Kangaroo Care
Kangaroo Mother Care is defined as the practice in which a premature infant is placed in an upright position against the parents’ chest, such that there is skin-to-skin contact between the infant and the parent. The infant is naked except for a nappy, socks and a hat (WHO 2003).
This skin-to-skin contact resembles the manner in which a kangaroo carries her baby in her pouch where it is kept warm and feeds on mothers’ milk until it is strong enough to survive outside the pouch. The concept was originally developed by Dr. Edgar Ray in Bogota, Colombia in 1978 as an alternative to the traditional incubator care for low birth weight infants because of the overcrowding and scarcity of resources in his country’s hospitals (Doyle, LW. 1997). Over the next three decades the kangaroo method was adapted and developed for use in western countries to encourage the bond between parents and their premature infant.
After the emotional upheavel of a premature birth, holding their baby is one of the first things parents long to do and once the baby's condition has stabilised, holding him or her is one of the few care giving activities that parents can perform for their precious baby. Each neonatal unit will have their own policy for Kangaroo Mother Care but it is generally introduced once the infants condition has stabilised and is practiced for a minimum of one hour. The decision as to when Kangaroo Mother Care can be commenced will be made by the team caring for the baby. The neonatal nurse caring for your baby will explain how it is done and will be there to support you and your baby throughout the sessions.
There are many documented benefits of Kangaroo Mother Care for both the infant and parents. Holding the infant in this manner appears to alleviate stress, produce feelings of satisfaction and lessen some of the negative emotions such as guilt and helplessness experienced after a premature birth (Alfonso D et al 1992, Pederson et al 1987). Research has also shown that mothers who practiced Kangaroo Mother Care reported more positive feelings towards their premature infants and felt more confident and competent in meeting their babies needs.
The abundant benefits of breastfeeding for vulnerable premature infants have been widely publicised and range from infection protection to improved developmental outcomes. Kangaroo Care had a positive effect on breastfeeding in the majority of studies. Positive results included a longer duration of breastfeeding, higher volumes of milk expressed and a higher percentage of breastfeeding exclusively at discharge (Meir P.2001).
Infants who received Kangaroo Care have been found to spend more time in quiet sleep, have a lower and more stable heart rate, are better able to maintain body temperature and develop less episodes of bradycardia and apnoea and importantly may have faster growth rates and decreased length of hospital stay (Ludington-Hoe S.M, Smith J.Y 1996, Fisher et al 1998.). It is also felt that the impact of Kangaroo Mother Care is not limited to the hospitalisation period only. After discharge it is thought to have a positive impact on breastfeeding, crying episodes and the sleep wake cycle.
Kangaroo Mother Care provides a crucial bonding experience, allowing parents to provide comfort for their premature infant during this vital stage of their development. Most importantly it should be an enjoyable experience for all concerned.
References:
World Health Organisation. Kangaroo Mother Care: A Practical Guide.Geneva.WHO Publications 2003.
Doyle L.W. Kangaroo Mother Care, Lancet 1997;350;1721-22.
Alfonso D. et al.1992. Reconciliation and Healing for mothers through skin to skin contact provided in an American tertiary level intensive care nursery. Neonatal Network 12(3):25-32.
Pederson DR, et al.1987. Maternal emotional responses to preterm birth. American Journal of Orthopsychiatry 57(1):15-21
Ludington-Hoe S.M., SmithJ.Y. Developmental aspects of Kangaroo Care.JOGNN 1996.;25(8) 691-703.
Fischer CG., Sontheimer D.,Scheffer F., Bauer J.,Inderkamp O. Cardiorespiratory stability of premature boys and girls during kangaroo care. Early Hum Dev 1998;52 145-53