You should plan to spend at least 1 hour doing kangaroo care. Shower before coming to the hospital. Check your chest for rashes or open wounds. If you have these, do not do kangaroo care until your skin has healed.
Wear or bring a loose-fitting shirt or warm-up jacket that buttons or zips up the front. Do not smoke or use perfume or scented lotions before doing kangaroo care. Pump your breasts and use the toilet right before you start kangaroo care. You can also pump your breasts while doing kangaroo care if you are holding your baby for a long time, just ask your nurse for help.
Your baby should be dressed in only a diaper. Mothers should remove their bra and dads should be bare-chested. The nurse will help you position your baby on your chest. Once your infant is on your chest, cover him or her with a blanket, then button or zip your shirt or a special kangaroo care wrap. This will help keep baby warm and in place. Make yourself comfortable. Sit back and raise the footrest on your recliner or prop your feet up.
Enjoy this special time with your baby. It is safe for you to fall asleep while performing kangaroo care in the hospital when you are wearing the special wrap to keep your baby safe. Introduction Mothers hold babies to their chest instinctively. Benefits of KC Since the inception of KC as a low-cost alternative to incubator care in areas with limited resources, clinicians and researchers have, over time, documented both physiologic and behavioral benefits for infant and mother see Table 1.
Mean temperature first 5 minutes of life: Attention more likely to be required in SC group RR Open in a separate window. Composite tool that indicates physiologic stability;. Physiologic benefits Homeostasis temperature regulation, physiological stability, blood glucose When compared with standard care incubator, radiant warmer, or open crib , KC has shown benefits for homeostasis.
Implications for practice The evidence for the ability of KC to promote homeostasis is strong, especially in developing countries, where good evidence suggests that continuous KC can reduce mortality. Implications for research Benefits that were discovered through research in developing countries should not be extrapolated to better resourced countries.
Growth, neurodevelopment, and neurosensory impairment Perhaps one of the most interesting benefits of KC is the effect on sleep, neurodevelopment, and growth.
Clinical implications Current evidence suggests that KC improves sleep, neurodevelopment, and growth, and should therefore be encouraged in clinical practice. Research implications The potential for KC to impact neurodevelopment and growth in preterm infants is exciting, but there is still much left to be understood. Behavioral benefits Breastfeeding rates The BFHI, devised by the World Health Organization, is an international set of guidelines to promote, protect, and support breastfeeding.
Clinical implications Based on consistent evidence for KC in promoting breastfeeding, clinicians should encourage KC for preterm infants both in the neonatal intensive care unit and following hospital discharge. Limitations and implications for future research A limitation in the research examining KC and breastfeeding is the reliance on maternal self-report.
Parent—infant attachment Attachment is defined as the emotional connection that is formed between infants and caregivers, and it is relevant for clinicians to consider this in infants of all gestational ages, especially in those born preterm. Research implications A consistent approach to the measurement of parent—infant attachment would be of benefit because measures vary and make interpretation more difficult. KC in the context of pain Given the benefits of improved physiological stability, and enhanced sleep and regulation, investigation of KC to diminish newborn procedural pain has become a rapidly growing field of study see Table 2.
Kangaroo care compared with incubator control Physiological parameters Physiological indicators reported were heart rate response, heart rate recovery, heart rate variability, oxygen saturation during the painful procedure, oxygen saturation after the painful procedure, and change in oxygen saturation. Kangaroo care versus alternative treatments or alternative providers Comparisons have been made in four studies with sweet taste, 60 , 68 breastfeeding, 71 enhanced KC including the addition of rocking and singing with KC , 62 fathers, 62 and unrelated females.
Clinical implications KC is a simple, natural, and cost-effective intervention to effectively diminish behavioral pain response in preterm infants. Considerations for implementation In spite of the plethora of documented benefits of KC in preterm infants, KC is not consistently practiced in this population. Conclusion Kangaroo care is a natural, effective, and low-cost intervention that can be utilized in any setting.
Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Konner M, Worthman C. Nursing frequency, gonadal function, and birth spacing among! Kung hunter-gatherers. Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation.
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Babies cared for in this way appeared to have lower mortality rates and staff were also able to focus on the most critically ill infants. When the results were published in , they immediately attracted international attention and were widely promoted by the United Nations' Children Fund Unicef.
Initially there were concerns around the robustness of the trial due to the way mortality figures were recorded, but subsequent research around the world has supported those initial results.
As it has been adopted in different countries around the world, more has been learned about its potential benefits. Lawn points to a number of trials which have demonstrated significant improvements in not only mortality rates but also in the subsequent illness of preterm babies.
Across the globe, an estimated The rates of pre-term births vary greatly by where in the world you look. Despite the evidence supporting kangaroo care, and an endorsement by the World Health Organization, the technique still struggles to obtain mainstream status in some areas.
In Nigeria's north-western state of Kebbi, Unicef is working with midwives to help teach mothers and traditional birth attendants about kangaroo care. In many hard-to-reach communities, expectant mothers rely upon traditional birth attendants to help deliver and care for their babies during labour.
These attendants are usually older local women who rarely have medical training , but are often highly respected within their local communities. Although use of untrained birth attendants has been declining , they are often used due to a shortage of midwives.
In most cases they provide invaluable care, but can struggle if there are complications during a birth without the right tools, says Nyam Musa, a midwife with Unicef who leads a team helping to introduce kangaroo care to rural communities in Kebbi. Before the coronavirus disrupted their work, her unit often visited villages in the area to help mothers of underweight babies.
Her team offers lessons to the mothers on how to apply kangaroo care by themselves and with help from family members. They show them how to secure the baby safely with cloth pieces so the child sits against their mother's skin, and offer tips on how to keep them clean in the event of accidents. But convincing the traditional birth attendants to embrace kangaroo care has involved overcoming many long-held beliefs. Some believe that if a mother or child dies, "it is just God that made it happen that way", explains Musa.
There is also a mindset in many communities that women should avoid attending hospital as a symbol of their strength and prestige, she says. Despite these challenges, they have found that most are eager to use kangaroo care. The Unicef team use case studies — inspiring examples of past successes — to mentor the most sceptical attendants.
But even in areas where incubators are available and primary healthcare centres close by, intermittent electricity supplies can leave equipment effectively useless. This could prove essential for a country with the third-highest number of premature births in the world behind India and China.
An estimated , children are born prematurely in Nigeria each year, putting enormous pressure on its health care facilities.
Oyejoke Oyapero, head of paediatrics at the Amuwo Odofin Maternal and Child Centre in Lagos, says the technique has helped free up incubators, but she believes having the baby in such close proximity to its mother brings many advantages.
Some of the [incubators] come with apnea monitors to detect if the baby stops breathing. For kangaroo mother care, the mother is all the gadget you need. For the mother, it means only a few hours' break. Antin Ehi, a year-old mother from Lagos whose daughter was born prematurely in April, has cherished the opportunity to be so close to her little girl, who she has called Ehi.
With the help of staff at the Maternal and Child Care Centre in Lagos, Antin Ehi learned to wrap her newborn daughter against her chest with linen as her condition stabilised. We normally would put on a nightgown and put her inside, against my body to feel the warmness.
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