Kangaroo care is a practice usually used with preterm, infants wherein the infant is held, skin-to-skin, with an adult. Kangaroo care for pre-term infants may be restricted to a few hours per day, but if they are medically stable that time may be extended. Some parents may keep their babies in-arms for many hours per day.
Kangaroo Care is a method of holding your baby in the NICU
that is beneficial for both you and your baby. Kangaroo Care gives you the opportunity to hold your baby close, with skin-to-skin contact. Your baby will lie on your bare chest dressed in a diaper and hat. Your body heat will transfer to your baby to keep him or her warm. Your baby will benefit from the warmth of your skin, the sound of your heart beat, and the gentle rhythm of your breathing.
You will sit in a reclining chair at your baby’s bedside. You can wear a loose fitting gown or a button down shirt. Your nurse will help you place your baby on your bare chest so that his or her skin will be in contact with your skin. Your nurse will then place a blanket over both of you. This enables you to embrace your baby in a special way that will provide warmth and nurturing as only parents can do.
Kangaroo care seeks to provide restored closeness of the newborn with mother or father by placing the infant in direct skin-to-skin contact with one of them. This ensures physiological and psychological warmth and bonding. The kangaroo position provides ready access to nourishment. The parent’s stable body temperature helps to regulate the neonate’s temperature more smoothly than an incubator, and allows for readily accessible breastfeeding.[1]
While this model of infant care is substantially different from the typical Western NICU procedures described here, the two are not mutually exclusive, and it is estimated that more than 200 neonatal intensive care units practice kangaroo care today. One recent survey found that 82 percent of neonatal intensive care units use kangaroo care in the United States today.
[edit]History
Not all areas in the world have resources to provide technical intervention and health care workers for premature and low weight babies. In 1978, due to increasing morbidity and mortality rates in the Instituto Materno Infantil NICU inBogotá, Colombia, Dr. Edgar Rey Sanabria, Professor of Neonatology at Department of Paediatry – Universidad Nacional de Colombia, introduced a method to alleviate the shortage of caregivers and lack of resources. He suggested that mothers have continuous skin-to-skin contact with their low birth weight babies to keep them warm and to give exclusive breastfeeding as they needed. This freed up overcrowded incubator space and care givers.
Another feature of kangaroo care was early discharge in the kangaroo position despite prematurity. It has proven successful in improving survival rates of premature and low birth weight newborns and in lowering the risks of nosocomial infection, severe illness, and lower respiratory tract disease (Conde-Agudelo, Diaz-Rossello, & Belizan, 2003). It also increased exclusive breast feeding and for a longer duration and improved maternal satisfaction and confidence.[2]
[edit]Eligibility Criteria
Originally babies who are eligible for kangaroo care include pre-term infants weighing less than 1500 grams, and breathing independently. Cardiopulmonary monitoring, oximetry, supplemental oxygen or nasal (continuous positive airway pressure) ventilation, intravenous infusions, and monitor leads do not prevent kangaroo care. In fact, babies who are in kangaroo care tend to be less prone to apnea and bradycardia and have stabilization of oxygen needs.[3][4]
During the early 1990s, the concept was advocated in North America for premature babies in NICU and later for full term babies. Research has been done in developed countries but there is a lag in implementation of kangaroo care due to ready access of incubators and technology.
[edit]Techniques
In kangaroo care, the baby wears only a diaper and a hat and is placed in a flexed (fetal position) with maximal skin-to-skin contact on parent’s chest. The baby is secured with a stretchy wrap that goes around the naked torso of the adult, providing the baby with proper support and positioning (maintain flexion), constant containment without pressure points or creases, and protecting from air drafts (thermoregulation). If it is cold, the parent may wear a shirt or hospital gown with an opening to the front and a blanket over the wrap for the baby. http://www.skintoskincontact.com/ssc-safe-technique.aspx
The tight bundling is enough to stimulate the baby: vestibular stimulation from the mother’s breathing and chest movement, auditory stimulation from the mother’s voice and natural sounds of breathing and the heartbeat, touch by the skin of the mother, the wrap, and her natural tendency to place the hands over the baby. All this stimulation is important for the baby’s development. Fathers can also use the skin-to-skin contact method.[citation needed]
“Birth Kangaroo Care” places the baby in kangaroo care with the mother within one minute after birth and up to the first feeding. The American Academy of Pediatrics recommends this practice, with minimal disruption for babies that don’t require life support. The baby’s head must be dried immediately after birth and then the baby is placed with a hat on the mother’s chest. Measurements, etc. are performed after the first feeding. According to the US Institute of Kangaroo Care, healthy babies should maintain skin-to-skin contact method for about 3 months so that both baby and mother are established in breastfeeding and have achieved physiological recovery from the birth process.
For premature babies, this method can be used continuously around the clock or for sessions of no less than one hour in duration (the length of one full sleep cycle.) It can be started as soon as the baby is stabilized, so it may be at birth or within hours, days, or weeks after birth.
Kangaroo care is different to the practice of babywearing. In Kangaroo care, the adult and the baby are skin-to-skin and chest-to-chest, securing the position of the baby with a stretchy wrap, and it is practiced to provide developmental care to premature babies for 6 months and full term newborns for 3 months. In Babywearing the adult and the child are fully clothed, the child may be in the front or back of the adult, can be done with many different types of carriers and slings, and is commonly practiced with infants and toddlers.
[edit]Benefits
[edit]For Parents
Kangaroo care is beneficial for parents because it promotes attachment and bonding, improves parental confidence, and helps to promote increased milk production and breastfeeding success [5][6][7][8][9]
[edit]For preterm and low birth weight infants
Kangaroo care arguably offers the most benefits for preterm and low birth weight infants, who experience more normalized temperature, heart rate, and respiratory rate,[10] increased weight gain,[2] fewer nosocomial infections and reduced incidence of respiratory tract disease. [8] Additionally, studies suggest that preterm infants who experience kangaroo care have improved cognitive development, decreased stress levels, reduced pain responses, normalized growth, and positive effects on motor development.[2][7][11][12][13][14] Kangaroo care also helps to improve sleep patterns of infants, and may be a good intervention for colic.[15] Earlier discharge from hospital is also a possible outcome [3]Finally, kangaroo care helps to promote frequent breastfeeding, and can enhance mother-infant bonding.[16]
[edit]For institutions
Kangaroo care often results in reduced hospital stays, reduced need for expensive healthcare technology, increased parental involvement and teaching opportunities, and better use of healthcare dollars.
[edit]For the community
Overall, kangaroo care helps to reduce morbidity and mortality, provides opportunities for teaching during postnatal follow-up visits, and decreases hospital-associated costs
What is Kangaroo Care?
Kangaroo Care is a method of holding your baby in the NICU that is beneficial for both you and your baby. Kangaroo Care gives you the opportunity to hold your baby close, with skin-to-skin contact. Your baby will lie on your bare chest dressed in a diaper and hat. Your body heat will transfer to your baby to keep him or her warm. Your baby will benefit from the warmth of your skin, the sound of your heart beat, and the gentle rhythm of your breathing.
You will sit in a reclining chair at your baby’s bedside. You can wear a loose fitting gown or a button down shirt. Your nurse will help you place your baby on your bare chest so that his or her skin will be in contact with your skin. Your nurse will then place a blanket over both of you. This enables you to embrace your baby in a special way that will provide warmth and nurturing as only parents can do. Curtains are available for privacy.
How Did Kangaroo Care Begin?
Kangaroo Care was first developed in Bogota, Colombia in 1979 by two neonatologists. There were not enough isolettes available to keep the premature infants warm. Therefore they had parents provide Kangaroo Care to give the warmth needed to maintain their temperatures. The results of this method of holding were so impressive that Kangaroo Care has been adopted in neonatal nurseries around the world. The name Kangaroo Care was chosen because of the similarity of care that kangaroos provide to their newborn young.
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