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Kangaroo
Care:
The Human Incubator For The Premature Infant
ABSTRACT:
The birth of a premature infant is documented to be a time of stress
and crisis for parents. Among these stressors are perceived losses and
grief from the early and abrupt termination of pregnancy, feelings of
guilt and failure from inability to carry the infant to term, uncertainty
regarding the infant's future health and developmental potential, and
immediate and long-term separation of the infant and family.
Nursing staff at the Health Sciences Centre, Winnipeg, Manitoba introduced
"Kangaroo Care" to their neonatal units in an attempt to diffuse some
of the stressors associated with premature birth. During "Kangaroo Care",
small stable premature infants, dressed only in a diaper and hat, are
placed in "skin-to-skin" contact with their parent's chest, for up to
2 to 3 hours per day. Cardiorespiratory monitoring and oximetry are
continued, if necessary, during "Kangaroo Care" while infants in the
"Kangaroo Care" position are kept warm through close contact with their
parent's skin.
This intimate handling encourages bonding, interaction and "cuddling"
between parents and small infants who would otherwise be confined to
incubator care. The emotional and psychological benefits of this practice
for both parents and infants have been immediately obvious. Reactions
from parents and infants support nursing perceptions that "Kangaroo
Care" is the best thing we've done for parents and premature infants
in a long time".
A POCKET GUIDE TO KANGAROO CARE - in the Neonatal Intensive
Care Unit and Intermediate Care Nursery. An information guide to the
practice of skin-to-skin contact to promote parent/infant bonding in
special care babies.
What Is Kangaroo Care?
It is a method of skin-to-skin contact to promote parent/infant bonding
especially for premature babies. KC was first initiated by two South
American neonatologists. It is the practice of holding a premature infant
dressed only in a diaper and a hat between a mother's bare breasts or
father's chest, similar to a kangaroo carrying their young. Through
contact with their parents' skin, the babies are kept warm and allow
a close interaction with their parents. KC has not been shown to have
any physical risks to the preterm babies.
Why Kangaroo Care?
The practice of KC was first introduced to neonatal units to involve
parents in the care of their preemies and to decrease some of the stress
associated with an infant needing neonatal intensive care. Parents who
have experienced KC have expressed excitement and joy with the practice
and many feel like parents for the first time since their infant's birth.
Infants have been observed in a restful sleep state while in the kangaroo
position. As well, KC has been found to promote parent/infant bonding,
breastfeeding and an early discharge for premature infants.
Where Is Kangaroo Care Practiced?
The neonatal intensive care unit (NICU) at Children's Hospital and the
Intermediate Care Nursery (IMCN) at Women's Hospital both promote and
encourage the practice of KC.
Who Can Practice Kangaroo Care?
Any mom, dad and babe who wishes to do so, of course.
When Can Kangaroo Care Be Initiated?
At Children's NICU and Women's IMCN, the policy includes stable babies
who are less than 1500 grams and are breathing on their own. Babies
needing oxygen or nasal continuous positive airway pressure (CPAP),
may also be eligible. Cardiopulmonary monitoring and oximetry may be
continued during KC. The bedside nurse will be nearby to monitor the
infant as necessary during this procedure.
How Do You Do Kangaroo Care?
With mom or dad sitting in a rocking chair, baby is placed in a head-up
position between mom's breasts or on father's chest. Babe is dressed
only in a diaper and a hat with a light blanket to cover baby after
he/she is in position. Screens are available for privacy. Initially
KC should be practiced for 30 minutes once a day and gradually increased
to 2-3 hours per day as tolerated.
About Kangaroo Care...
"I used to be worried of what I would see or hear in the nursery, but
as I learned to feel my baby get stronger in the K position, I started
to visit the baby more often because it was not a scary place anymore."
"I feel like I have moved into the nursery. I now can walk in and out
of any room in the nursery and be comfortable. Such a difference, and
it's because I'm not afraid for my baby anymore."
"I used to feel my baby had to be monitored by the machines or it might
die without it. But as I saw and felt my baby doing well on my breasts,
I now know the machines are there to help the nurses when I'm not here
to put the baby in this K position. So I'm not afraid of anything in
this place anymore."
Developed by Maria Robles, R.N., B.N.
Used with permission of Dr. John A. McCoshen; University
of Manitoba Department of Obstetrics, Gynecology and Reproductive Sciences
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