Skin-to-skin contact for preemie NICU infants is called Kangaroo Care for its similarity to a marsupial's pouch, and has greatly increased the survival and improved the development of NICU babies and preemies all over the world.
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Skin Contact and Preemies
A premature baby in the NICU faces an extremely stressful environment, where he is vulnerable to painful medical procedures, bright lights, separation from the mother, and noisy machines. This high level of stress has been correlated with inhibited gut function, digestion, and growth.
Preemies who are kept in the incubator and separated from their parents have problems with lowered heart rate, decreased temperature, longer incubator stays, reduced rates of breastfeeding, and increased stress hormone production.
History of Kangaroo Care
Nils Bergman, M.D. studied the care of newborn babies in the rainforests of South America in 1979, where incubators are unavailable, and where a high percentage of babies are born prematurely.
Immediately after birth, all these babies are placed upon their mothers' bare chests where they remain, 24 hours a day, skin-to-skin, wrapped in baby slings, for months. For the preemie kept in the natural habitat of their mother's body, the outlook for survival and normal development is greatly increased.
Bergman coined the phrase "Kangaroo Mother Care" to describe this behavior, and has introduced the method all around the world, regardless of whether or not the advanced technology of neonatal intervention is available.
Implementing Kangaroo Care in the NICU
Kangaroo care can begin for a premature baby in the NICU as soon as the baby's condition is stable, sometimes immediately after birth, or for others after a few days or even weeks, but the earlier the better.
Wearing just a diaper, the baby is held skin-to-skin upon his mother under a loose-fitting shirt or open blouse, against her breasts. The baby is able to look at his mother, is encouraged to suckle, can sleep peacefully, and can hear his mother's voice. This environment lessens the effects of overstimulation, which is unfortunately considered a normal condition for babies in the bustling NICU.
Even a baby who is intubated can benefit greatly from kangaroo care. Fathers can also participate in kangaroo care with their preemies in the NICU, and fathers should be encouraged to provide skin-to-skin contact while the mothers are resting or pumping.
Kangaroo Care Benefits for Baby
Babies who receive kangaroo care generally suffer from fewer illnesses, and are moved out of incubators and into open cribs sooner, are released from the hospital sooner. Parents who provide kangaroo care for their preemies also feel more confident about handling and caring for their babies in the hospital and also confident to bring their babies home, more so than parents of babies who receive conventional medical care.
The preemie can benefit from kangaroo care right beside the incubator or crib, as the parents use a recliner chair on wheels, and possibly a screen for privacy. Kangaroo care takes some getting used to with babies who have several IV or PICC lines, tubes, and wires, which need to remain attached to the support machines.
The NICU nurses, neonatologists, La Leche League leader, and lactation consultants can be of great assistance to place your baby upon your chest and to position him or her comfortably and safely.
You may remain in kangaroo care for several hours at a time, and will notice a remarkable improvement in your baby's condition as a result. Preemies under kangaroo care breastfeed sooner, more frequently, and for a longer duration of time.
Kangaroo Care Breastmilk Benefits for Moms
NICU mothers who regularly practice kangaroo care have reported an increase in their milk supply, as they are able to measure each time they use the breast pump.
A mother holding her baby close in this way may experience an enhanced let-down response, due to an increase in prolactin and calmness; therefore, she should schedule her pumping sessions for immediately after kangaroo care. The baby can be fed his mother's milk via nasogastric tube while upon his mothers chest, then eventually fed by dropper or cup while learning to breastfeed.
It should be noted for all parents and caregivers that kangaroo care should be considered an essential part of baby care, for all babies. Dr. Bergman estimated that kangaroo care could save a million lives every year worldwide, and stated, "Though Kangaroo Mother Care started for prematures, it is how all newborns should be treated."
Bergman, N. Personal communication, April 2002.
Bergman, N. and Jurisoo, L. The "Kangaroo-method" for treating low birth weight babies in a developing country. Trop Doctor 1994; 24:57-60.
Mohrbacher, N. and Stock, J. La Leche League International The Breastfeeding Answer Book 2003 Third revised edition 284-287.