The kangaroo mother figured out the best way to feed, care, and bond with her joey long, long ago. But it took humans much longer to learn the benefits of what is now known in the world of neonatology as “kangaroo care” (KC).
The beginning of kangaroo care
Kangaroo care first came about as a response to the high death rate in preterm babies seen in Bogotá, Colombia, in the late 1970s. The death rate for premature infants was as high as 70 percent. These babies were dying from respiratory problems, infections, overcrowding, and insufficient resources in neonatal intensive care units.1
With little available resources and diminishing hope for these babies to survive, healthcare workers started placing the babies skin to skin with their mothers. Formal research studies were eventually done and confirmed what was evident in Bogotá, Colombia: babies who were held close to their mothers’ bodies for large portions of the day not only survived, but thrived.
Kangaroo care continues to be vital
Since we now have so many highly technologically advanced resources in the United States today, you may be asking, “why are we still imploring the practice of kangaroo care?”
The answer to this question is evident not only through research, but simple observation. Babies show decreased crying, improved ability to regulate and stabilize their body temperature, heart rate, respiratory pattern, and oxygenation, show increased weight gain, and greater breastfeeding success when their parents provide kangaroo care.2
We know human milk is the best medicine for any baby, especially a premature infant who has a high morbidity and mortality rate. Research showed that mothers of infants who did kangaroo care were more likely to be breastfeeding at discharge or at 40 to 41 weeks postmenstrual age and at one to three months’ follow-up.3
Kangaroo care for all NICU patients
You might be thinking, “I see the magnitude of benefits that KC provides, but this baby is too sick to do KC.” Don’t be so sure.
Depending on the baby’s condition, kangaroo care can begin immediately after delivery or may start after they are more stable. Even very small babies with major health issues who are mechanically ventilated can benefit from these sessions.
Once a baby is stabilized, KC is important for not only the baby, but the mother and/or father as well. It is the norm for hospitals to develop their own policies around when it is appropriate to KC. In some cases, a physician’s order may be required.
Helping parents to understand the benefits
Parents are a child’s biggest advocate. Studies have shown that the NICU poses a barrier to bonding simply because the mother feels there is nothing she can do to “help” her infant.
Empower the parent to help comfort their baby and give their baby some of the best medicine… their own touch. Just as these infants will benefit, the parents will benefit as well. They will have an increased sense of control and confidence in their ability to care for their baby, decreased stress, increased milk production, and improved bonding.2
It is very important to discuss the benefits of kangaroo care with both the mother and father. This will give them a sense of control in knowing that KC is something only they can provide to their infant.
In the United States, hospitals that encourage kangaroo care typically have their mothers or fathers provide skin-to-skin contact with their preterm babies on the parent’s chest for several hours each day. A good suggestion to parents is to KC their infant from one feeding to the next. Sessions should be at least one hour, as anything less can be too stressful for the baby.
A mother or father who is modest may hesitate to do kangaroo care. A good suggestion would be to have them wear a shirt that has a button-down front. Place the baby upright on the parent’s chest and wrap the clothing or a blanket around the back of the baby. Reassure the parent that you will be there to monitor the transition to kangaroo care. Parents will be especially fearful the first time they hold their very fragile miracle. Encourage them and help build their confidence.
Nurses make a difference
As nurses, we do everything possible to ensure babies “graduate” from the NICU. This is an incredible goal for the parents and the entire healthcare team, but it is so important to remember we are also laying the foundation for their future health and development.
All of the latest and greatest technologically advanced medicine and equipment is crucial to decreasing the morbidity and mortality of so many of these infants, but giving them the best start with simple interventions like a mother’s milk and a mother and father’s touch is some of the best medicine. Be the nurse that makes that difference for a parent and their baby.
3 Conde-Agudelo, A & Díaz-Rossello, JL. (2016). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews, 2016(8), 2. doi:10.1002/14651858.CD002771.pub4