\nSimple activities holding Adjusting twins for Neighbour helping with Keeping baby safe and\nthe baby in KP KP on mother one of the triplets for KP comfortable when not in KP\nFig. 27: Steps for Kangaroo Position/KMC"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d7ea1e17-e96f-4a63-94b5-28f32989960b
encoding: FLOAT32
metadata:
{"source": "pdfs\\home_based_kmc_demo_file.pdf", "file_path": "pdfs\\home_based_kmc_demo_file.pdf", "page": 93, "total_pages": 94, "Author": "Administrator", "CreationDate": "D:20211120130806+05'30'", "Creator": "CorelDRAW X7", "ModDate": "D:20211120130929+05'30'", "Producer": "Corel PDF Engine Version 17.0.0.491", "Title": "HBKMC-Manual.cdr", "chunk_index": 267, "chroma:document": "Printed in 2021\nFor further information, please contact:\nProf. Shashi N Vani, M.D., D. Ped., FIAP, FNNF\nManaging Trustee KMC Foundation, India\nEmeritus Professor of Paediatrics including Neonatology,\nP S Medical College, Karamsad, Gujarat.\nEmail: shashinvani@googlemail.com\nDirector of Health Services,\nState Family Welfare Bureau, Department of Public Health\nRaj Bahadur Mill Road, Naidu Hospital Compound, Pune - 411 001.\nEmail: sfwbcell@gmail.com\nHealth Specialist,\nUnited Nations Children's Fund\n215 Atrium, Andheri - Kurla Road, Hanuman Nagar, Andheri (East), Mumbai - 400 059.\nEmail: kbhuyan@unicef.org"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 9b54873d-a552-455a-9ab6-7d3311cc3140
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 0, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 268, "chroma:document": "KANGAROO MOTHER CARE\nKangaroo is an animal\nfound in Australia. She\ninvariably delivers a\npremature baby. The\npremature, baby kangaroo\nstays in the pouch of her\nmother, where it gets\nwarmth and exclusive\nbreast feeding till it is\nmature enough to survive\noutside."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: e640455d-3b9b-4368-8580-1e9b53cfae10
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 1, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 269, "chroma:document": "Milestones in KMC History\n\u2022 Team of pediatricians started KMC in Instituto Materno Infantil\n(IMI) in Bogota, Colombia\n1978\n\u2022 KMC was introduced in India\n1994\n\u2022 WHO formally endorsed KMC and published KMC practice\nguidelines\n2003\n\u2022 Centres of excellence established at three centres AIIMS, PGI\nChandigarh & KEM, Mumbai\n2004\n\u2022 MOHFW, Government of India\u2019s Operational guidelines on KMC\n& optimal feeding of LBW\n2014"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 6cfa76a9-6b4c-4691-b7ec-06f41c30f834
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 2, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 270, "chroma:document": "What is KMC?\nKangaroo Mother Care (KMC) is a simple method\nof care for low birth weight infants that includes\nearly and prolonged skin-to-skin contact with the\nmother (or a substitute caregiver) and exclusive &\nfrequent breastfeeding.\nShort: 4 hours daily* extended: 5-8 hours daily* long: 9-12\nhours daily* Continuous: More than12 hours daily*\nBenefits to the newborn\n\uf0fc Stabilizes body temperature\n\uf0fc Decrease morbidities; better neurodevelopment\n\uf0fc Early discharge\n\uf0fc Promotes breastfeeding; prevents infection\n\uf0fc Encourages bonding in mother & Child"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: d5fddf13-0cba-4522-9b01-12c89cbc4a5e
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 3, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 271, "chroma:document": "Skin-to-Skin contact\nHowever, KMC should not be\nconfused with routine skin-to-skin\ncare at birth.\n\u201cWorld Health Organization (WHO)\nrecommends skin-to-skin care immediately\nafter delivery for every newborn, irrespective\nof the birth weight\u201d"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 8082fd5e-a1e4-443f-b4bd-75325bf03731
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 4, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 272, "chroma:document": "KMC can be provided by mother, father and other adult family\nmembers who is willing, healthy with basic standards of hygiene"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4ad735d4-431d-4542-8d63-ccdd6680d5af
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 5, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 273, "chroma:document": "How to provide KMC?\nCounseling; Effective counseling for the initiation of KMC is a\npre-requisite to overcome socio-cultural barriers and anxiety\ntowards handling a low birth weight infant by the mother and health\ncare providers\nClothing\n\uf076Mother: Any front-open, light dress as per the\nlocal culture, not mandatory to have any special\ndress\n\uf076Infant: should be dressed in cap, socks,\ndisposable diapers and front-open sleeveless\nshirt or \u2018Jhabala\u2019 made of a soft natural fabric\nlike cotton."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: feb496c2-a83c-4f9a-8606-6c6b68f9a8ab
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 6, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 274, "chroma:document": "KMC Position\n1. The infant should be placed between\nthe \u008dmother\u2019s breasts in an upright\nposition.\n2. The head should be turned to one side\nand (cid:141)in a slightly extended position.\n3. The hips should be flexed and\nabducted in a \u201cfrog\u201d position; the\narms should also be flexed.\n4. The infant\u2019s abdomen should be at\nthe \u008dlevel of the mother\u2019s epigastrium.\n5. Support the infant from the bottom\nwith a (cid:141)sling/binder."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 0a8fdadb-98f9-4e6c-a81c-d29dc879e61b
encoding: FLOAT32
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{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 7, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 275, "chroma:document": "\uf0d8Mother in the KMC position can walk, stand,\nsit, or engage in activities. If comfortable, mother\ncan sleep in KMC position with her infant\n\uf0d8Infants receiving KMC should be monitored (cid:141)carefully during\nKMC to ensure that the infant\u2019s airway is clear, breathing is\nregular, colour is pink and s/he is maintaining temperature."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: f836e822-c16b-440b-a8a7-e5f45553fc1a
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 8, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 276, "chroma:document": "Discharge & Follow-up\nFollow-up\nDischarge\n\u2022 Follow-up is a fundamental\nThe infant is\nprerequisite of KMC, to make a\n\u2022 Stable and not on parenteral\nregular assessment of growth,\nmedication\nsensory functions, behaviour and\n\u2022 Maintaining temperature in neurodevelopment.\nmother\u2019s bed for 3 \u2022 ASHA will continue to provide\nconsecutive days at room care to the infant under HBNC in\nthe community, following\ntemperature\ndischarge\n\u2022 Gaining 15-20 grams per day\n\u2022 First Follow-up should be at one\nfor at least 3 consecutive days\nweek, followed by fortnightly\n\u2022 Accepting feeds directly from\nfollow-ups till next two visits.\nbreast (preferable) by spoon, Additional follow-up visits may\npaladai or cup be done until s/he reaches 40\nPMA/2500 grams."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: af9b41ca-1efb-4ead-b91c-8ed9c235716a
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 9, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 277, "chroma:document": "OPTIMAL FEEDING OF LOW BIRTH\nWEIGHT INFANTS\nLow birth weight (LBW)\ninfants need optimal nutrition\nduring the neonatal period\nfor proper growth and\ndevelopment. Appropriate\nfeeding of low birth weight\nand very low birth weight\ninfants improves their\nchances of survival and is\nimportant for their optimum\ngrowth and development."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: ea16884f-42f1-4df8-beb2-6b4f0b9ff7d4
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 10, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 278, "chroma:document": "Breastfeeding\nThe best milk for LBW infants is mother\u2019s milk.\nAll else is inferior.\nIn case mother\u2019s milk is not available, then the\nchoices in the order of preference are:\n\u2022 Expressed donor milk from other lactating mothers.\n\u2022 Formula milk- When not enough breast milk is available to\nmeet the needs of a LBW infant, formula milk may be given\nwith proper preparation and hygiene.\n\u2022 Animal Milk- Cow or buffalo milk are the last choice Such\nmilks are unsuitable and may be given with great caution\nwithout dilution with alternate methods of feeding.\n\u201cBottle feeding is not appreciated\u201d"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 2107dd3f-f5bb-4a79-a042-16a8a697bead
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 11, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 279, "chroma:document": "Alternative feeding methods\nFeeding tube\nPaladai\nFeeding tube, spoon,\nCup\npaladai or cup are the\nalternative methods\nof feeding when\ndirect breastfeeding is\nSpoon\nnot possible."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 2713e1b0-c702-4529-92bd-2d32cfde9234
encoding: FLOAT32
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{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 12, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 280, "chroma:document": "Feeding progression: Infant should progress from the initial method through the\nintermediate steps to feeding exclusively from the breast directly."}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 4d150bc8-7649-4b88-95e9-c193a3b3a1af
encoding: FLOAT32
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{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 13, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 281, "chroma:document": "Principles of advancing feeding modes"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
id: 5b1b4d5e-2a4c-4dec-b9c2-abeab96f4f31
encoding: FLOAT32
metadata:
{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 14, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 282, "chroma:document": "Monitoring of infants for adequate feeding\nInfants lose weight in the first few days, loss would not exceed\n10-15% of the birth weight.\nThey regain their birth weight by about 2 weeks and then 15-20\ngrams per kilogram of their own body weight per day.\nFor infants below 1,500 grams (less than 32 weeks), use a\npostnatal growth chart to plot weight every day until they are of\n40 weeks PMA or 2500 grams.\nIf the infant has inadequate weight gain, the provider should\ncheck the amount of intake, and assess and spluttering/ spillage.\nNipple and breast problems in the mother should be looked for."}


created_at: 2025-05-02 10:00:24
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{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 15, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 283, "chroma:document": "KMC Roll out plan;\nThe aim is to advocate KMC to be\npracticed for all infants eligible for KMC at public health facilities.\nModel KMC services to\nbe established in 25\nRegional & State\nResource Centers by the\nend of 2017\nKMC services to be\nprovided in all SNCUs\nand well-functioning\nNBSUs (at CHCs and\nFRUs) across the country"}


created_at: 2025-05-02 10:00:24
topic: persistent://default/default/f26ae22c-10bf-47f3-97c5-33d18eae1e5e
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{"source": "pdfs\\KMC-PPT.pdf", "file_path": "pdfs\\KMC-PPT.pdf", "page": 16, "total_pages": 20, "Title": "KANGAROO MOTHER CARE (KMC)", "Author": "Intel", "CreationDate": "D:20230119170728+05'30'", "ModDate": "D:20230119170728+05'30'", "Producer": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "Creator": "Microsoft\u00ae Office PowerPoint\u00ae 2007", "chunk_index": 284, "chroma:document": "States level activities;\n\u2022 State level orientation cum planning workshops for KMC roll\nout.\n\u2022 Identification of medical colleges as state resource centers.\n\u2022 Initially, saturate the SNCUs with KMC services on priority..\n\u2022 Develop resource pool for training and ensure adequate and\ntrained human resource at SNCU.\n\u2022 Seek support from respective state lead development partners\nto ensure KMC implementation\n\u2022 Review progress of implementation every quarter.\n\u2022 Developing linkages with RBSK and community follow-up by\nASHA also integrate KMC into FBNC."}


